New Clinical Guideline for Arthritis Pain

Published Online: Wednesday, May 1, 2002

The American Pain Society (APS), the leading US professional organization devoted to pain management, recently released the first evidence-based, multidisciplinary guideline for treating acute and chronic arthritis pain.

The full text of the APS guideline is available at www.ampainsoc.org/pub/ arthritis.htm. It strongly emphasizes that arthritis pain is best treated through a combination of ongoing pain assessment, medication, proper nutrition, exercise, and patient and family education.
Recommendations:

? For mild-to-moderate pain?acet-aminophen is the drug of choice because of its mild side effects, wide availability, and low cost.
? For moderate-to-severe pain?cyclooxygenase-2 (COX-2) non-steroidal anti-inflammatory drugs (NSAIDs), such as Celebrex and Vioxx, are the drugs of choice for their pain-relieving potency and absence of gastrointestinal (GI) side effects.
? If the patient fails to respond to acetaminophen and COX-2 drugs, nonselective NSAIDs should be considered, but only if the patient is not at risk for NSAID-induced GI side effects.
? For severe arthritis pain for which COX-2 drugs and nonspecific NSAIDs do not provide substantial relief, opioid medications, such as oxycodone and morphine, are recommended



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