EULAR recommendations for the health professional’s approach to pain management in inflammatory arthritis and osteoarthritis

Paskins

Abstract

Pain is the predominant symptom for people with inflammatory arthritis (IA) and osteoarthritis (OA) mandating the development of evidence-based recommendations for the health professional’s approach to pain management. A multidisciplinary task force including professionals and patient representatives conducted a systematic literature review of systematic reviews to evaluate evidence regarding effects on pain of multiple treatment modalities. Overarching principles and recommendations regarding assessment and pain treatment were specified on the basis of reviewed evidence and expert opinion. From 2914 review studies initially identified, 186 met inclusion criteria. The task force emphasized the importance for the health professional to adopt a patient-centered framework within a biopsychosocial perspective, to have sufficient knowledge of IA and OA pathogenesis, and to be able to differentiate localized and generalized pain. Treatment is guided by scientific evidence and the assessment of patient needs, preferences and priorities; pain characteristics; previous and ongoing pain treatments; inflammation and joint damage; and psychological and other pain-related factors. Pain treatment options typically include education complemented by physical activity and exercise, orthotics, psychological and social interventions, sleep hygiene education, weight management, pharmacological and joint-specific treatment options, or interdisciplinary pain management. Effects on pain were most uniformly positive for physical activity and exercise interventions, and for psychological interventions. Effects on pain for educational interventions, orthotics, weight management, and multidisciplinary treatment were shown for particular disease groups. Underpinned by available systematic reviews and meta-analyses, these recommendations enable health professionals to provide knowledgeable pain management support for people with IA and OA.

Citation

Paskins. (2018). EULAR recommendations for the health professional’s approach to pain management in inflammatory arthritis and osteoarthritis. Annals of the Rheumatic Diseases, 797-807. https://doi.org/10.1136/annrheumdis-2017-212662

• Acceptance Date: Mar 28, 2018
• Publication Date: May 3, 2018
• Journal: Annals of the Rheumatic Diseases
• Print ISSN: 0003-4967
• Publisher: BMJ Publishing Group
• Pages: 797-807
• DOI: https://doi.org/10.1136/annrheumdis-2017-212662
• Keywords: arthritis, osteoarthritis, pain, pain management
• Publisher URL: https://doi.org/10.1136/annrheumdis-2017-212662