PHARMACOLOGICAL MANAGEMENT OF MUSCULOSKELETAL PAIN: CLINICAL EVALUATION OF DRUG EFFICACY AND SAFETY

Abstract

Musculoskeletal pain has been a top cause of disability in the global population and it is also a significant clinical and socioeconomic burden. Pharmacological treatment continues to play a leading role in the management of symptoms, but rising data suggest that analgesic effects are weak most of the time and thus need to be weighed against significant safety concerns. It is a comprehensive review of existing evidence on the effectiveness and adverse-effect profile of key drug classes in the treatment of osteoarthritis, low back pain, and musculoskeletal issues associated with them. NSAIDs show a regular analgesic effect in the short term with a tendency to show an inflammatory phenotype, although they necessitate cautious cardiovascular, renal, and gastrointestinal risk evaluation. The limited benefit of acetaminophen is only adjunctive. The use of centrally acting agents like duloxetine can enhance the results in a selected patient with the characteristics of central sensitization. Routine opioid use cannot be supported in acute spinal pain, and long-term opioid treatment is also linked to major harm. Topical and intra-articular therapy provide local relief of symptoms with relatively desirable systemic safety issues. Overall, successful pharmacological treatment entails the need to undertake individual risk stratification, realistic treatment objectives, and combine with non-pharmacological measures to streamline the patient-centred outcome and reduce preventable adverse events.