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Chronic Pain

There are two kinds of pain. Acute pain begins suddenly, lasts for a short time, and goes away as your body heals.

pain-and-pain relief
pain-and-pain relief

You might feel acute pain after surgery or if you have a broken bone, infected tooth, or kidney stone.

Pain that lasts for 3 months or longer is called chronic pain. This pain often affects older people. For some people, chronic pain is caused by a health condition such as arthritis. It may also follow acute pain from an injury, surgery, or other health issue that has been treated, like post-herpetic neuralgia after shingles.

Living with any type of pain can be hard. It can cause many other problems. For instance, pain can:

  • Get in the way of your daily activities
  • Disturb your sleep and eating habits
  • Make it difficult to continue working
  • Be related to depression or anxiety
  • Keep you from spending time with friends and family

Pain is a feeling set off in the nervous system. Acute pain lets you know that you may be injured or have a problem you need to take care of. Chronic pain is different. The pain signals go on for weeks, months, or even years. The original cause may have been an injury or infection

There may be an ongoing cause of pain, such as arthritis or cancer. But in some cases there is no clear cause.

Problems that cause chronic pain include

Chronic pain usually cannot be cured. But treatments can help. They include medicines, acupuncture, electrical stimulation and surgery. Other treatments include psychotherapy, relaxation and meditation therapy, biofeedback, and behavior modification.

chronic Pain
chronic Pain

Describing Pain

Many people have a hard time describing pain. Think about these questions when you explain how the pain feels:

  • Where does it hurt?
  • When did the pain start? Does it come and go?
  • What does it feel like? Is the pain sharp, dull, or burning? Would you use some other word to describe it?
  • Do you have other symptoms?
  • When do you feel the pain? In the morning? In the evening? After eating?
  • Is there anything you do that makes the pain feel better or worse? For example, does using a heating pad or ice pack help? Does changing your position from lying down to sitting up make it better?
  • What medicines, including over-the-counter medications and non-medicine therapies have you tried, and what was their effect?

Your doctor or nurse may ask you 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. Or, your doctor may ask if the pain is mild, moderate, or severe. Some doctors or nurses have pictures of faces that show different expressions of pain and ask you to point to the face that shows how you feel. Your doctor may ask you to keep a diary of when and what kind of pain you feel every day.

Attitudes About Pain

Everyone reacts to pain differently. Some people feel they should be brave and not complain when they hurt. Other people are quick to report pain and ask for help.

Worrying about pain is common. This worry can make you afraid to stay active, and it can separate you from your friends and family. Working with your doctor, you can find ways to continue to take part in physical and social activities despite having pain.

Some people put off going to the doctor because they think pain is part of aging and nothing can help. This is not true!

It is important to see a doctor if you have a new pain. Finding a way to manage pain is often easier if it is addressed early.

Treating Pain

Treating, or managing, chronic pain is important. Some treatments involve medications, and some do not. Your treatment plan should be specific to your needs.

Most treatment plans focus on both reducing pain and increasing ways to support daily function while living with pain.

Talk with your doctor about how long it may take before you feel better. Often, you have to stick with a treatment plan before you get relief. It’s important to stay on a schedule. Sometimes this is called “staying ahead” or “keeping on top” of your pain. Be sure to tell your doctor about any side effects. You might have to try different treatments until you find a plan that works for you. As your pain lessens, you can likely become more active and will see your mood lift and sleep improve.

non-steroidal anti-inflammatory drugs (NSAIDs)
non-steroidal anti-inflammatory drugs (NSAIDs)

Your doctor may prescribe one or more of the following pain medications. Talk with your doctor about their safety and the right dose to take.

  • Acetaminophen may help all types of pain, especially mild to moderate pain. Acetaminophen is found in over-the-counter and prescription medicines. People who have more than three drinks per day or who have liver disease should not take acetaminophen.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) include aspirin, naproxen, and ibuprofen. Long-term use of some NSAIDs can cause side effects, like internal bleeding or kidney problems, which make them unsafe for many older adults. You may not be able to take ibuprofen if you have high blood pressure.
  • Narcotics (also called opioids) are used for moderate to severe pain and require a doctor’s prescription. They may be habit-forming. They can also be dangerous when taken with alcohol or certain other drugs. Examples of narcotics are codeine, morphine, and oxycodone.
  • Other medications are sometimes used to treat pain. These include antidepressants, anticonvulsive medicines, local painkillers like nerve blocks or patches, and ointments and creams.

As people age, they are at risk for developing more side effects from medications. It’s important to take exactly the amount of pain medicine your doctor prescribes. Don’t chew or crush your pills if they are supposed to be swallowed whole. Talk with your doctor or pharmacist if you’re having trouble swallowing your pills.

Mixing any pain medication with alcohol or other drugs can be dangerous. Make sure your doctor knows all the medicines you take, including over-the-counter drugs and dietary supplements, as well as the amount of alcohol you drink.

Remember: If you think the medicine is not working, don’t change it on your own. Talk to your doctor or nurse.

What Other Treatments Help with Pain?

In addition to drugs, there are a variety of complementary and alternative approaches that may provide relief. Talk to your doctor about these treatments. It may take both medicine and other treatments to feel better.

  • 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, muscle tension, and other body functions. This may help reduce your pain and stress level.
  • Cognitive behavioral therapy is a form of short-term counseling that may help reduce your reaction to pain.
  • Distraction can help you cope with acute pain, taking your mind off your discomfort.
  • Electrical nerve stimulation uses electrical impulses to relieve pain.
  • 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.
  • Mind-body stress reduction combines mindfulness meditation, body awareness, and yoga to increase relaxation and reduce pain.
  • Physical therapy uses a variety of techniques to help manage everyday activities with less pain and teaches you ways to improve flexibility and strength.
back pain
back pain

Helping Yourself

There are things you can do yourself that might help you feel better. Try to:

  • Keep a healthy weight. Putting on extra pounds can slow healing and make some pain worse. A healthy weight might help with pain in the knees, back, hips, or feet.
  • Be physically active. Pain might make you inactive, which can lead to more pain and loss of function. Activity can help.
  • Get enough sleep. It can reduce pain sensitivity, help healing, and improve your mood.
  • Avoid tobacco, caffeine, and alcohol. They can get in the way of treatment and increase pain.
  • Join a pain support group. Sometimes, it can help to talk to other people about how they deal with pain. You can share your thoughts while learning from others.

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