The perception of pain

Most people experience occasional musculoskeletal pain, which is pain in the muscles, joints, ligaments, and tendons. For instance, you may get sore muscles or achy joints after exercising or doing yard work. The pain usually goes away after you rest or take an over-the-counter pain medication.

But when is pain a sign of trouble?

"Not all pain is the same, and it should never be ignored if it begins to affect your daily life," says Dr. Mohammed Issa, medical director of the pain management center at Harvard-affiliated Brigham and Women's Hospital. "While some temporary pain is normal, it's never normal to live with pain."

Pain in the brain

Research has found that older adults who develop more sarcopenia (age-related muscle loss) have a higher risk for musculoskeletal pain. (Muscle mass tends to decrease about 3% to 5% each decade after age 30.) Older adults also are more likely to experience musculoskeletal pain from dealing with the general wear and tear of aging as well as health conditions that can cause pain.

But people also become more sensitive to pain as they age. "Pain receptors in the brain change, so we feel pain more often and at a higher level," says Dr. Issa. Still, many older adults feel they can live with pain and adjust their lifestyle to accommodate it. "They also don't want to appear complaining, so they keep their pain to themselves," says Dr. Issa. "Eventually, this makes their pain feel worse than it needs to be and makes it harder for them to cope."

Acute or chronic?

One way to determine if your musculoskeletal pain is a cause for concern is to identify whether it's acute (short-term) or chronic (long-lasting).

Acute. Most acute pain comes from damage to body tissues caused by physical trauma, such as a sport or exercise injury, or a household accident, like a bruising fall, or bumping into something. The pain might feel sharp, aching, or throbbing, and it often heals within a few days to a few weeks. Acute pain from these types of injuries should diminish with a combination of rest, home remedies, and over-the-counter pain medication.

Chronic. Chronic pain lasts longer than acute pain. It can be related to ongoing tissue injuries, persistent inflammation, or irritated nerves. Symptoms may include a dull ache, shooting, burning, stabbing, or electric shock–like pain and sensations like tingling and numbness. Chronic pain lasts at least two or three months, often long after you have recovered from any injury or illness that precipitated it, and may even become permanent.

Addressing the pain

Most acute musculoskeletal pain from injuries can be treated with home remedies. Dr. Issa recommends beginning with what's known as the RICE regimen — rest, ice, compression, elevation. This includes resting the body, applying cold to the sore area, wearing an elastic wrap to compress the painful area, and elevating the sore area, like propping up your leg on pillows.

Many people find relief with over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) and naproxen (Aleve). To avoid side effects, take the lowest effective dose for the shortest period. People who have kidney disease, have had a peptic ulcer, or take blood thinners should not take NSAIDs unless directed by their doctor.

Another option is acetaminophen (Tylenol). High doses of acetaminophen can damage the liver, so it's important not to take more than 3,000 milligrams per 24-hour period. Many pain relievers contain acetaminophen without highlighting it on the packaging, so be sure to read all the details on the labels.

The bottom line is that you should never ignore ongoing pain. Take the appropriate action to treat acute pain to help prevent it from becoming chronic. "Any pain that lingers, even if partially relieved with medication, needs medical evaluation," says Dr. Issa. "Pain is your body telling you something is wrong."

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