**1. Introduction**

The numbers of older persons are increasing worldwide; which means there will also be an increase in their health needs [1–13]. Sometimes health issues concerning older persons are neglected [14]. The aging process affected by several factors. Older persons may have more than one disease leading to comorbidities as well as chronic pain [14–18]. Generally pain is a common complaint in senior citizens but it is not part of the aging process as pain in the elderly is underreported and under treated [9, 13, 15, 17, 19]. Pain management in older persons is problematic due to the various changes associated with the aging process that occur in the different body organs and systems [10]. The perception of pain is beneficial for survival [15]. Pain management is an important aspect of healthcare [20]. The rudiments of effective pain management includes close monitoring for adverse effects, regular assessment of the pain using various validated pain assessment tools and adjustment of the dose of analgesics administered to the corresponding response. Any pain causing physical and psychosocial functionality problems should be regarded as a significant health problem [15]. Pain is the most common reason why an older person will consult a physician [21].

## **2. What is pain?**

Everyone feels pain though some researchers argue that neonates do not feel pain. The word pain is derived from the Greek word, which means penalty in Greek [20]. The taxonomy of the International Association for the Study of Pain (IASP) defines pain as 'an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage [20, 22–24]. Pain is a complex phenomenon characterized by a sensory and emotional experience that is unpleasant [25–27] and it is also distressing [28]. Pain is the most common symptom complained by the elderly [29]. Older people tend to underreport pain due to several barriers and challenges such as cultural beliefs and ageism [29]. Pain management is generally under diagnosed, overlooked and undertreated in older adults [15, 27, 30]. Pain is a subjective personal experience known only by the sufferer [30].
