Chronic pain is a major cause of disability in the elderly. According to the POWER study (a review of the health status of women in Ontario), 31% of women aged 75 and older are limited in their activities of daily living because of arthritis-related pain. Unfortunately, treatment options are limited. NSAIDs must be prescribed with caution, and physicians are reluctant to prescribe opioids because of an increased risk of falls and sedation. But opioids have an important role to play in therapy. Elderly patients with severe biomedical pain conditions often respond very well to low doses of opioids. They are at low risk for opioid addiction, and falls and sedation can be minimized with careful titration.