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Health Agencies Update
March 28, 2012

Pain Management

JAMA. 2012;307(12):1243. doi:10.1001/jama.2012.335

An updated review of the comparative effectiveness and safety of analgesics found no clear answer about which option provides the best pain relief and has the fewest adverse effects for patients with osteoarthritis. The review was conducted by the Agency for Healthcare Research and Quality, which also reviewed the effects of the supplements glucosamine and chondroitin and topical products for this condition.

The review provides an update to a 2006 report and includes studies published from 2005 to 2011 (http://tinyurl.com/6twtovb). Opioid pain medications were excluded from the review. However, the review noted there are different trade-offs between benefits and adverse effects for specific selective and nonselective nonaspirin nonsteroidal anti-inflammatory medications, aspirin, salsalate, and acetaminophen. The report provides charts and other tools to help physicians weigh these options. In light of the many factors involved in choosing a pain management option for patients with osteoarthritis, the review's authors emphasize the importance of discussing the options with the patient and have drafted a version geared specifically for patients.