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<p>Pain management in rheumatic diseases rests on two main pillars: reducing inflammation and providing analgesia. The first pillar is inflammation control, mainly through disease-modifying anti-rheumatic drugs (DMARDs), which slow disease progression and reduce inflammation but have side effects requiring limited use. Glucocorticoids are the strongest anti-inflammatory drugs, but should only be used for limited periods due to their side effects. The second pillar is symptom-focused pain relief, following the World Health Organization (WHO) pain ladder: nonsteroidal anti-inflammatory drugs (NSAIDs) are first-line therapy, providing pain-relief and reducing inflammation.</p><p>Opioids (WHO step 2 and 3) are sometimes necessary for severe, persistent pain despite inflammation control. The potential for dependency warrants caution and must be taken seriously, but this should not lead to refusal of these drugs, especially since strict medical supervision, accurate risk stratification, intensive patient education and integration into a&#xa0;multimodal concept significantly increase treatment safety.</p><p>Multimodal pain therapy, combining medications, physiotherapy, occupational therapy and psychological support is the gold standard. This holistic approach addresses physical, psychological and social factors underlying chronic pain, aiming to improve quality of life, functionality and enable patients to lead active, fulfilling lives despite ongoing symptoms. Rheumatic pain therapy today is an individualized, comprehensive treatment concept that goes beyond mere medication administration.</p>

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Schmerz lass nach – Schmerztherapie bei rheumatischen Erkrankungen

  • 期刊论文

  • 发表日期：

    2026年1月26日

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  • Thomas Ettenauer

摘要

Pain management in rheumatic diseases rests on two main pillars: reducing inflammation and providing analgesia. The first pillar is inflammation control, mainly through disease-modifying anti-rheumatic drugs (DMARDs), which slow disease progression and reduce inflammation but have side effects requiring limited use. Glucocorticoids are the strongest anti-inflammatory drugs, but should only be used for limited periods due to their side effects. The second pillar is symptom-focused pain relief, following the World Health Organization (WHO) pain ladder: nonsteroidal anti-inflammatory drugs (NSAIDs) are first-line therapy, providing pain-relief and reducing inflammation.

Opioids (WHO step 2 and 3) are sometimes necessary for severe, persistent pain despite inflammation control. The potential for dependency warrants caution and must be taken seriously, but this should not lead to refusal of these drugs, especially since strict medical supervision, accurate risk stratification, intensive patient education and integration into a multimodal concept significantly increase treatment safety.

Multimodal pain therapy, combining medications, physiotherapy, occupational therapy and psychological support is the gold standard. This holistic approach addresses physical, psychological and social factors underlying chronic pain, aiming to improve quality of life, functionality and enable patients to lead active, fulfilling lives despite ongoing symptoms. Rheumatic pain therapy today is an individualized, comprehensive treatment concept that goes beyond mere medication administration.