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Management of chronic pain in osteoporosis: challenges and solutions

Authors Paolucci T, Saraceni V, Piccinini G

Received 30 November 2015

Accepted for publication 2 February 2016

Published 1 April 2016 Volume 2016:9 Pages 177—186

DOI https://doi.org/10.2147/JPR.S83574

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 3

Editor who approved publication: Dr Michael E Schatman


Teresa Paolucci,* Vincenzo Maria Saraceni, Giulia Piccinini*

Physical Medicine and Rehabilitation Unit, Azienda Policlinico Umberto I, Rome, Italy

*These authors contributed equally to this work

Abstract: Osteoporosis (OP) is a pathological condition that manifests clinically as pain, fractures, and physical disability, resulting in the loss of independence and the need for long-term care. Chronic pain is a multidimensional experience with sensory, affective, and cognitive aspects. Age can affect each of these dimensions and the pain that is experienced. In OP, chronic pain appears to have sensory characteristics and properties of nociceptive and neuropathic pain. Its evaluation and treatment thus require a holistic approach that focuses on the specific characteristics of this population. Pain management must therefore include pharmacological approaches, physiotherapy interventions, educational measures, and, in rare cases, surgical treatment. Most rehabilitative treatments in the management of patients with OP do not evaluate pain or physical function, and there is no consensus on the effects of rehabilitation therapy on back pain or quality of life in women with OP. Pharmacological treatment of pain in patients with OP is usually insufficient. The management of chronic pain in patients with OP is complicated with regard to its diagnosis, the search for reversible secondary causes, the efficacy and duration of oral bisphosphonates, and the function of calcium and vitamin D. The aim of this review is to discuss the most appropriate solutions in the management of chronic pain in OP.

Keywords:
physical therapy, exercise, pharmacological treatment, posture and balance

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