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Pain Management

Getting Rid of Chronic Pain

As people age, chronic pain becomes a real problem. In your younger years, you probably had pain for a short while – from a broken arm, say, or a bad toothache. But pain can become a constant, unwelcome companion for older people who have age-related illnesses like arthritis, cancer or diabetes.

However, though chronic pain often accompanies aging, that doesn’t mean it’s something you should put up with. Don’t delay going to your doctor. Here, from the National Institute on Aging (NIA), are tips on how to talk to your doctor so your pain problem can be solved.

Even though they’re very familiar with their pain, patients can have a hard time describing it. So before you go to the doctor, think about how you would describe your own pain. Some questions to consider, according to the NIA:

*Where does it hurt?

*When did it start? Does the pain come and go?

*What does it feel like? Is the pain sharp, dull, or burning? Would you use some other word to describe it?

*When do you feel the pain? In the morning? In the evening? After eating? Another time?

*Is there anything you do that makes the pain feel better or worse? For example, if you use a heating pad or ice pack, does that help? Does changing your position from lying down to sitting up make it better? Have you tried any over-the-counter medications?

*Do you have other symptoms?

You may be asked to rate your pain on a scale of 0 to 10, with 0 being no pain and 10 being the worst pain you can imagine. Your health care provider may also ask you to describe the pain, using words like mild, moderate or severe.

Treating Pain

The good news is that there are a variety of ways to treat chronic pain. Some treatments involve medications, and some do not. Your doctor may make a specialized treatment plan for you. It’s important to remember, the NIA says, that pain doesn’t always go away overnight, so ask your doctor how long it will take you to feel better. Even if you don’t get results right away, stay on schedule. As your pain lessens, you will be more active and will see your mood lift and sleep improve.As part of your pain-fighting plan, your doctor may prescribe one or more medications. They include:

Acetaminophen. This medicine is good for all types of pain, especially mild to moderate pain. It’s not habit-forming, and it’s found in over-the-counter and prescription medicines. There are some instances of allergic reactions such as hives, trouble breathing or swelling of tongue, lips and face. Heavy drinkers or people with liver disease should not take acetaminophen, the NIA says.

Often, acetaminophen, known to most of us as Tylenol, is found in other pain medicines. It’s important that you and your doctor know how much acetaminophen you are taking each day because it can cause liver damage at high doses. Talk with your doctor or pharmacist about safe dosages.

Nonsteroidal anti-inflammatory drugs (NSAIDs) include aspirin medications, naproxen (Aleve and its generic counterparts), and ibuprofen (Advil and its generic counterparts). NSAIDs may have side effects like nausea, vomiting, diarrhea, rash, dizziness, headache, or allergic reactions. More serious side effects are kidney or liver failure, ulcers, and prolonged bleeding after an injury or surgery. In some older people who have high blood pressure or heart conditions, or who have had a stroke in the past, NSAIDS can be particularly unsafe. They’re better when used for a limited time in limited doses.

Narcotics (also called opioids) are used for severe pain and require a doctor’s prescription. A word of warning: they may be addictive. Some examples include codeine, morphine, and oxycodone. Side effects can include constipation, sleepiness and nausea. Narcotics may have unwanted side effects including constipation, sleepiness, and nausea. These may fade over time, but ask your doctor how you can manage them. And see if he or she knows of any other medicines that might work better.

Other medications sometimes used to treat pain, according to the NIA, are antidepressants, anticonvulsive medicine, and local pain killers like nerve blocks or patches.

It’s especially important for older people to take medicine exactly as prescribed, because side effects are more frequent with age. Tell your doctor, as always, what over-the-counter drugs you are taking, as well as any dietary or herb/alternative supplements and the amount of alcohol you drink.

If the dose you’re taking isn’t working, talk to your health care practitioner. He or she may adjust the dose or give you another medicine.

However, not all doctors have been trained in pain management. If you find that your doctor can’t help you, ask him or her for the name of a pain medicine specialist. You also can ask for names from friends and family, a nearby hospital, or your local medical society.

What Other Treatments Help With Pain?

Complementary and alternative approaches won’t cure your pain, but they can help moderate it. Talk to your doctor about including some of these treatments in your plan. It may take both medicine and other treatments to feel better. The NIA’s list of alternative treatments:

Acupuncture uses hair-thin needles to stimulate specific points on the body to relieve pain.

Biofeedback helps you learn to control your heart rate, blood pressure, and muscle tension.

Cognitive behavior therapy is a form of short-term counseling that may help reduce your reaction to pain.

Distraction can help you cope with pain by learning new skills that may take your mind off your discomfort.

Guided imagery uses directed thoughts to create mental pictures that may help you relax, manage anxiety, sleep better, and have less pain.

Hypnosis uses focused attention to help manage pain.

Massage therapy can release tension in tight muscles.

Physical therapy uses a variety of techniques to help manage everyday activities with less pain and teaches you ways to improve flexibility and strength.

Self-care
In addition to your treatments, the NIA says these steps could help you feel better. Try to:

Keep your weight down. Extra weight can slow healing and make some pain worse; for example, pain in the back, knees, hips, and feet.

Try to keep moving. Pain may make you inactive, and that can lead to a cycle of more pain and loss of function. Mild exercise can help.

Get enough sleep. It will improve healing and your mood.

Avoid tobacco, caffeine, and alcohol. They can have a negative impact on your treatment and increase your pain.

Join a pain support group. Sometimes it can help to talk to other people about how they deal with pain.

Reprinted with permission from the National Institute on Aging. For more information, visit National Institute on Aging. You can also read more about chronic pain at the American Chronic Pain Association.