There are effective osteoporotic treatments to decrease the risk of further fractures, as well as the risk of developing acute or chronic pain or its intensity. Reducing the loss of bone mass, adequately treating clinical symptoms, and preventing osteoporotic fractures are the major therapeutic targets.
Though many treatment modalities are available, reducing pain is much more important and represents a key response in the framework of biopsychosocial model of chronic pain in osteoporosis patients. Prerequisite is that chronic pain should obtain the same level of importance and care as the disease that caused it. To overwhelm the difficulties associated with the management of chronic pain, the physician must efficiently adapt treatment, through a personalization of the pain treatment after evaluating each individual’s pain history and assessing the consequences of pain to the patient.
The most common used therapeutic strategy in the treatment of chronic pain is based on a three-ladder approach, involving the use of opioids for moderate and severe pain. Among the most commonly prescribed drugs in the world, the non-steroidal anti-inflammatory drugs (NSAIDs) are usable to all steps of the pain ladder.
Seventy percent of the elderly patients and nearly 20% of hospitalized patients are treated with NSAIDs. As proposed by the World Health Organization (WHO), according to the intensity of chronic pain, analgesic treatment can be established. The first-line approach for the treatment of mild musculoskeletal pain is represented by use of NSAIDs or acetaminophen with possibility of using adjuvants.