Case Reports

Successful opioid tapering using a non-pharmacological approach in chronic pain: a case report

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Received: 9 April 2026
Published: 3 July 2026
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Chronic pain in older adults is a major clinical challenge due to its high prevalence, complex pathophysiology, and frequent impact on function and quality of life. Polypharmacy and prolonged analgesic use, particularly opioids, often complicate management, leading to dependence and adverse effects. We report the case of a 75-year-old woman with chronic low back pain associated with significant functional impairment and opioid dependence. A multimodal, patient-centered approach was implemented, including gradual morphine tapering, transcutaneous electrical nerve stimulation, functional rehabilitation, and structured psychological support. This integrated strategy aimed to control pain while improving mobility and autonomy and addressing psychological dimensions of chronic pain. The patient showed a favorable evolution, with reduced pain intensity, improved functional capacity, and decreased reliance on opioids. Functional autonomy improved the Instrumental Activities of Daily Living score from 4/8 to 6/8; transition from Groupes Iso-Ressources 2 to 4, along with social reintegration. She also reported a subjective improvement in quality of life and increased engagement in her care. This case emphasizes the value of multimodal, non-pharmacological strategies and individualized, function-oriented management in older adults with chronic pain.

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Lin HM, Hsieh PS, Chen NC, et al. Impact of cognitive behavior therapy on osteoarthritis-associated pain, insomnia, depression, fatigue, and physical function in patients with knee/hip osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Front Med 2023;9:1083095. DOI: https://doi.org/10.3389/fmed.2022.1083095

Lautenbacher S, Peters JH, Heesen M, et al. Age changes in pain perception: a systematic review and meta-analysis of age effects on pain and tolerance thresholds. Neurosci Biobehav Rev 2017;75:104-13. DOI: https://doi.org/10.1016/j.neubiorev.2017.01.039

Krein SL, Heisler M, Piette JD, et al. The effect of chronic pain on diabetes patients’ self-management. Diabetes Care 2005;28:65-70. DOI: https://doi.org/10.2337/diacare.28.1.65

Bazelmans E, Bleijenberg G, Voeten MJ, et al. Impact of a maximal exercise test on symptoms and activity in chronic fatigue syndrome. J Psychosom Res 2005;59:201-8. DOI: https://doi.org/10.1016/j.jpsychores.2005.04.003

Yang L, Wang P, McGill B. The relationship between experience of knee pain and physical activity participation: a scoping review of quantitative studies. Int J Nurs Sci 2023;10:258-67. DOI: https://doi.org/10.1016/j.ijnss.2023.03.010

Leung DKY, Fong APC, Wong FHC, et al. Nonpharmacological interventions for chronic pain in older adults: a systematic review and meta-analysis. Gerontologist 2024;64:gnae010. DOI: https://doi.org/10.1093/geront/gnae010

Rosemann T, Joos S, Laux G, et al. Case management of arthritis patients in primary care: a cluster-randomized controlled trial. Arthritis Rheum 2007;57:1390-7. DOI: https://doi.org/10.1002/art.23080

Bender T, Karagülle Z, Bálint GP, et al. Hydrotherapy, balneotherapy, and spa treatment in pain management. Rheumatol Int 2005;25:220-4. DOI: https://doi.org/10.1007/s00296-004-0487-4

Aguilova L, Sauzéon H, Balland É, et al. Grille AGGIR et aide à la spécification des besoins des personnes âgées en perte d’autonomie. Rev Neurol 2014;170:216-21. DOI: https://doi.org/10.1016/j.neurol.2014.01.039

Chiarotto A, Koes BW. Nonspecific low back pain. N Engl J Med 2022;386:1732-40. DOI: https://doi.org/10.1056/NEJMcp2032396

Chou R, Deyo R, Friedly J, et al. Systemic pharmacologic therapies for low back pain: a systematic review for an American College of Physicians clinical practice guideline. Ann Intern Med 2017;166:480-92. DOI: https://doi.org/10.7326/M16-2458

Foster NE, Anema JR, Cherkin D, et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet 2018;391:2368-83. DOI: https://doi.org/10.1016/S0140-6736(18)30489-6

Ho EKY, Chen L, Simic M, et al. Psychological interventions for chronic, non-specific low back pain: systematic review with network meta-analysis. BMJ 2022;376:e067718. DOI: https://doi.org/10.1136/bmj-2021-067718

Rizzo RR, Cashin AG, Wand BM, et al. Non-pharmacological and non-surgical treatments for low back pain in adults: an overview of Cochrane reviews. Cochrane Database Syst Rev 2025;3:CD015123. DOI: https://doi.org/10.1002/14651858.CD014691.pub2

Knotkova H, Hamani C, Sivanesan E, et al. Neuromodulation for chronic pain. Lancet 2021;397:2111-24. DOI: https://doi.org/10.1016/S0140-6736(21)00794-7

CRediT authorship contribution

Gloire Mazita Bovy-Lumingu, David Gondele: patient management and follow-up. Gloire Mazita Bovy-Lumingu: study concept and draft of the manuscript. Lionel Helmut Loic Mevo Sonagnon: data collection, follow-up, and revision. Arriel Makembi Bunkete, Francis Findula: rehabilitation planning and revision. Mamadou Mouctar Diallo: psychological support and revision. Kazi Anga Muamba: clinical assessment and interpretation. Lydie Nyunga: nursing coordination and data support. Dan Kankonde: supervision and critical revision. Arriel Makembi Bunkete: study design, supervision, final approval. All authors approved the final manuscript and are accountable for the work.

How to Cite



Successful opioid tapering using a non-pharmacological approach in chronic pain: a case report. (2026). Geriatric Care, 12(1). https://doi.org/10.4081/gc.2026.15524