[Systematic review: are major opioids effective in the treatment of musculoskeletal pain?].
OBJECTIVE
To evaluate the efficacy of major opioids in the treatment of musculoskeletal pain.


METHODS
Systematic review. A sensitive search strategy was undertaken in MEDLINE and EMBASE up to April 2005. The Cochrane Library and the abstracts of the 2004-2005 meetings of the American College of Rheumatology were also hand searched. All randomized controlled trials of major opiods in patients with musculoskeletal pain were selected. An analytical review was performed and evidence tables produced. A meta-analysis was run when appropriate.


RESULTS
We obtained 427 references from the search, (27 duplicated from MEDLINE and EMBASE, 2 from the Cochrane Library, and 5 abstracts), of which 68 articles plus one meeting abstract were selected for detailed analysis. Of these, 23 finally met the inclusion criteria. Combined analysis of oral major opioids versus placebo showed significant improvement in pain relief in patients with osteoarthritis.


CONCLUSIONS
Specific major opioids can reduce pain in patients with chronic musculoskeletal disorders. The clinical trials report positive effects on pain and the meta-analysis confirms these effects.
Abásolo
Lydia
L
Servicio de Reumatología, Hospital Clínico San Carlos, Madrid, España. lydia.abasolo@ser.es
Carmona
Loreto
L
D000701:Analgesics, Opioid / Q000627:therapeutic use*; D006801:Humans; D009140:Musculoskeletal Diseases / Q000150:complications / Q000188:drug therapy*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D000701:Analgesics, Opioid