Paliatívna medicína a liečba bolesti 3/2008

Pain management in osteoarthrosis

Authors in their overview article deal with osteoarthrosis (OA) as one of the most frequent diseases viewed from the point of both the algesiologist and orthopedist. Nevertheless, the substantial part of the article is dedicated to the possibilities of the disease treatment that regularly accompanies the OA and is its most unpleasant feature. In the first part the authors are concerned with the OA ethiology, its phases of development as well as with possibilities of the OA diagnosis and treatment that is divided into conservative (both pharmacological and non-pharmacological) and surgical. Second part of the article is focused on both patophysiologic and clinical characteristics of pain in the OA, mainly related to weight-carrying joint; on possibilities of pain pharmacotherapy according to the analgetics scale using non-opoid analgetics, weak and strong opioids and several groups of adjuvancies. Also, attention is paid to the issues of administering non-steroid analgetics including COX-2 inhibitors as well as opioids when taken by patients suffering from non-cancer disease other than cancer-related disease. The authors also mention both anesthesiological and neuromodulational techniques as well as non-pharmacological procedures in pain treatment accompanying the OA.

Keywords: treatment of osteoarthrosis, non-opioid and opioid analgetics, non-pharmacological treatment.