ABSTRACT: Chronic pain is a significant problem for many elderly patients. Unfortunately, it is often accepted as a normal part of aging, and these patients may be undertreated for it. There are many challenges that can make it difficult to treat pain in this age group, most notably the presence of other significant health problems and the difficulty of assessing pain in the cognitively impaired. Medication management remains a mainstay of the treatment of chronic pain. Recent literature has called into question the use of NSAIDs as one of the first-line drugs and indicates that it may be safer to try an opioid before an NSAID. The decision about which medication to use should be based on the type of pain, the side-effect profile of the drugs, and the overall health status of the individual patient.