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Arthritis Pain Guidelines Issued

Mike Mitka
JAMA. 2002;287(16):2067. doi:10.1001/jama.287.16.2067.
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New clinical guidelines for the treatment of arthritis pain were released in March by the American Pain Society.

Guideline for the Management of Pain in Osteoarthritis, Rheumatoid Arthritis and Juvenile Chronic Arthritis is the first multidisciplinary, evidence-based clinical guideline treating arthritis pain.

Among the recommendations are:

  • All treatment for arthritis should begin with a comprehensive assessment of pain and function.

  • For mild-to-moderate pain, acetaminophen is the choice because of its mild adverse effects, over-the-counter availability, and low cost.

  • For moderate-to-severe pain from both osteoarthritis and rheumatoid arthritis, cyclooxygenase 2 (COX-2) nonsteroidal anti-inflammatory drugs (NSAIDs) are the medications of choice. Use of nonselective NSAIDs should be considered only if a patient is nonresponsive to acetaminophen and COX-2 drugs and is not at risk for NSAID-induced gastrointestinal adverse effects.

  • Opioid medications, such as oxycodone and morphine, are recommended for treating severe pain for which COX-2 drugs and nonspecific NSAIDs don't provide substantial relief.

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