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

Rinie Geenen, Cécile L Overman, Robin Christensen, Pernilla Åsenlöf, Susana Capela, Karen L Huisinga, Mai Elin P Husebø, Albère J A Köke, Zoe Paskins, Irene A Pitsillidou, Carine Savel, Judith Austin, Afton L Hassett, Guy Severijns, Michaela Stoffer-Marx, Johan W S Vlaeyen, César Fernández-de-Las-Peñas, Sarah J Ryan, Stefan Bergman

Research output: Contribution to journalArticleAcademicpeer-review

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 emphasised the importance for the health professional to adopt a patient-centred framework within a biopsychosocial perspective, to have sufficient knowledge of IA and OA pathogenesis, and to be able to differentiate localised and generalised 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.

Original languageEnglish
Pages (from-to)797–807
Number of pages11
JournalAnnals of the Rheumatic Diseases
Volume77
Issue number6
DOIs
Publication statusPublished - 2018

Keywords

  • Journal Article
  • RHEUMATOID-ARTHRITIS
  • RANDOMIZED CONTROLLED-TRIALS
  • osteoarthritis
  • OLDER-ADULTS
  • rheumatoid arthritis
  • spondyloarthritis
  • TASK-FORCE
  • DECISION-MAKING
  • patient perspective
  • CHRONIC MUSCULOSKELETAL PAIN
  • COGNITIVE-BEHAVIORAL THERAPY
  • psoriatic arthritis
  • KNEE OSTEOARTHRITIS
  • STANDING-COMMITTEE
  • CLINICAL-PRACTICE

Cite this

Geenen, R., Overman, C. L., Christensen, R., Åsenlöf, P., Capela, S., Huisinga, K. L., Husebø, M. E. P., Köke, A. J. A., Paskins, Z., Pitsillidou, I. A., Savel, C., Austin, J., Hassett, A. L., Severijns, G., Stoffer-Marx, M., Vlaeyen, J. W. S., Fernández-de-Las-Peñas, C., Ryan, S. J., & Bergman, S. (2018). EULAR recommendations for the health professional's approach to pain management in inflammatory arthritis and osteoarthritis. Annals of the Rheumatic Diseases, 77(6), 797–807. https://doi.org/10.1136/annrheumdis-2017-212662