Osteoporosis pain management in Italy

Abstract

Purpose: The aim of the authors was to investigate physicians’ practical approach to pain in patients with osteoporosis. Methods: A questionnaire prepared by a board of Italian experts was administered to members of scientific societies involved in the management of osteoporosis. Results: Chronic pain was more frequent in individuals with osteoporosis than in the general population (approximately 50% vs 26-28%). The pain experienced by patients with osteoporosis is localized to the main sites of fractures. The respondents’ answers suggest that some fragility fractures go undiagnosed. The use of objective tools for assessing pain was found to be very frequent among anesthesiologists and geriatricians, and rare in the other specialization groups. Acute or recurrent pain is often treated with NSAIDs, but several other options are also chosen. Conclusions: The answers indicate low adherence to the national regulation on pain management (Italian law 38/2010), and inadequate evaluation of patients’ clinical conditions. The therapeutic choices reported reveal a very inconsistent clinical behavior and suggest a lack of confidence with shared recommendations. KEY WORDS: Osteoporosis, pain, fragility fracture, pain scales.