EULAR recommendations for the health professional's approach to pain management in inflammatory arthritis and osteoarthritis

Rinie Geenen*, Cécile L. Overman, Robin Christensen, Pernilla Åsenlöf, Susana Capela, Karen L. Huisinga, Mai Elin P. Husebø, Albère J.A. Köke, Zoe Paskins, Irene A. Pitsillidou, Carine Savel, Judith Austin, Afton L. Hassett, Guy Severijns, Michaela Stoffer-Marx, Johan W.S. Vlaeyen, César Fernández-De-Las-Peñas, Sarah J. Ryan, Stefan Bergman

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Pain is the predominant symptom for people with inflammatory arthritis (IA) and osteoarthritis (OA) mandating the development of evidence-based recommendations for the health professional's approach to pain management. A multidisciplinary task force including professionals and patient representatives conducted a systematic literature review of systematic reviews to evaluate evidence regarding effects on pain of multiple treatment modalities. Overarching principles and recommendations regarding assessment and pain treatment were specified on the basis of reviewed evidence and expert opinion. From 2914 review studies initially identified, 186 met inclusion criteria. The task force emphasised the importance for the health professional to adopt a patient-centred framework within a biopsychosocial perspective, to have sufficient knowledge of IA and OA pathogenesis, and to be able to differentiate localised and generalised pain. Treatment is guided by scientific evidence and the assessment of patient needs, preferences and priorities; pain characteristics; previous and ongoing pain treatments; inflammation and joint damage; and psychological and other pain-related factors. Pain treatment options typically include education complemented by physical activity and exercise, orthotics, psychological and social interventions, sleep hygiene education, weight management, pharmacological and joint-specific treatment options, or interdisciplinary pain management. Effects on pain were most uniformly positive for physical activity and exercise interventions, and for psychological interventions. Effects on pain for educational interventions, orthotics, weight management and multidisciplinary treatment were shown for particular disease groups. Underpinned by available systematic reviews and meta-analyses, these recommendations enable health professionals to provide knowledgeable pain-management support for people with IA and OA.

Original languageEnglish
JournalAnnals of the Rheumatic Diseases
Volume77
Issue number6
Pages (from-to)797-807
ISSN0003-4967
DOIs
Publication statusPublished - Jun 2018

Fingerprint

Pain Management
Health
Orthotics
Exercise
Education
Advisory Committees
Joints
Patient Advocacy
Weights and Measures
Needs Assessment
Patient Preference
Expert Testimony
Pain Measurement
Meta-Analysis

Keywords

  • osteoarthritis
  • patient perspective
  • psoriatic arthritis
  • rheumatoid arthritis
  • spondyloarthritis

Cite this

Geenen, Rinie ; Overman, Cécile L. ; Christensen, Robin ; Åsenlöf, Pernilla ; Capela, Susana ; Huisinga, Karen L. ; Husebø, Mai Elin P. ; Köke, Albère J.A. ; Paskins, Zoe ; Pitsillidou, Irene A. ; Savel, Carine ; Austin, Judith ; Hassett, Afton L. ; Severijns, Guy ; Stoffer-Marx, Michaela ; Vlaeyen, Johan W.S. ; Fernández-De-Las-Peñas, César ; Ryan, Sarah J. ; Bergman, Stefan. / EULAR recommendations for the health professional's approach to pain management in inflammatory arthritis and osteoarthritis. In: Annals of the Rheumatic Diseases. 2018 ; Vol. 77, No. 6. pp. 797-807.
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abstract = "Pain is the predominant symptom for people with inflammatory arthritis (IA) and osteoarthritis (OA) mandating the development of evidence-based recommendations for the health professional's approach to pain management. A multidisciplinary task force including professionals and patient representatives conducted a systematic literature review of systematic reviews to evaluate evidence regarding effects on pain of multiple treatment modalities. Overarching principles and recommendations regarding assessment and pain treatment were specified on the basis of reviewed evidence and expert opinion. From 2914 review studies initially identified, 186 met inclusion criteria. The task force emphasised the importance for the health professional to adopt a patient-centred framework within a biopsychosocial perspective, to have sufficient knowledge of IA and OA pathogenesis, and to be able to differentiate localised and generalised pain. Treatment is guided by scientific evidence and the assessment of patient needs, preferences and priorities; pain characteristics; previous and ongoing pain treatments; inflammation and joint damage; and psychological and other pain-related factors. Pain treatment options typically include education complemented by physical activity and exercise, orthotics, psychological and social interventions, sleep hygiene education, weight management, pharmacological and joint-specific treatment options, or interdisciplinary pain management. Effects on pain were most uniformly positive for physical activity and exercise interventions, and for psychological interventions. Effects on pain for educational interventions, orthotics, weight management and multidisciplinary treatment were shown for particular disease groups. Underpinned by available systematic reviews and meta-analyses, these recommendations enable health professionals to provide knowledgeable pain-management support for people with IA and OA.",
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author = "Rinie Geenen and Overman, {C{\'e}cile L.} and Robin Christensen and Pernilla {\AA}senl{\"o}f and Susana Capela and Huisinga, {Karen L.} and Huseb{\o}, {Mai Elin P.} and K{\"o}ke, {Alb{\`e}re J.A.} and Zoe Paskins and Pitsillidou, {Irene A.} and Carine Savel and Judith Austin and Hassett, {Afton L.} and Guy Severijns and Michaela Stoffer-Marx and Vlaeyen, {Johan W.S.} and C{\'e}sar Fern{\'a}ndez-De-Las-Pe{\~n}as and Ryan, {Sarah J.} and Stefan Bergman",
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Geenen, R, Overman, CL, Christensen, R, Åsenlöf, P, Capela, S, Huisinga, KL, Husebø, MEP, Köke, AJA, Paskins, Z, Pitsillidou, IA, Savel, C, Austin, J, Hassett, AL, Severijns, G, Stoffer-Marx, M, Vlaeyen, JWS, Fernández-De-Las-Peñas, C, Ryan, SJ & Bergman, S 2018, 'EULAR recommendations for the health professional's approach to pain management in inflammatory arthritis and osteoarthritis', Annals of the Rheumatic Diseases, vol. 77, no. 6, pp. 797-807. https://doi.org/10.1136/annrheumdis-2017-212662

EULAR recommendations for the health professional's approach to pain management in inflammatory arthritis and osteoarthritis. / Geenen, Rinie; Overman, Cécile L.; Christensen, Robin; Åsenlöf, Pernilla; Capela, Susana; Huisinga, Karen L.; Husebø, Mai Elin P.; Köke, Albère J.A.; Paskins, Zoe; Pitsillidou, Irene A.; Savel, Carine; Austin, Judith; Hassett, Afton L.; Severijns, Guy; Stoffer-Marx, Michaela; Vlaeyen, Johan W.S.; Fernández-De-Las-Peñas, César; Ryan, Sarah J.; Bergman, Stefan.

In: Annals of the Rheumatic Diseases, Vol. 77, No. 6, 06.2018, p. 797-807.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - EULAR recommendations for the health professional's approach to pain management in inflammatory arthritis and osteoarthritis

AU - Geenen, Rinie

AU - Overman, Cécile L.

AU - Christensen, Robin

AU - Åsenlöf, Pernilla

AU - Capela, Susana

AU - Huisinga, Karen L.

AU - Husebø, Mai Elin P.

AU - Köke, Albère J.A.

AU - Paskins, Zoe

AU - Pitsillidou, Irene A.

AU - Savel, Carine

AU - Austin, Judith

AU - Hassett, Afton L.

AU - Severijns, Guy

AU - Stoffer-Marx, Michaela

AU - Vlaeyen, Johan W.S.

AU - Fernández-De-Las-Peñas, César

AU - Ryan, Sarah J.

AU - Bergman, Stefan

PY - 2018/6

Y1 - 2018/6

N2 - Pain is the predominant symptom for people with inflammatory arthritis (IA) and osteoarthritis (OA) mandating the development of evidence-based recommendations for the health professional's approach to pain management. A multidisciplinary task force including professionals and patient representatives conducted a systematic literature review of systematic reviews to evaluate evidence regarding effects on pain of multiple treatment modalities. Overarching principles and recommendations regarding assessment and pain treatment were specified on the basis of reviewed evidence and expert opinion. From 2914 review studies initially identified, 186 met inclusion criteria. The task force emphasised the importance for the health professional to adopt a patient-centred framework within a biopsychosocial perspective, to have sufficient knowledge of IA and OA pathogenesis, and to be able to differentiate localised and generalised pain. Treatment is guided by scientific evidence and the assessment of patient needs, preferences and priorities; pain characteristics; previous and ongoing pain treatments; inflammation and joint damage; and psychological and other pain-related factors. Pain treatment options typically include education complemented by physical activity and exercise, orthotics, psychological and social interventions, sleep hygiene education, weight management, pharmacological and joint-specific treatment options, or interdisciplinary pain management. Effects on pain were most uniformly positive for physical activity and exercise interventions, and for psychological interventions. Effects on pain for educational interventions, orthotics, weight management and multidisciplinary treatment were shown for particular disease groups. Underpinned by available systematic reviews and meta-analyses, these recommendations enable health professionals to provide knowledgeable pain-management support for people with IA and OA.

AB - Pain is the predominant symptom for people with inflammatory arthritis (IA) and osteoarthritis (OA) mandating the development of evidence-based recommendations for the health professional's approach to pain management. A multidisciplinary task force including professionals and patient representatives conducted a systematic literature review of systematic reviews to evaluate evidence regarding effects on pain of multiple treatment modalities. Overarching principles and recommendations regarding assessment and pain treatment were specified on the basis of reviewed evidence and expert opinion. From 2914 review studies initially identified, 186 met inclusion criteria. The task force emphasised the importance for the health professional to adopt a patient-centred framework within a biopsychosocial perspective, to have sufficient knowledge of IA and OA pathogenesis, and to be able to differentiate localised and generalised pain. Treatment is guided by scientific evidence and the assessment of patient needs, preferences and priorities; pain characteristics; previous and ongoing pain treatments; inflammation and joint damage; and psychological and other pain-related factors. Pain treatment options typically include education complemented by physical activity and exercise, orthotics, psychological and social interventions, sleep hygiene education, weight management, pharmacological and joint-specific treatment options, or interdisciplinary pain management. Effects on pain were most uniformly positive for physical activity and exercise interventions, and for psychological interventions. Effects on pain for educational interventions, orthotics, weight management and multidisciplinary treatment were shown for particular disease groups. Underpinned by available systematic reviews and meta-analyses, these recommendations enable health professionals to provide knowledgeable pain-management support for people with IA and OA.

KW - osteoarthritis

KW - patient perspective

KW - psoriatic arthritis

KW - rheumatoid arthritis

KW - spondyloarthritis

U2 - 10.1136/annrheumdis-2017-212662

DO - 10.1136/annrheumdis-2017-212662

M3 - Journal article

VL - 77

SP - 797

EP - 807

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

SN - 0003-4967

IS - 6

ER -