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You Don't Have to Live With Persistent Pain
Identifying Your Pain
- Where it hurts
- How often it hurts
- How much it hurts
What the pain feels like, for example:
- Burning pain
- Sharp or dull pain
- Achy pain
- Pins and needles
- "Shooting" through the body
- What makes the pain go away
- What causes the pain to worsen
- What were you doing when the pain started
- How long the pain lasted
- Pattern of pain (does it fluctuate or is it constant)
- What medications or treatments have been tried, how well they have worked, and what side effects (if any) they may have caused
Understanding Pain Medications
Over-the-counter Pain Relievers
- Acetaminophen—This drug can be very helpful for mild to moderate pain caused by musculoskeletal conditions, such as osteoarthritis or 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)—NSAIDs may be more effective for inflammatory pain, such as that associated with rheumatoid arthritis. While generally available without a prescription, these drugs should be taken only after discussion with your doctor. They tend to have more side effects (like gastrointestinal problems) and may also affect medical conditions (like cardiovascular disease) and interact with prescription drugs. Side effects may be more pronounced in older people. 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
Prescription Pain Medications
- Local anesthetics
From NSAIDs or COX-2 inhibitors:
- Kidney problems (more common in older adults)
- Problems with high blood pressure
- Stomach bleeding
- Increased risk of heart attack and stroke
From opioid medications:
- Nausea and vomiting
- Short term memory problems
- Constipation—For the other side effects, the body usually adapts quickly. But for constipation, you may need to take a stool softener or laxative on a daily basis.
- Sexual dysfunction
Trying Other Means to Ease Your Pain
- Exercise, including physical therapy and fitness programs—Exercises like yoga and tai chi can help you stay flexible, improve your balance, and reduce your risk of falls.
- Eat a healthy diet, rich in fruits, vegetables, and whole grains—A healthy diet will give you the energy you need to stay active.
- Maintain an active lifestyle, including keeping up social engagements—This can help you avoid isolation and depression.
- Stay involved in your care—Tell your doctor how your medications are working and if you are having any side effects.
- Use of heat therapy
- Relaxation therapy
American Chronic Pain Association http://www.theacpa.org
American Pain Society http://www.ampainsoc.org
Chronic Pain Association of Canada http://www.chronicpaincanada.com
Health Canada http://www.hc-sc.gc.ca
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 June 16, 2014. Accessed July 16, 2014.
Celecoxib. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 10, 2014. Accessed July 16, 2014.
Chronic low back pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 10, 2014. Accessed July 16, 2014.
Falls in the elderly. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 14, 2014. Accessed July 16, 2014.
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 July 16, 2014.
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 June 23, 2014. Accessed July 16, 2014.
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.
- Reviewer: Michael Woods, MD
- Review Date: 07/2014
- Update Date: 00/71/2014