Health & Wellness
When is Pain a Problem

When is Pain a Problem

Keys to recognizing and managing your pain
By Kathy Kidwell

Your health is pretty good for someone your age (if you do say so yourself!), but you have the occasional recurrent aches and pains. How do you know when a pain is something to see a doctor about, and what can you do to manage it on your own?

According to information from the AGS Foundation for Health in Aging Web site, many older adults do not tell anyone about their pain or how severe it is. In some cases, they think—often incorrectly—that pain is a consequence of aging that cannot be avoided or treated. Others ignore or deny the pain because they don’t want to accept what the pain may mean, such as a worsening condition or progressing cancer. Some people try to ignore pain because they don’t want to be seen as troublesome or a burden. However, none of these is a good reason for living with persistent pain.

What’s the impact?

First, ask yourself how your pain is affecting your life. Is it decreasing your quality of life? Are you experiencing any of the following?
  • difficulty in performing activities of daily living
  • problems thinking
  • depression
  • anxiety
  • social isolation
  • loss of appetite
  • sleep problems
  • difficulty with balance and walking (this can increase the risk of dangerous falls)

If you answer “yes” to any of these, it may be time to talk to a doctor.

Assessing your pain

Pain is more than just a simple sensation. It is a very complex sensory experience that is influenced by memories, expectations and emotions. The AGS Foundation for Health in Aging explains that pain is transmitted by nerves that travel through the spinal cord. One type of pain response travels on a “fast track,” relaying information directly to the brain about the physical location and type of pain (sharp, severe or sudden). A second, “slower track” deals with the emotional qualities of pain. People have described such pain as “burning,” “frightening” or “cruel.” There also is a third nervous response that helps to lessen the pain sensation.

“Pain is a perception that signals the individual that tissue damage has occurred or may be occurring. It is very subjective and very complex,” says James Fugedy, M.D., of Atlanta Pain Doctors. Robert Montgomery with Peachtree Spine agrees, stating that the complexity of pain results in cases unique to each patient. “Anytime you have pain that’s abnormal and there’s not a specific activity that’s related to it, you should always have it at least checked out,” Montgomery says.

Various rating scales have been developed to help us assess pain more accurately. You may be asked to rate your pain on a numerical scale or match the level of your pain to specific written descriptions. For example, “Rate the pain from one to 10, with 10 being the worst pain imaginable.” Your healthcare provider may even ask you to keep a “pain diary” to describe your pain on a day-to-day basis.

A psychological assessment also may be conducted. Most people with chronic pain have significant symptoms of depression or anxiety and may benefit dramatically from psychological or psychiatric support.

The physical examination will include a careful examination of the main site of the pain, and of any part of the body that may be a source of referred pain (pain in which the source of the pain is different from the area where the pain is felt). The muscles, bones and joints will be looked at carefully because they are common sources of pain in older adults. Other specific tests (blood tests, X-rays, MRIs, etc.) may be recommended as needed.

Your aching back

Most often, pain occurs after a strenuous activity, and the pain that occurs is commonly located in the back. The prescription for back pain? Time. “If you’re experiencing low-back pain, give it time,” says Jeremy Beckworth, M.D., assistant professor of physical medicine, rehabilitation and orthopaedics for The Emory Clinic. “The vast majority of low-back pain resolves within the first 3 months, regardless of what you do. Even with a large herniated disc, studies show that in 2 years, most large herniations are essentially resorbed.” According to Fugedy, relatively short-term pain, stiffness and/or muscle tension anywhere along the neck and back accounts for the most common reason for doctor visits. “About 85 percent of acute neck and back pain are diagnosed as non-specific, meaning the doctor doesn’t know what causes it. If you have anxiety, depression and/or mental stress, your risk for this pain could be higher than normal,” Fugedy says. “Without the right amount of early treatment, acute low-back pain may become a chronic condition. Treatment starts with pain medication and advice to stay active, but modify the things you do to avoid further pain.” Generally, pain is treated with a combination of medication and physical adjustments and prevented by staying healthy and fit. Reducing levels of stress in your life and getting regular exercise are great ways to lower your risk for disorders that cause chronic pain. If you’ve seen your doctor and filled your prescription, but you don’t want to take pills every day for the rest of your life, there are several treatment options available.

Pill-Free Pain Relief

Rub it away
Massage and rubs applied to the skin can help manage pain in muscles, bones, and joints. Many of these methods relax tense muscles and feel soothing. Topical rubs containing menthol, salicylate or even an extract of hot peppers (capsaicin) give a sensation of heat or cold that works very well for some people.

Hot and cold
Remember that caution must be exercised with the prolonged use of heat or cold to avoid burns and other skin injury. Heat or cold packs should only be applied for 15-20 minutes at a time. Some people alternate heat with cold to obtain relief.

Distract yourself
Many people find comfort in music, meditation or prayer. Inactivity and inability to move around may contribute to depression and greater pain.

Stay active
Staying involved in activities, exercise and recreation as much as possible can make you feel better and take your mind off the pain.

Have fun
A sense of humor, the companionship of a pet and visits by family and friends can also play significant roles in pain relief.

—The AGS Foundation for Health in Aging,