Living with dementia: Non-drug options for pain management

The Bottom Line

  • Currently, 55 million people live with dementia worldwide, and around 50% experience pain as they go through their daily lives.
  • Non-drug strategies, such as massage, exercise, meditation, painting, and robot care, are generally the preferred initial treatment.
  • In people living with dementia, non-drug strategies may reduce pain in the short-term, but more research is needed.
  • People living with dementia and their caregivers should discuss pain management options with the patient’s healthcare team, and work towards the development of an individualized management plan.   

Pain. A small word with huge impacts.

From scraped knees in childhood to heartbreak in adolescence to illness in adulthood, we experience many different types of pain throughout our lives. Some pain is mild and fleeting, while other pain is long-lasting or severe enough to have us seek assistance from a healthcare professional.

In fact, when we look at what pushes people to seek medical care, pain comes out on top (1;2).

One group of people that is heavily impacted by pain is those living with dementia (1). Over the next 26 years, the number of people living with dementia is estimated to increase from 55 million to over 152 million (3;4). Around 50% of these folks will experience pain in their daily lives (1;5-8). As such, finding strategies to help manage pain is incredibly important for both patients and their caregivers.

So, what is the “go to” strategy for assisting with pain management in this population? Surprisingly, medication is not the preferred solution. Given that most living with dementia take multiple medications and are at risk for negative drug-related side effects when taking multiple medications, the preferred approach for pain management is non-drug strategies (1;5;9).

A more thorough look at the evidence for using non-drug options for decreasing pain in people living with dementia has been addressed in a recent systematic review (1).

What the research tells us

The review specifically looks at non-drug options like massage, exercise, meditation, painting, and robot care. These strategies are compared to receiving nothing at all or being on a waitlist to receive something, palliative care, a friendly visit, standard pain medication or treatment, reading books or magazines, or engaging in health education. Ultimately, the results reveal that non-drug strategies may help to reduce pain in people living with dementia, but the effect appears to be short lived; specifically, 4-8 weeks after engaging in the strategy.

Additional research is needed to further support these findings and help us better understand what age groups of older adults these strategies work for, how best to deliver them, and how individual strategies perform (1).

In the immediate term, if a person living with dementia is experiencing pain, either the patient and/or their caregiver should discuss this with the patient’s healthcare team. Through collaboration, a tailored pain management plan that considers the needs, preferences, and abilities of the patient can be developed.

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Author Details


  1. Saragih ID, Suarilah I, Son NT, et al. Efficacy of non-pharmacological interventions to reduce pain in people with dementia: A systematic review and meta-analysis. J Clin Nurs. 2023; 32(15-16):5286-5299. doi: 10.1111/jocn.16444.
  2. Raja SN, Carr DB, Cohen M, et al. The revised International Association for the Study of Pain definition of pain: Concepts, challenges, and compromises. Pain. 2020; 161(9):1976-1982. doi: 10.1097/j.pain.0000000000001939.
  3. World Health Organization. Dementia. [Internet] 2023. [cited December 2023]. Available from   
  4. World Health Organization. Dementia: Number of people affected to triple in next 30 years. [Internet] 2017. [cited December 2023]. Available from,to%20152%20million%20by%202050.
  5. Achterberg W, Lautenbacher S, Husebo B, et al. Pain in dementia. Pain Rep. 2020; 5(1):e803. doi: 10.1097/PR9.0000000000000803. 
  6. van Dalen-Kok AH, Pieper MJ, de Waal MW, et al. Association between pain, neuropsychiatric symptoms, and physical function in dementia: A systematic review and meta-analysis. BMC Geriatr. 2015; 15(1):1-18. doi: 10.1186/s12877-015-0048-6.
  7. Barry HE, Parsons C, Passmore AP, et al. Exploring the prevalence of and factors associated with pain: A cross-sectional study of community-dwelling people with dementia. Health & Social Care in the Community. 2016; 24(3):270-282. doi: 10.1111/hsc.12204. 
  8. van Kooten J, Smalbrugge M, van der Wouden J, et al. Prevalence of pain in nursing home residents: The role of dementia stage and dementia subtypes. J Am Med Dir Assoc. 2017; 18(6):522-527. doi: 10.1016/j.jamda.2016.12.078.
  9. Zhong W, Liu X, Voss T, et al. Medications in patients with dementia and behavioral disturbance. J Alzheimers Dis Rep. 2021; 5(1):535-540. doi: 10.3233/ADR-210023.

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (

Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of new and old blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with changing public health recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.