[Influence of adjuvant pain medication on quality of life in the treatment of postmenopausal osteoporosis].
OBJECTIVE
Chronic pain is the main symptom of postmenopausal osteoporosis. This can decrease mobility and quality of life of the patients. The hypothesis of this study was that administration of an adjuvant pain medication is essential additionally to the basic therapy. The second question was if a recommendation can be formulated whether a peripheral or a central acting pain medication is more effective to prevent osteoporosis induced chronic pain.


METHODS
Three pseudorandomised patient groups were prospectively compared. Group 1 was treated with alendronate, vitamin D, and calcium. Group 2 also received ibuprofen, and group 3 also received tramadol. In 117 women suffering from postmenopausal osteoporosis, quality of life was measured before and 26 weeks after therapy using the International Osteoporosis Foundation Qualeffo-41 score, and pain intensity was measured using a visual analogue scale.


RESULTS
No therapy-associated complications were observed during the study. After 26 weeks, quality of life significantly increased in groups 2 and 3 compared with group 1 (p<0.001). Pain intensity decreased in group 1 by only 6 points, whereas it decreased in group 2 by 31 points and in group 3 by 24 points. Pain relief was significantly different between the treatment groups and the control group and between the treatment groups themselves (p<0.001 and p<0.01).


CONCLUSIONS
We conclude that pain therapy with an almost peripherally acting drug such as ibuprofen can reduce osteoporosis-associated chronic pain better than a centrally acting pain medication such as tramadol. It therefore can be recommended to prescribe ibuprofen rather than tramadol for treating osteoporosis-associated chronic pain in postmenopausal women if the specific risk for gastrointestinal side effects is considered.
Krocker
D
D
Klinik für Orthopädie, Centrum für Muskuloskeletale Chirurgie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin. Doerte.krocker@charite.de
Ullrich
H
H
Buttgereit
F
F
Perka
C
C
D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage; D000701:Analgesics, Opioid / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage*; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis* / Q000188:drug therapy*; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy*; D010147:Pain Measurement / Q000187:drug effects*; D011788:Quality of Life; D014147:Tramadol / Q000008:administration & dosage*; D016896:Treatment Outcome
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D014147:Tramadol; D007052:Ibuprofen