Modern pain management mandates that patients receive precise diagnoses of the etiology of their pain and then achieve the best possible pain relief using the most appropriate method of administration. Elderly patients are quite prone to the side effects of systemic medication used to treat pain, and it is fortunate that there exist today so many efficacious alternatives from which to choose. With more precise diagnosis and treatment of pain syndromes in the elderly, patients can achieve a higher level of function. It is therefore incumbent upon all physicians to ensure that their patients achieve adequate pain relief without untoward side effects by using the most appropriate amount of medication delivered by the most effective method.