Reference : Understanding osteoporotic pain and its pharmacological treatment: supplementary pres...
Scientific journals : Article
Human health sciences : General & internal medicine
Understanding osteoporotic pain and its pharmacological treatment: supplementary presentation
Vellucci, R [> >]
Terenzi, R [> >]
Kanis, J.A. [> >]
Kress, H.G. [> >]
Mediati, R.D. [> >]
Reginster, Jean-Yves mailto [Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé >]
Rizzoli, R [> >]
Brandi, M.L. [> >]
Osteoporosis International
Yes (verified by ORBi)
[en] analgesic treatment ; chronic pain ; opioids ; osteoporotic fracture pain ; osteoporotic pain mechanism ; osteoporotic pain treatment
[en] Osteoporosis, a disorder that affects millions of people worldwide, is characterized by decreased bone mass and microstructural alterations giving rise to an increased risk of fractures. Osteoporotic fractures can cause acute and chronic nociceptive and neuropathic pain that mainly affects elderly patients with multiple comorbidities and commonly on different drug regimens.
Central sensitization seems to play a pivotal role in developing and maintaining chronicity of post-fracture pain in osteoporosis. Antiosteoporosis drugs are able to partially control pain, but additional analgesics are always necessary for pain due to bone fractures. Nonsteroidal anti-inflammatory drugs (NSAIDs) and selective COX-2 inhibitors reduce acute pain but with a poor effect on the chronic neuropathic component of pain and with relevant side effects. Opioid drugs
can control the whole spectrum of acute and chronic bone pain, but they differ with respect to their efficacy on neuropathic components, their tolerability and safety. Chronic pain after osteoporotic fractures requires a multifaceted approach, which includes a large spectrum of drugs (antiosteoporosis treatment, acetaminophen, NSAIDs, selective COX-2 inhibitors, weak
and strong opioids) and non-pharmacological treatment. Based on a better understanding of the pathogenesis of osteoporotic and post-fracture pain, a guided stepwise approach to post-fracture osteoporotic pain will also better meet the needs of these patients.

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