[Opioids in rheumatology]

Pain and disability are the main common characteristics of rheumatic diseases. Chronic pain must be evaluated like disease per se and there is need to be systematically diagnosed and treated. Intensity of pain could be measured with verbal, numeric and visual analog scale. There are three therapeutic approaches according to WHO analgesic ladder. Opioid treatment is indicated after nonopioid analgesics fail. Development of addiction and tolerance are infrequent and dose escalation related to worsening of disease. Special caution is needed in elderly and previous narcotic consumers.