[Opioids in musculoskeletal pain]

Abstract

Opioids are the most potent analgesics available and are well established for the treatment of severe acute, surgical and cancer pain. Due to their high effectiveness, their use in chronic non-cancer pain (CNCP) is being propagated. However, the use of opioids is still controversial due to their side effects, such as tolerance, addiction or withdrawal, and administrative difficulties associated with their prescription. Chronic rheumatic diseases, in particular low back pain and arthritis, are the leading causes of CNCP. The present article provides a brief overview of the role of opioids in chronic rheumatic diseases, pointing out that a national guideline for opioid use in CNCP is expected at the end of 2008. Furthermore, the peripheral effects of opioids on pain and inflammation in rheumatic diseases will be outlined.