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Section 4: treating the patient in pain.

Warren A Katz1, Russell Rothenberg

  • 1University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.

Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases
|December 17, 2005
PubMed
Summary

Managing painful rheumatic diseases involves diverse pharmacologic and nonpharmacologic strategies. Effective pain relief and functional improvement are key goals for osteoarthritis and rheumatoid arthritis patients.

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Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases·2005

Area of Science:

  • Rheumatology
  • Pain Management
  • Pharmacology

Background:

  • Rheumatic diseases, including osteoarthritis (OA) and rheumatoid arthritis (RA), significantly impact patients' quality of life.
  • Effective pain management and functional improvement are crucial therapeutic goals for these conditions.
  • Pharmacologic and nonpharmacologic interventions offer a range of treatment options.

Observation:

  • Osteoarthritis (OA) is the most prevalent form of arthritis necessitating pain management.
  • Disease-modifying antirheumatic drugs and biologic agents can improve RA disease states.
  • Once RA inflammation is controlled, treatment focuses on degenerative joint disease symptoms.

Findings:

  • Analgesics like acetaminophen and NSAIDs (including COX-2 inhibitors) should be used at lowest effective doses.

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  • Combination therapy (e.g., acetaminophen with opioids or tramadol) can enhance pain relief and duration.
  • Adjunctive therapies include topical analgesics, intra-articular agents, and various psychotropic medications.

    • Implications:

    • Nonpharmacologic approaches like exercise, physical therapy, and psychological counseling are vital.
    • Alternative therapies such as yoga, acupuncture, and massage may also provide pain relief and improve outcomes.
    • A multimodal approach integrating pharmacologic and nonpharmacologic strategies is essential for comprehensive rheumatic disease management.