[Analgesics use in patients with chronic musculoskeletal complaints]

Chronic musculoskeletal complaints are common in the clinical setting and a therapeutic challenge. Little is known about the extent and type of pain-relieving drugs used by these patients in Norway.

500 patients were referred for specialist evaluation because of chronic musculoskeletal pain, most of them from the National Insurance Administration. The diagnoses were grouped into four main categories. 95% of the patients had non-specific myofascial pain syndromes and about 5% had some form of osteoarthritis. In the majority the pain was chronic. All patients were asked which pain-relieving drugs they had taken during the previous week, prescribed drugs as well as over-the-counter drugs. Those taking non-steroidal anti-inflammatory drugs (NSAIDs) were also asked if these had been prescribed under the National Health Insurance scheme.

40% had completely abstained from analgesics. 32% had taken an NSAID; 20% a codeine-paracetamol compound; 15% paracetamol; 8% muscle-relaxants, while 26 patients had taken some other type of medication. About two thirds of the patients reported having received reimbursable NSAID-prescriptions, of which only about 9% were judged to qualify for this.

Even though a substantial number of patients had not taken pain-relieving drugs during the previous week, the number of patients having taken either NSAIDs, opioids or muscle relaxants was relatively high, both with regard to actual or potential side effects and to existing recommendations. The study also suggests that stricter application of the rules for reimbursement of drugs seems justified.