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Minerva Ortopedica e Traumatologica 2020 March;71(1):23-31

DOI: 10.23736/S0394-3410.19.03955-9

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Management of musculoskeletal pain in the setting of territorial orthopedics

Sergio GIGLIOTTI 1 , Giuseppe SANTÈ 1, Giacomo PUTAGGIO 2, Luigi DI BISCEGLIE 3, Giovanni GRIMALDI 4, Franco GENTILE 5, Giuseppe SIRIANNI 6

1 ASL Napoli 1 Centro, Naples, Italy; 2 ASL Torino 3, Turin, Italy; 3 Department of Rehabilitation, Universe Health Opera Don Uva Bisceglie, Bari, Italy; 4 ASL Salerno, Salerno, Italy; 5 ASL Roma 5, Rome, Italy; 6 A.S.P of Crotone and Cosenza, Day Surgery Service of Orthopedics, San Giovanni in Fiore Civil Hospital, Cosenza, Italy



The correct management of the symptoms in patients suffering from musculoskeletal pain plays a key role in improving the quality of life. Acute pain or exacerbations in these patients may represent a functionally limiting symptom, the consequences of which should not be underestimated, not only for its impact on the patient’s quality of life but also for the risk of chronic pain. For an optimal control of musculoskeletal pain, a team of experts, orthopedic surgeons of the S.S.N., recommends a multimodal analgesic approach, which results in some pain relief and improved patient compliance to the prescribed treatment, minimisation of the doses of single components and consequently reduction in the adverse effects, mitigating the risk profile of each drug. In choosing the pharmacological association, it is suggested to adopt analgesics with different mechanisms of action. Paracetamol is the analgesic to be considered as a first choice for the treatment of mild to moderate acute pain and is preferred for long-term therapy, but if combined with ibuprofen allows reduce the dosages of both, with a drastic reduction in side effects related to NSAIDs. This combination has all the aforementioned advantages, guaranteeing the highest probability of pharmacological success in the management of mild to moderate pain present in some very common pathological situations such as post-traumatic sports and non-inflammatory inflammations, the exacerbation of chronic pain, the post-operative course of minor surgery and post-immobilization rehabilitation.


KEY WORDS: Musculoskeletal pain; Analgesics; Pharmacology

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