[EVALUATION OF PAIN AND LOCAL PHARMACOLOGICAL PAIN TREATMENT IN RHEUMATOLOGY].

Abstract

The objective of this review is to present outcome measurement tools for chronic musculoskeletal pain in rheumatology patients and to provide an overview of local pharmacological pain treatment. Reliable and valid assessment of pain is fundamental for both clinical trials and effective pain management. The complex nature of pain makes objective measurement impossible. Evaluation of chronic musculoskeletal pain and its impact on physical, emotional, and social functions requires multidimensional qualitative tools and health-related quality of life instruments. The main recommendation concerning outcome measurements of pain is that they should include an evaluation of pain, fatigue, disturbed sleep, physical functioning, emotional functioning, and patient global ratings of satisfaction and quality of life. Despite the growing field of new instruments and publications related to measuring the various aspects of chronic pain, there is still little agreement on the topic among researchers and clinical experts and no unified approach has been adopted. There is still considerable need for the development of a core set of measurement tools and response criteria regarding chronic pain management. It is well known that pain in articular joints and soft tissues of the musculoskeletal system represents the most common symptom presenting to rheumatologists. Therefore, local pharmacological pain tretment has an important role in rheumatology treatment algorithms. Topical administration, as well as injection administration in joints and soft tissue trigger points, can be done under the control of musculoskeletal ultrasound. The most frequently prescribed drugs include NSARs and corticosteroids, with their effectiveness being well-proven in evidence-based practice.