Although many people experience more pain with age, it is not a normal part of life. Here are some tips for identifying your pain and working with your doctor to manage it.
The American Geriatrics Society (AGS) released guidelines on explaining and managing persistent pain. This term refers to pain or discomfort that continues for an extended period of time. Pain may come and go for months or years. Persistent pain can lead to further problems including
, social isolation, disability, difficulty walking, sleep problems, and diminished appetite. However, there are ways you can reduce this pain.
Identifying Your Pain
The first step is to keep track of your pain and tell your doctor about it. To give a clear explanation of what you are feeling, write down details about the pain, such as:
Where it hurts
How often it hurts
How much it hurts
What the pain feels like, for example:
Sharp or dull pain
Pins and needles
"Shooting" through the body
What makes the pain go away
What causes the pain to worsen
What medications or treatments have been tried, how well they have worked, and what side effects (if any) they may have caused
The AGS has created a "Pain Diary" to help you keep track of this information. This involves using a scale of 1-10 to rate the severity of pain, as well as recording the pertinent information listed above. You should bring this diary to all your medical appointments. This information will help determine the best way to manage your pain.
Many medications are available to help treat pain, these include over-the-counter pain relievers and prescription pain medications.
Over-the-counter Pain Relievers
If you have mild to moderate pain that lasts for only a few days, over-the-counter products are both safe and helpful. However, if your pain is severe or lasts longer than a few days, you might need a prescription drug for relief.
There are two main categories of over-the-counter pain relievers:
(eg, Acephen, Genapap, Tylenol)—These drugs can be very helpful for mild to moderate pain caused by musculoskeletal conditions, such as
low back pain
. If you need to take acetaminophen for more than a few days at a time, tell your doctor.
Also, never take more than the recommended dose, as there is a risk of serious liver damage with overuse of acetaminophen.
Nonsteroidal anti-inflammatory drugs (NSAIDs)–While generally available without a prescription, these drugs should be taken only after discussion with your doctor. They tend to have more side effects in older people and may also interact with other medical conditions and prescription drugs. Tell your doctor about your use of these drugs and all other medications, both prescription and over-the-counter. Examples of over-the-counter NSAIDs include:
COX-2 inhibitors—These are a newer form of NSAIDs, which may be safer for short-term use. However, they are only available with a prescription (see below).
Prescription Pain Medications
Depending on your pain, your doctor may prescribe pain medication. Some common drugs are:
The action of these drugs is similar to that of over-the-counter NSAIDs, but is more selective. Therefore, COX-2 inhibitors are able to relieve pain and inflammation with a lower risk of
and blood clotting problems.
In 2004, Merck took the COX-2 inhibitor Vioxx off the market due to safety concerns (a small risk of patients having a
, another COX-2 inhibitor, also carries the same risk, as well as potentially causing stomach bleeding.
These are drugs that work on the central nervous system to relieve pain. Examples of mild opioids include hydrocodone (eg,
). Strong opioids include
. There is some concern that
are addicting. However, the AGS points out that addiction to opioid pain medications is rare in older adults, and this concern should not prevent people and their doctors from trying this option for pain relief.
It is important to know that if you are taking an opioid drug, you should not stop it abruptly. This can cause unpleasant symptoms.
Depending on the cause of your pain, your doctor may prescribe one of these other types of drugs to help ease your discomfort:
Pain management programs (offered at some hospitals or local health centers)
Even if these methods do not resolve all of your pain, you may be able to reduce your pain to a more manageable level. The most important thing is to know that you do not have to suffer. Work with your doctor to find some relief.
Furlan, AD, Sandoval, JA, Mailis-Gagnon, A, Tunks, E. Opioids for chronic noncancer pain: a meta-analysis of effectiveness and side effects.
Lo V, Meadows SE, Saseen J. When should COX-2 selective NSAIDs be used for osteoarthritis and rheumatoid arthritis?
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McGettigan P, Henry D. Cardiovascular risk and inhibition of cyclooxygenase: a systematic review of the observational studies of selective and nonselective inhibitors of cyclooxygenase 2.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a