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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 medicines 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 (eg, Acephen, Genapap, Tylenol)—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 in older people and may also affect medical conditions (like cardiovascular disease) and interact with prescription drugs. Tell your doctor about your use of these drugs and all other medicines, both prescription and over-the-counter. Examples of over-the-counter NSAIDs include:
- Ibuprofen (eg, Advil, Motrin-IB, Nuprin)
- Naproxen (eg, Aleve, Naprosyn, and others)
- COX-2 inhibitors
Prescription Pain Medications
- Antidepressants (eg, Desipramine and Duloxetine)
- Anticonvulsants (eg, Tegretol and Neurontin)
- Local anesthetics (eg, lidocaine)
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 medicines:
- 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, veggies, 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 medicines are working and if you are having any side effects.
- Use of heat therapy
- Relaxation therapy
American Chronic Pain Association http://www.theacpa.org/
The American Geriatrics Society Foundation for Health in Aging http://www.healthinaging.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 July 2, 2012. Accessed August 1, 2012.
Celecoxib. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated June 15, 2012. Accessed July 17, 2012.
Chronic low back pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated June 29, 2012. Accessed August 1, 2012.
Falls in the elderly. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated July 16, 2012. Accessed July 30, 2012.
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 July 13, 2012. Accessed July 30, 2012.
Pain management. Health in Aging website. Available at: http://www.healthinaging.org/aging-and-health-a-to-z/topic:pain-management/. Updated March 2012. Accessed July 30, 2012.
Pharmacological management of persistent pain in older persons. American Geriatrics Society website. Available at: http://www.americangeriatrics.org/files/documents/2009%5FGuideline.pdf. Published 2009. Accessed July 30, 2012.
12/11/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: 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 DynaMed's Systematic Literature Surveillance: 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: Brian Randall, MD
- Review Date: 07/2012
- Update Date: 07/30/2012