Analgesic Effects of Antiosteoporotic Drugs

STUDY DESIGN: Literature review. OBJECTIVES: To propose possible mechanisms of osteoporotic back pain and its management with antiosteoporotic drugs. SUMMARY OF LITERATURE REVIEW: No general conclusion has yet been reached regarding whether osteoporosis without fractures can cause pain. Instead, only treatments for back pain without osteoporotic spine fractures have been reviewed in the previous literature. Although key studies of antiosteoporotic drugs have not investigated their analgesic efficacy, plausible mechanisms have been suggested. MATERIALS AND METHODS: The analgesic effects of antiosteoporotic agents available in Korea were reviewed. RESULTS: Rather than the long-term use of conventional analgesics or narcotics, antiosteoporotic drugs would be more beneficial because they can enhance bone strength and have fewer side effects. Both anabolic and antiresorptive agents available in Korea have been proven to have an analgesic effect against osteoporotic back pain, with or without fractures. Anabolic agents depend on skeletal effects. Among antiresorptive agents, bisphosphonates have both skeletal and extraskeletal mechanisms for analgesia. Calcitonin and selective estrogen receptor modulators mostly depend on extraskeletal effects. The order of analgesic strength for osteoporotic back pain is teriparatide > bisphosphonate > calcitonin. This implies that the analgesic effect of antiosteoporotic drugs primarily depends on their skeletal effects rather than on their extraskeletal effects. Moreover, because non-fracture osteoporotic pain has been recognized only in the spine, where fractures can occur without a sensible injury, pain may arise from undiscovered spine fractures. CONCLUSIONS: Antiosteoporotic drugs ameliorate osteoporotic back pain. Their analgesic strength is proportional to their fracture prevention efficacy.

Effectiveness of exclusive salcatonin and combining salcatonin and Xianling Gubao in treatment of osteoporotic pain patients:a control study / 中国生化药物杂志

Objective To research and compare the effectiveness distinction between applying exclusive salcatonin and combining salcatonin and Xianling Gubao to treat osteoporotic pain patients.Methods 84 cases of osteoporotic pain patients in our hospital from Feb.2013 to Feb.2014 were selected and divided into two groups.Patients in treatment group were received combination of salcatonin and Xianling Gubao treatment.Patients in control group received salcatonin treatment only.To apply VAS judge the pain degree of patients.The clinical performance and results were observed and recorded.The degree of satisfaction of patients was surveyed through questionnaire.Results The VAS of patients in treatment group was (2.17 ±1.02), while it was (4.26 ±1.37)in control group.There were 15 cases of excellent,and 23 cases of efficacious in treatment group and the total effective rate was 90.48%.There were 10 cases of excellent,and 19 cases of efficacious in control group and the total effective rate was 60.95%.The degree of satisfaction of patients in treatment group was 95.24%,while it was 71.43% in control group.Conclusion Combining salcatonin and Xianling Gubao has better clinical effect than applying exclusive salcatonin in treatment of patients with osteoporotic pain.The combination of them could quicken the speed of recovery and increase the degree of satisfaction of patients.

Evaluation and analysis of efficacy of pulsed electromagnetic field stimulation for relief of osteoporosis induced pain / 国际生物医学工程杂志

Objective The aim of this study was to observe the outcome and evaluate the clinical efficacy of pulsed electromagnetic fields (PEMF) on pain management in patients with osteoporosis.MethodsA total of 58 patients with osteoporosis were treated with PEMF stimulation.Pains as main indicators of their symptom were evaluated before and after treatments.The clinical outcomes were assessed by observing the visual analogue scale (VAS).Statistical analysis was carried out to support the data.Results After PEMF treatment,the patients exhibited significant pain relief from mean VAS of 6.97±1.83 to 3.36±1.69(t-test,P＜0.05 ).Of the 58 patients,28 obtained significant symptom alleviation and 18 obtained moderate symptom alleviation,while 8 obtained slight alleviation,indicating the total clinical efficacy of 93%(54/58).Conclusion The current study provides the clinical outcomes indicating that PEMF may help to release the pain from primary osteoporosis and it might be an applicable supplementary treatment method for the osteoporosis related pain.