alexa Optimising pain control in osteoarthritis.
Bioinformatics & Systems Biology

Bioinformatics & Systems Biology

Journal of Phylogenetics & Evolutionary Biology

Author(s): Wenham CY, Conaghan PG

Abstract Share this page

Abstract A recent large survey showed that 81\% of people with osteoarthritis (OA) are in constant pain or are limited in their ability to perform everyday tasks. Patients present with joint pain and stiffness and are often unable to carry out their usual activities which impacts significantly on their quality of life. Anxiety and depression are common in patients with OA and will affect their mood and response to pain so identifying and treating associated anxiety and depression is very important. The PHQ9 and GAD7 can be used to screen for depression and anxiety. The OA process affects all structures within a joint, including the synovial lining and the subchondral bone. When sensitive MRI techniques are used synovitis is found to be almost ubiquitous in painful knee OA. When ultrasound is used, synovitis is seen in up to 45\% of patients with painful hand OA. Many current treatments for OA are thought to target the synovium e.g. NSAIDs and this may be why they are effective. Changes in the subchondral bone are also common on MRI and associated with pain. Paracetamol and topical NSAIDs should be tried before oral NSAIDs. Topical NSAIDs are effective in the short-term and are not associated with systemic toxicity. Oral NSAIDs should be used at the lowest effective dose for the shortest possible time. All oral NSAIDs and COX-2 drugs should be prescribed with a PPI. There is less trial data on opioids than on NSAIDs but there is evidence for their efficacy. Patients who have moderate to severe pain that is not responding to oral analgesics or anti-inflammatories may benefit from intra-articular corticosteroids. Timing of analgesia is important. Advise patients to use analgesia before they exercise, so adherence to exercise routines is maintained. Consider long-acting preparations so pain relief is at a maximum throughout the most symptomatic period of the day or night.
This article was published in Practitioner and referenced in Journal of Phylogenetics & Evolutionary Biology

Relevant Expert PPTs

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

[email protected]

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Material Sciences Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

[email protected]

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001 Extn: 9042

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords