An update on chronic pain management in osteoporosis
Osteoporosis (OP) is a condition that weakens bones, making them fragile and more likely to break. Osteoporosis-related fractures most commonly occur in the hip, wrist or spine. OP can manifest clinically as pain, fractures, and physical disability, resulting in the loss of independence and the need for long-term care.
Chronic pain is a major issue in osteoporosis. The frequency of chronic pain usually rises with age, affecting 41% persons aged 65–75 years, 48% aged 75–84 years, and 55% aged >85 years. The treatment and its evaluation of chronic pain in OP patients needs a holistic approach which concentrates on the specific characteristics of this population, assessing their comorbidities, mental status, functional status and independence in carrying out daily activities.
Management of pain must include pharmacological approaches, physiotherapy interventions, and in rare cases, surgical treatment. The pharmacological treatment for chronic pain in patients with OP is bisphosphonates, particularly alendronate, followed by denosumab, strontium ranelate, and teriparatide. However, exercises based rehabilitation treatments helps to manage these symptoms quickly without any adverse effects or complications.
This review discussed the most appropriate solutions in the management of chronic pain in OP, considering the recent scientific evidence on pharmacological and nonpharmacological therapies and surgical treatment. Despite the development of guidelines on the diagnosis and treatment of OP, the management of chronic pain in these patients remains complicated.