Analgesia: a wide range of measures

Edito of 11/01/2013

All symptomatic treatments of osteoarthritis aim to relieve pain. Reactions to the various measures, which vary according to each patient, lead to being able to personalise the treatment.

Irrespective of the site of the osteoarthritis, pain is the main symptom of the disease. It is this that leads to seeking medical advice, in particular with elderly patients in whom osteoarthritis is the leading cause of pain.

It is usual to distinguish between drug and non-drug treatment measures. And subdivide drug treatments into oral and topical treatments.

The two analgesics most commonly administered orally are paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs). It is advisable to prescribe short courses of them and for NSAIDs, take into account the benefit/risk ratio on a digestive and cardiovascular level.
In long term treatments, symptomatic slow-acting drugs (SYSADOA) hold a special place. However, to "get through a difficult episode" an intra-articular corticosteroid injection is indicated.

In treating the pain of osteoarthritis, the role of non-drug measures is as great as that of drugs. The choice is personal and takes into account the situation (and wishes) of the patient.
Physical activity, technical aids, orthotics, physical exercises planned by the physiotherapist and "articular economy" advice without forgetting the surgery involved in pain relief.

The effectiveness of these measures is only optimal if the patient has understood the principles and interest in them. This is the role of therapeutic patient education.

References
- Richette P.Management of osteoarthritis: oral therapies. Rev Prat. 2012 May;62(5):654-60.

Arthrolink Editorial Committee