When it comes to treating chronic pain such as arthritis or low back pain, it’s important to remember that what works for one patient may not work for the next patient. Some people are able to control their pain by taking a nonprescription medication such as acetaminophen (Tylenol), while others may need an opioid (also known as narcotics). Tablets or capsules containing the opioid hydrocodone plus acetaminophen (known as Vicodin or Lortab) are among the most commonly dispensed medications in the US. But remember: just because this medication is popular doesn’t make it the best pain reliever for everyone!
For example, a recent study showed the older adults who were prescribed a short-acting opioid such as hydrocodone or oxycodone (e.g., Percocet) were twice as likely to break a bone in the following year compared to those on a long-acting opioid or a different pain medication altogether. How can doctors tell which pain medication to prescribe to best treat your pain, without increasing the risk of side effects? People also frequently turn to their pharmacist for medication advice – how does the pharmacist know what to recommend for your pain?
It all starts with a careful description of your pain. When you talk to your doctor or pharmacist, it’s important to completely describe your pain. Questions your doctor or pharmacist should ask regarding your pain are shown below. And if you aren’t asked, you should volunteer this information!
• Where is the pain, and does the pain move to any other areas in your body?
• Do any activities bring the pain on or make it worse such as walking, working, or lying down?
• Do any activities relieve the pain or make it better such as heat or cold application, resting or rubbing the area?
• What medications have you tried to treat the pain? How well did the medication work, and did you have any side effects from the medication?
• Describe what the pain feels like – is it sharp, stabbing, shooting, throbbing, burning or is there another word that describes it?
• How severe is the pain? On a scale of zero to ten (where zero is no pain and ten is the worst pain you can imagine), how bad is your pain right now? What is the best the pain is during an average day? The worst? On average?
• Is the pain there all the time or does it come and go during the day? If it comes and goes, how many times a day do you have the pain? How long does it last when you have the pain?
• What does the pain keep you from doing (such as work, shopping, playing with your children, gardening, sleeping, and so forth)?
This information, along with a physical exam and perhaps other testing will help your health care team determine the best pain medication for you. Remember – if your doctor or pharmacist doesn’t ASK you all these questions about your pain, you should bring it up. Remind them – “it’s your JOB to listen to my pain story!”