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You Don't Have to Live With Pain

Pain doesn’t have to be a normal part of life. Here are tips to help you label your pain and work with your doctor to treat it.

Long-term (chronic) pain is pain that lasts for a long time. It may come and go for months or years and lead to depression, loneliness, inability to work, problems walking, falls, sleep problems, and loss of hunger. But, there are ways you can treat your pain.

Identifying Your Pain

The first step is to keep track of your pain and tell your doctor about it. Use a diary to keep track of:

  • Where it hurts
  • How often it hurts
  • How much it hurts
  • Whether the pain is:
    • Burning
    • Sharp or dull
    • Achy
    • Pins and needles
    • Shooting
  • What makes the pain go away
  • What causes the pain to get worse
  • What you were doing when the pain started
  • How long the pain lasted
  • Whether the pain comes and goes or is there all the time
  • What you have tried to treat the pain and whether it made the pain better or worse

Rate the pain using a scale of 1-10. You should bring this diary to all your health visits. You and your doctor can use it to find ways to treat your pain.

About Pain Medicines

Over-the-counter and prescription pain medicines can help treat pain.

Over-the-counter Pain Relievers

If you have mild to medium pain that lasts a few days, over-the-counter medicines are safe and helpful. If your pain is strong or lasts longer than a few days, you might need prescription pain medicine.

There are 2 main types of over-the-counter pain medicines:

  1. Acetaminophen —This medicine can be ease mild to medium pain caused by muscle or bone problems, such as osteoarthritis or low back pain. If you need to take it for more than a few days, tell your doctor. Do not take more than the amount on the label. Using too much can cause liver problems.
  2. Nonsteroidal anti-inflammatory drugs (NSAIDs) —NSAIDs may be a better choice for inflammatory pain like arthritis. Take it only after talking with your doctor. They have more side effects, and may cause problems with other medicines or health problems that you have. Older adults are more likely to have side effects. Talk to your doctor about these and any other medicines you take. Examples of NSAIDs include:
    • Aspirin
    • Ibuprofen
    • Naproxen

Prescription Pain Medications

If you have severe pain, your doctor may prescribe pain medicine. Some common ones are:

COX-2 Inhibitors

These are like over-the-counter NSAIDs, but they block pain and swelling. They cost more than other NSAIDs, but do not bother the stomach as much.

Opioid Medications

Opioids may be a better choice for older adults who are at risk of problems that NSAIDs can cause. People worry that opioids are addicting. But addiction is rare in older adults who have never abused drugs. This worry should not stop people and their doctors from thinking of them as an option. Your doctor can use tests to tell if you are at risk.

If you are taking an opioid medicine, you should not stop taking it without talking to your doctor. You will need to stop taking it slowly so you do not have problems.

Other Medicines

Your doctor may also prescribe one of these medicines alone or with pain medicines:

  • Antidepressants
  • Antiseizure medicines
  • Local anesthetics

Side Effects

Tell your doctor about any problems you have when you take medicine. There are other options. Some problems include:

  • Feeling faint
  • Fatigue
  • Nausea and vomiting
  • Memory problems
  • Problems passing stool
  • Problems having sex

Other Ways to Ease Your Pain

Medicines are not the only way to ease pain. Here are some things that can help:

  • Exercise, including therapy and fitness classes
    • Yoga and tai chi can help you stay loose, help you balance, and lower your risk of falls.
    • Don't do too much, since too much working out can worsen pain.
  • Eat healthy foods, such as fruits, vegetables, and whole grains—They will help power the things that you do.
  • Keep up with your friends and family members—This can improve your mood.
  • Stay involved in your care—Tell your doctor how your medicines are working and if you have any problems.

Here are some other ways to ease pain:

Even if these methods don’t make your pain go away, you may be able to lower it. You do not have to suffer. Work with your doctor to find some relief.

RESOURCES:

American Chronic Pain Association
http://www.theacpa.org

American Pain Society
http://www.ampainsoc.org

CANADIAN RESOURCES:

Chronic Pain Association of Canada
http://www.chronicpaincanada.com

Health Canada
http://www.hc-sc.gc.ca

REFERENCES:

Ballantyne JC, Mao J. Opioid therapy for chronic pain. N Engl J Med. 2003;349:1943.

Cancer pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 21, 2016. Accessed May 17, 2016.

Celecoxib. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated may 6, 2016. Accessed May 17, 2016.

Chronic low back pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 11, 2016. Accessed May 17, 2016.

Falls in the elderly. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 11, 2016. Accessed May 17, 2016.

Ferrell B, Argoff CE, et al. Pharmacological management of persistent pain in older persons. J Am Geriatr Soc. 2009;57(8): 1331-1346. Available at: http://www.healthinaging.org/aging-and-health-a-to-z/topic:pain-management. Accessed May 17, 2016.

Furlan AD, Sandoval JA, Mailis-Gagnon A, Tunks E. Opioids for chronic noncancer pain: a meta-analysis of effectiveness and side effects. CMAJ. 2006;174(11):1589.

Opioids for chronic pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 10, 2015. Accessed May 17, 2016.

12/11/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Leveille SG, Jones RN, Kiely DK, et al. Chronic musculoskeletal pain and the occurrence of falls in an older population. JAMA. 2009;302(20):2214-21.

11/5/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Buckeridge D, Huang A, Hanley J, etc. Risk of injury associated with opioid use in older adults. J Am Geriatr Soc. 2010;58(9):1664-1670.

Last reviewed May 2016 by Michael Woods, MD  Last Updated: 4/19/2018