Ask the Geriatrician: Persistent Pain
Ask the Expert
David R. Mehr, MD, MS
William C. Allen Professor in Family and Community Medicine
University of Missouri School of Medicine
Keela A. Herr, PhD, RN, AGSF, FAAN
University of Iowa College of Nursing
AGS Expert Panel, The Management Of Chronic Pain in Older Persons
Persistent pain is pain or discomfort that lasts for a long period of time. The pain can come and go for months or years. Pain can keep people from being happy with life. It can cause depression, disability, and problems with walking and with sleep.
Yet, there is good news! There are many treatments and methods that can help. Talk to your healthcare provider about your pain. Telling your healthcare provider about your pain is the only way he or she can know how you feel.
Q. Is persistent pain just part of growing old?
A. No. Pain is very common in older people but it is not normal or healthy. It should not be ignored or said to be a “part of getting older.”
Q. How can I explain my pain to my doctor or health care provider?
A. You can use a “pain diary” to help you describe your pain to your healthcare professional. A pain diary is a journal or record of your pain. A pain diary can help your doctor or health care provider find a cause for your pain and a plan of care.
Here is what you can write down:
- Where it hurts
- How often it hurts
- How much it hurts
- What the pain feels like? (Does it burn? Is it sharp or dull? Does it ache? Does it feel like pins and needles, or does it "shoot" through a part of your body?)
- What makes the pain go away?
- What makes the pain get worse?
- What medicines or treatments have been tried? Do they work? What side effects (if any) they caused.
Q. Can I take over-the-counter medicine for pain?
A. Ask your healthcare provider. Over-the-counter (no prescription needed) pain medications are safe and helpful for mild-to-moderate pain for a few days. For severe pain or pain that lasts longer than a few days, you should talk to your healthcare provider.
If you are already taking prescription medicines you need to be sure that it will be safe to take over-the-counter medications along with your prescription drugs.
Q. What type of over-the-counter medicine can I take?
A. Acetaminophen (Tylenol, for example) may be the best choice for mild-to-moderate pain caused by muscle or bone conditions, such as osteoarthritis or broken bone. If you take acetaminophen for more than a few days, you should talk to your health care provider.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are another type of over-the-counter pain medicine. Aspirin, ibuprofen, or naproxen, are some examples of NSAIDs. NSAIDs should be used very carefully because they may have more side effects in older adults. These medicines may also interact with other health problems and medicines. If you have heart problems or stomach bleeding, you should not use NSAIDs.
Be sure to tell your healthcare provider about all of your medications, including any over-the-counter medicines.
Q. I am already taking a prescription pain medicine. Can I take another over-the-counter medicine for pain?
A. Many medicines should not be taken together. They may have overlapping ingredients, leading to getting too much of a drug. Medicines can also interact with each other or with foods, and cause unpleasant or dangerous side effects. Your healthcare provider can tell you how to take your medicines in a safe way.
Be sure to follow the instructions on the bottle label, for both over-the-counter and prescription medicines. If you have any questions, you can also ask the pharmacist at your local drugstore or call your healthcare provider.
Q. My health care provider suggests that I take antidepressants for my pain. Does this mean the pain is just in my head?
A. No! Research has shown that some antidepressants (medicines used to treat depression) can help ease some types of pain. These medicines can help pain caused by nerve damage.
Q. I don’t like the side effects from my pain medicine. What can I do?
A. Always talk to your healthcare provider about any side effects. He or she may be able to help you find a different medicine, or make sure you are taking your medicine the right way. Your healthcare professional can help you to find the safest and most effective medicine for your pain.
Q. What can I do besides taking medicines?
A. There are many things you can do that do not involve taking medicine. The more you know about your pain, the more you can do to control it. There are education programs that can teach you about pain and how to cope with it.
Ask your health care provider about programs in your area. Exercise is also extremely helpful. Ask about physical therapy, exercise, or fitness programs. These programs can help make you stronger, improve the way you move your joints and limbs, steady your walking and increase your endurance.
Other non-drug treatments may help some people. These treatments include using heat, cold, massage, acupuncture, and transcutaneous electrical nerve stimulation (TENS). Other mental and physical treatments such as relaxation, music and distraction may help as well.
It is important to ask your healthcare provider about these non-drug options for your specific problem.
Q. What if my pain is not going away?
A. Don't give up! Ask your healthcare provider for a referral to a pain management center. Your local hospital may offer patient education programs and support groups for patients and family members. Some persistent pain problems are very complex. You may need a team of specialists to diagnose and manage them. Although you may not get complete relief of all pain, a lot can be done to control or manage most persistent or chronic pain problems.
Updated: October 2013
Posted: October 2013
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