Bring your pain diary when you follow up with your healthcare provider or pain specialist heat helps decrease pain and muscle spasms apply heat on the area for 20 to 30 minutes every 2 hours for as many days as directed ice helps decrease swelling and pain. Nonpharmacologic approaches to pain management are essential and include osteopathic manipulative treatment cognitive behavioral therapy exercise and spiritual interventions the holistic and interdisciplinary approach of osteopathic medicine offers an approach that can optimize effective pain management in older adults. Treating pain in older adults can be complex because of the age related physiologic changes comorbidities and polypharmacy thus an individualized multimodal treatment approach is recommended treatment plans should include pharmacologic and nonpharmacologic strategies several important clinical guidelines and expert panel statements are available to guide health care providers in the best practices for treating pain in older adults this article provides evidence based recommendations . Pain management is becoming more diverse as the clinical research validates and acknowledges that chronic pain is a multidimensional phenomenon involving biological psychological and sociological components 40 according to the national institute on aging 41 of older adults ages 60 to 69 are frequent users of complementary and alternative medicine cam including vitamins and herbal supplements chiropractic manipulation acupuncture meditation and massage 41