How do you approach the management of chronic pain in older adults who are poor candidates for both opioids and NSAIDs?  

Usually, it helps to start with the diagnosis of the cause of the pain, since that can make a major difference in optimal pain-relieving treatment. For example, pain due to high VEGF levels, such as pulmonary hypertrophic periosititis, is best treated with anti-VEGF agents. Pain from spinal stenosis...