For a 70-year-old patient with constant back pain and not a surgical candidate, which class of medication is advisable?

In the context of managing constant back pain in a 70-year-old patient who is not a surgical candidate, anticonvulsants can be particularly beneficial, especially if the pain has a neuropathic component. Medications like gabapentin or pregabalin can help alleviate nerve pain, which may be a contributing factor to the patient's discomfort.

In managing back pain, particularly in older adults, it is essential to consider safety and side effects. Anticonvulsants are typically viewed as safer alternatives to opioids, which carry risks of dependence and significant side effects, especially in the elderly. Nonsteroidal anti-inflammatory drugs (NSAIDs), while commonly used, can pose risks of gastrointestinal bleeding and renal impairment in older populations. Corticosteroids may also provide relief, but long-term use can lead to serious side effects such as osteoporosis, particularly in older individuals.

Choosing anticonvulsants allows for a targeted approach to pain management that can be both effective and safer for older adults, making them a more advisable option in this case.