Objective:

To synthesize and critically interpret chronic pain management approaches in light of recent advances in neuroscience, rehabilitation science, pain physiology, and psychological research, focusing on functional restoration in aging populations affected by chronic spinal pain, based on literature from 2020 to the present.

Key Findings:

• Chronic spinal pain is a leading cause of disability, particularly in older adults.
• Traditional pharmacological and surgical treatments have limited long-term efficacy and significant risks.
• Non-pharmacological and regenerative strategies, such as Pain Neuroscience Education, structured exercise, and psychological therapies, improve pain and functional outcomes.
• Adjunctive modalities like extracorporeal shockwave therapy and high-intensity laser therapy may enhance treatment effects.
• Regenerative interventions, including ultrasound-guided mechanical needling, show promise in addressing fibrosis and calcification.

Interpretation:

The review proposes a tiered, function-oriented model that integrates various treatment modalities, including non-pharmacological and regenerative strategies, to create accessible and cost-effective pain care systems for older adults.

Limitations:

• The review synthesizes literature of varying methodological quality, including studies with small sample sizes and lack of control groups.
• There is a need for protocol standardization and robust randomized trials for some interventions.

Conclusion:

The findings support a shift from symptom-focused to function-oriented pain management approaches, emphasizing the importance of integrating biological, psychological, and social determinants of pain, which is crucial for improving outcomes in chronic pain management.