Treatment of chronic pain in osteoarthritis: do opioids have a clinical role?
Pain is the most prominent symptom and clinical finding in osteoarthritis (OA). Acetaminophen and nonsteroidal anti-inflammatory drug (NSAID) therapy are the mainstays of OA analgesia, but other drug and non-drug therapy, joint injections, and surgery may be needed to provide reasonable quality of life. Regularly scheduled, low-dose opioids can produce good relief of chronic nonmalignant pain including pain caused by OA. This paper reviews the potential risks and benefits of opioids, the evidence supporting their use in OA pain, and guidelines for their use in OA pain.
Lipman
A G
AG
College of Pharmacy and University Hospitals and Clinics Pain Management Center, University of Utah Health Sciences Center, 30 South 2000 East, RM 258, Salt Lake City, UT 84112-5820, USA. alipman@pharm.utah.edu
D000082:Acetaminophen / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D006801:Humans; D009293:Opioid-Related Disorders; D010003:Osteoarthritis / Q000188:drug therapy* / Q000503:physiopathology; D010146:Pain / Q000503:physiopathology / Q000523:psychology; D010166:Palliative Care
D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen