Management of chronic musculoskeletal pain in the Elderly: Opinions on oral medication use

Kean, Walter F.; Rainsford, K. D.; Kean, Iain

doi:10.1007/s10787-008-1623-7

Cited by 49 publications

(66 citation statements)

References 148 publications

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“…The most commonly prescribed drugs were systemic and/or local NSAIDs. It has been established that NSAIDs are useful in chronic musculoskeletal pain, but the incidence of musculoskeletal disorders increases with age, and this is in parallel with the increased risk of adverse effects to the NSAIDs (16,17). Moreover, our findings indicate that pharmacological interventions for multiple musculoskeletal diseases make a remarkable contribution to the polypharmacy in elderly.…”

Section: Discussionmentioning

confidence: 61%

Osteoporozu Olan Yaşlı Hastalarda Kas İskelet Sistemi Ağrısı: Çok Merkezli Bir Çalışma

...

2012

tftr

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Objective: The aim of this study was to identify the ones with osteoporosis (OP) in elderly patients presenting with musculoskeletal complaints and to evaluate the distribution of region of pain and the medications used for the musculoskeletal disease(s) in these patients. Materials and Methods: 1141 elderly patients who were consecutively admitted to the outpatient clinics in nine different provinces were screened for the diagnosis of OP. Age, gender, complaints, diagnosis and current medications related to musculoskeletal system disorder(s) were recorded. Results: 382 elderly (341 female, 41 male) with a mean age of 71.9±5.3 years had the diagnosis of OP. Low (54.5%) and upper back (39.6%) pain were the most common complaints in both sexes. These were followed by knee, hip, cervical and shoulder pain, respectively. Osteoarthritis (36%), lumbar (21%) and cervical spondylosis/stenosis (10%) were the most common musculoskeletal diseases accompanying OP. The mean number of drugs used was 3.0±1.2. The most commonly Özet Amaç: Çalışmanın amacı kas iskelet sistemi (KİS) yakınması ile başvuran yaşlı hastalar içerisinden osteoporozu (OP) olanları belirlemek, bu hastaların ağrıyan bölgelerinin dağılımını ve KİS hastalıklarına yönelik kullandıkları ilaçları değerlendirmektir. Gereç ve Yöntem: Dokuz farklı şehirdeki polikliniklere ardı sıra başvuran 1141 hasta OP tanısına yönelik olarak tarandı. Hastaların yaşları, cinsiyetleri, kas iskelet sistemine dair başvuru yakınmaları, tanıları ve ilaç kullanımları kaydedildi. Bulgular: Yaş ortalaması 71,9±5,3 yıl olan 382 hastanın (341 kadın, 41 erkek) OP tanısı mevcuttu. Her iki cinste de hastaların en sık başvuru yakınmaları bel (%54,5) ve sırt ağrısı (%39,6) olarak belirlendi. Bunları sırasıyla diz, kalça, boyun ve omuz ağrısı takip ediyordu. OP'ye en sık eşlik eden tanılar arasında osteoartrit (%36), lomber spondiloz/stenoz (%21) ve servikal spondiloz/stenoz (%10) ilk sıralarda yer alıyordu. Hastaların kullanmakta olduğu ortalama ilaç sayısı 3±1,2 idi. OP tedavisine yönelik Original Article / Orijinal MakaleYeşim GÖKÇE KUTSAL, Oya ÖZDEMİR*, Sevilay KARAHAN**, Yeşim AKYOL***, Pınar BORMAN****, Asuman DOĞAN*****, Sibel EYİGÖR******, Rengin GÜZEL*******, Özgür ORTANCIL********, Serpil SAVAŞ*********, Kazım ŞENEL**********, Ayşe Dicle TURHANOĞLU***********, İlker YAĞCI************

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Section: Discussionmentioning

confidence: 61%

Osteoporozu Olan Yaşlı Hastalarda Kas İskelet Sistemi Ağrısı: Çok Merkezli Bir Çalışma

...

2012

tftr

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“…APAP is usually the first choice because it is relatively safe for older people. It was reported that APAP treatment reduced pain behaviors associated with musculoskeletal pain in persons with dementia in community-dwelling [45,46]. Dosing of APAP should be limited to avoid liver toxicity, and topical analgesics are preferred for focal pain.…”

Section: Nonopioidsmentioning

confidence: 99%

“…According to the 2009 guidelines for pharmacologic management of persistent pain in older persons published by the AGS, NSAIDs should be used only with extreme caution in highly selected individuals once other safer therapies have failed. Absolute contraindications for NSAIDs use in older adults are chronic kidney disease, heart failure, and active peptic ulcer disease [16,46,49].…”

Section: Nonopioidsmentioning

confidence: 99%

“…For patients who may not be able to take oral preparations periodically, opioids are available as parenteral, sublingual (buprenorphine hydrochloride), suppository (oxymorphone hydrochloride), and transdermal (eg, fentanyl patch) products. Long-acting opioids should seldom be initiated in opioid-naive older patients [7,46]. Patient-controlled analgesia (PCA), whether using oral or parenteral agents, can be most beneficial in a cognitively intact population, with the likelihood of the best pain control in conjunction with the least amount of opioid needed to control musculoskeletal pain [4].…”

Section: Opioidsmentioning

confidence: 99%

“…Finally, older adults with CMP taking opioid analgesics should be reassessed for ongoing attainment of therapeutic goals, adverse effects, and safe and responsible medication use [46].…”

Section: Opioidsmentioning

confidence: 99%

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Management of Chronic Musculoskeletal Pain in the Elderly: Dilemmas and Remedies

Edeer¹,

Tuna²

2012

Pain in Perspective

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Pain in Perspective 94percent of community dwelling adults aged 60 years or above have been found to experience pain and this number increases to 45-80% in the nursing home population with analgesics being used in 40% to 50% of residents [1,[13][14][15][16][17][18][19]. Brown et al report higher percentage and state that more than 90% of the elderly living in the community experienced pain within the past month [6]. Given the prevalence of chronic pain, its impact on health, and its costs, which approach $100 billion annually, chronic pain represents a major public health issue [20].While the existence of acute pain remains approximately the same across the adult life span, there is an age-related increase in the prevalence of chronic pain at least until the seventh decade of life [13,15]. Approximately 57% of older adults report experiencing pain for 1 or more years compared with less than 45% of younger people. Furthermore, long-term care data indicate that over 40% of patients, who were known to have pain at an initial assessment, had worsening or severe pain at the time of the second assessment 2-6 months later [21]. Chronic musculoskeletal painChronic musculoskeletal pain (CMP) is the most common, non-malignant disabling condition that affects at least one in four older people [22,23]. The most musculoskeletal pain in the joints of the upper and lower extremities, especially hips, knees, and hands, is associated with the degenerative changes of osteoarthritis. Older adults may also develop tendonitis and bursitis, as well as inflammatory joint and muscle disease [24]. The most common painful musculoskeletal conditions among older adults are osteoarthritis, low back pain, fibromyalgia, chronic shoulder pain, knee pain, myofascial pain syndrome and previous fracture sites [7,23,25].It is reported that the most common causes of pain identified in nursing home patients included arthritis and previous fractures. Arthritis alone affects well over 20 million Americans with an increase to 40 million expected by 2020. Twenty-nine percent of Medicare patients in nursing homes with a fracture in the prior 6 months suffer with daily pain [13]. Also surgical procedures are more frequently performed on older people. In the Medicare population in the United States for example, rates of total joint replacement surgery for patients with severe hip or knee osteoarthritis are more than doubled between 1988 and 1997. Over the same time period, rates of spine surgery in Medicare patients increased by 57% [23]. Chronic low back pain (CLBP) is one of the most common, poorly understood, and potentially disabling chronic pain condition s i n o l d e r a d u l t s [ 2 6 ] . M a n y o l d e r a d u l t s r e m a i n q u i t e functional despite CLBP, and because age-related co-morbidities often exist independently of pain, the unique impact of CLBP is unknown [27]. The Framingham Study (1992-1993 reported 63% of women pain in one or more regions, compared to 52% of men. Widespread CMP was more prevalent among women than men (15 versu...

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Viscosupplementation for knee osteoarthritis

Zychowicz

2014

Journal of the American Association of Nurse Practitioners

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Purpose To provide an overview of the diagnosis and pathophysiology of osteoarthritis (OA), and to describe appropriate treatments for knee OA, with a focus on the efficacy and safety of viscosupplementation. Because nurse practitioners (NPs) can inject viscosupplements, a section on injection technique is included. Data sources Manuscripts were identified using PubMed and EMBASE with a review of the reference lists from retrieved articles. Conclusions Viscosupplements are safe and effective at improving function and alleviating knee pain from OA for up to 26 weeks. Implications for practice As the number of patients with OA is increasing, NPs need to be prepared to prescribe various treatment options to alleviate osteoarthritic knee pain, including viscosupplementation.

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Management of chronic musculoskeletal pain in the Elderly: Opinions on oral medication use

Cited by 49 publications

References 148 publications

Osteoporozu Olan Yaşlı Hastalarda Kas İskelet Sistemi Ağrısı: Çok Merkezli Bir Çalışma

Osteoporozu Olan Yaşlı Hastalarda Kas İskelet Sistemi Ağrısı: Çok Merkezli Bir Çalışma

Management of Chronic Musculoskeletal Pain in the Elderly: Dilemmas and Remedies

Viscosupplementation for knee osteoarthritis

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