How to assess pain and find the right medication

Pain is hard to explain and finding the right medication can be a difficult trial and error process. Here are some ways to describe pain to your doctor and some safer medicines you might want to try.

Pain is so subjective that it's often difficult to describe to other people, including doctors. It's also impossible to measure — there is no "pain" chemical or virus you can test for. So doctors often rely on simple rating systems as a way to determine the intensity of your pain. They often are as easy as rating your pain on a scale from 1 to 10, or picking a drawing of a face that best portrays the pain level (they range from smiling happily to crazy grimacing). Another way doctors monitor pain is through nonverbal indicators, such as these.

• Vocal complaints: moans, gasps, sighs, or exclamations
• Facial expressions: such as grimaces, winces, clenched teeth, furrowed brows, or narrowed eyes
• Bracing movements: clutching a railing or grabbing a body part
• Rubbing movements: massaging the affected area

Next time you have a headache or your arthritis flares, stop before you swallow those mainstay medicines of pain relief:

• Older people have been systematically excluded from most clinical studies on nonsteroidal anti-inflammatory drugs (NSAIDs), the category of drug under which ibuprofen and aspirin fall.
• As it turns out, older people are most likely to experience one of NSAIDs' few troublesome side effects — stomach bleeding.
• The risk of gastrointestinal (GI) bleeding in the general population is about one percent; for those age 60 and older, it's three to four percent; and for those with a history of GI bleeding, it's about nine percent.

• If you need medication to control your pain, you may wish to start with acetaminophen, which is milder on most people's digestive systems.
• If prescription-grade relief is necessary, you may be better off with opioids like codeine and morphine, low-dose corticosteroid therapy, or antidepressants or anticonvulsants, depending on the type of pain you're experiencing.
• One caveat: If your doctor prescribes narcotic pain relievers, make sure you take the smallest possible dose. Older people tend to be more sensitive to the effects of these drugs, getting stronger and longer pain relief on much smaller doses than younger individuals.

Explaining your discomfort and finding a safe medication can be difficult but it's not impossible! Remember the nonverbal ways to explain your pain and keep these safer remedies in mind.