Many times when I ask a patient to describe their pain, I get the same refrain;  “I don’t know, it is pain.”  “How am I supposed to describe it?” Pain is a common experience for the young and the elderly. The extent to which it disrupts daily routines seems to get worse with age. It is often poorly evaluated and managed, particularly in the elderly. There is no reason to suffer silently with persistent pain as you get older.

Healthcare professionals agree, that it is everyone’s right to receive adequate pain management that improves their quality of life, and conserves the ability to carry out the activities of daily living. Good pain management can also keep you healthier, by allowing you to stay active, eat well, and enjoy a normal social life.

If you are in pain, you may not want to talk about it, or tell anyone how bad it really is. There are several common reasons that may prompt you to keep silent about it, including:

• belief that pain is unavoidable
• fear that pain will increase as the underlying disease gets worse
• desire to avoid expensive tests or going to the hospital
• desire to not be seen as a complainer
• not wanting to be a burden to loved ones or caregivers.

Whatever the reason, it is important to report any pain, and seek evaluation and identification of a treatment plan. In most cases, it is possible to manage pain to allow you to do the things that are important to you.  Pain that is poorly managed is associated with:

• Depression and anxiety
• Poor sleep
• Loss of appetite
• Inability to carry out daily functions
• Loss of independence
• Social withdrawal
• Increased difficulty with thinking (dementia)

What Does “Pain” Refer To?

Pain is a complex, unpleasant experience, that you feel through your sense organs. It is influenced by your memories and expectations, and it also causes an emotional reaction. The sensation of pain travels on nerves to the spinal cord and then to your brain. The message informs your brain about its severity (mild or severe); pattern (sudden or persistent); and the location that it is coming from. Another important part of pain is its quality (aching, burning, stabbing, crushing).  How you describe the quality helps determine the cause, such as nerve-related, muscle/bone, or organ related.

Your primary care provider may be able to find a medical reason for your condition by doing an x-ray or other imaging tests, but with persistent or chronic pain, there is often no identifiable cause.  This does not mean that the pain is not real. Your own experience is what matters.

The Most Common Types of Pain

Pain may be acute or persistent (sometimes called chronic).  It is possible to experience both acute and persistent pain simultaneously. Acute pain, which comes on quickly and may not last very long, results from an injury, surgery, or other type of tissue damage. It usually goes away when the injury heals.

Persistent pain – that is, it has been ongoing for at least 3 to 6 months, can be long-lasting, and may or may not be associated with a disease or injury. If you have persistent pain, you are more likely to suffer from depression or anxiety, and feel that your quality of life and daily functioning have been impacted.

Pain may also have different causes. If related to muscles, bones, and organs, it is a response to an injury or disease. It usually stays in a single area and responds well to treatment with related medicines. Pain caused by damaged nerves or the brain is likely to cause unusual sensations; may be harder to identify location; and can be difficult to treat with standard pain relievers.

How Common is Pain in Older Adults?

Pain is one of the most common health problems experienced by older adults. Between 25-50% of all older people living at home, and up to 80% of older people living in nursing homes, report that they are in serious pain. Some kinds of pain, such as back, seem to decline in frequency as people get older. Other types, such as large joint pain (in the knees, hip, or feet), may increase. About 12% of older adults have widespread pain, which is reported more often by women than by men.

For pains in your lower limbs and feet, check your podiatrist; for other parts of your body, check your doctor, who would refer you on if necessary.

Your feet mirror your general health . . . cherish them!