Pain management of sickle cell disease

Management of sickle cell disease continues to be primarily palliative, including supportive, symptomatic, and preventive approaches to therapy. There are three major types of sickle cell pain: acute, chronic, and neuropathic pain. The acute painful episode is the insignia of the disease and the most common cause of hospitalization. Its management entails the use of nonpharmacologic and pharmacologic modalities. Pain management should follow certain principles that include an assessment stage, treatment stage, reassessment stage, and adjustment stage. Chronic sickle cell pain may be due to certain complications of the disease, such as leg ulcers and avascular necrosis; intractable chronic pain may be due to central sensitization. Management of chronic pain should take a multidisciplinary approach.