He'd follow the account with a pained expression (5)
I believe the answer is:
ached
'pained expression' is the definition.
'ached' can be an answer for 'pained' (I've seen this in another clue). I am unsure of the 'expression' bit.
'he'd follow the account' is the wordplay.
'follow' is a charade indicator (letters next to each other).
'the account' becomes 'ac' (abbreviation for account).
'hed' after 'ac' is 'ACHED'.
'with a' acts as a link.
Can you help me to learn more?
(Other definitions for ached that I've seen before include "Yearned" , "Felt a dull pain" , "caused discomfort" , "Hurt" , "suffered" .)