Crossword Genius

He follows the account painfully (4)

Ross

I believe the answer is:

ache

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'he follows the account painfully' is the definition.
Although both the answer and definition are singular nouns, I can't see how they can define each other.

'he follows the account' is the wordplay.
'follows' says to put letters next to each other.
'the account' becomes 'ac' (abbreviation for account).
'he' put after 'ac' is 'ACHE'.

Can you help me to learn more?

(Other definitions for ache that I've seen before include "Cause pain" , "Long ? pain" , "Dull steady pain" , "A dull lingering pain" , "Similar" .)

I've seen this clue in The Globe and Mail.
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