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Take Control of Your Pain

How to be an active participant in your own condition

iStock 000011824811Small 1Aging, as they say, is most decidedly not for sissies. As we get older, a myriad of conditions and symptoms can cause various and sundry types of pain in our bodies. Of course, some aches and pains are temporary. They resolve and heal within a reasonable amount of time, allowing us to go back to life as usual. Chronic pain, on the other hand, can often be a dull, nagging pain that feels like it will just go on forever. And, indeed, sometimes it does. There is not always a cure for chronic pain. In some cases, the best we can do is to learn how to live with and manage it.

From my perspective as a physician who cares for older adults, I firmly believe that everyone is entitled to feel as good and to be as functional as possible. So I help my patients focus on attaining the highest quality of life given their specific health conditions. The goal is to enjoy life and continue to do the things that are gratifying and make you happy. And those things are different for everyone.

Talk to Your Physician. 
One of the most powerful things you can do is to have a frank and honest discussion with your primary care physician or provider. Let them know the truth about your pain, how it is impacting your life, and the things it is keeping you from doing. Ranking your pain, on a scale of 1 to 10, is helpful. As pain is very individual and personal, your physician needs to understand how bad it is for you. How much pain other people might feel is irrelevant.

Have an Effective Pain Plan.
Once your provider has a complete understanding of your situation, the two of you will be able to craft an effective “pain plan” together and stock your “toolbox” with the things you need to feel better. Some elements of an effective pain plan include:

  1. Ask for help when you need it. There is nothing heroic about enduring an 8-out-of-10 pain episode for three days before, desperate, you finally call your doctor. When an incident begins, you can’t possibly know whether the problem will be gone in a short while or will stick around. Get help early so you can feel better sooner.
  1. Stay ahead of it. It is much more effective to get in front of pain and pre-empt it than to try and relieve it once it’s become really bad. If you know, for example, that your knee hurts by 10 am every day, you may learn that you need to do an intervention at 7 am to prevent it from happening.
  1. Be informed and make good choices. You can empower yourself and take control. If you are an arthritis sufferer, for example, you understand that weather changes can be a big trigger for your discomfort. When you know what to expect, you can plan for conditions and arrange your life. In this situation, you might watch the weather forecast and wait until the 70 degree day to play golf, instead of playing in chillier temps that will cause you trouble later.
  1. Have a toolbox of interventions at your disposal. Depending on the cause of your pain and your specific circumstances, there are a variety of things you may be able to employ. Choosing from and alternating between multiple modalities is often helpful. Some of the things in your toolbox may include:
    • Pain relievers, such as extra-strength Tylenol
    • Anti-inflammatory medications, such as ibuprofen
    • Ointments
    • Ice and/or heat
    • Movement and exercise, including physical therapy and occupational therapy
    • Nutritional supplements
    • Acupuncture
    • Massage
    • Narcotic pain medications (these are a last resort, in my book--certainly not the first choice but sometimes necessary)

It is critically important that your primary care physician/provider is aware of everything that you are taking and doing to manage your pain. Medications and other substances, such as nutritional supplements and herbs, may conflict with one another and cause harmful side effects. We don’t want you to be harmed in the process of being helped.  Please, be honest! Most physicians will be interested in and willing to support the things you want to try.

  1. Have a backup plan. Discuss some backup choices with your provider so you have resources if exacerbations occur. An effective backup plan can help prevent weekend emergency room visits and provide a greater quality of life during those times when your chronic pain is on the upswing.

Chronic Pain and Depression

iStock 000012894837SmallChronic pain can ebb and flow, like the tide. You may experience very difficult periods alternating with “I feel pretty good” days. I caution my patients not to be overly optimistic on those good days. While you should certainly enjoy and appreciate the absence of pain, it’s important not to think that you’re “done” with the pain forever. It can be very disheartening if you’ve convinced yourself that you’ve been cured, but the pain eventually returns.

Depression is a frequent side effect of chronic pain. Again, in the spirit of taking control, knowing as much as you can about your condition and having realistic expectations can be helpful. Talk with others about what’s going on. Ask your physician questions like, “What is the usual progression of my condition?” and “What should I expect?” You do not have to be alone in your pain and you do have choices.

While it’s true that chronic pain may not be curable, it should be manageable. It’s your body and your life—take control of your own situation and manage your own expectations. You’ll be on your way to a happier, more joyful experience!


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