Treatment of chronic osteomuscular pain

Objective. To describe the prevalence of use of the 3 analgesic steps of the WHO in patients with chronic osteomuscular pain at 2 primary care centres, by means of personal interviews during the second semester of 2003 and first of 2004. Design. Cross-sectional, observational, descriptive study. Setting. Health centres of Puerto de Sagunto (Valencia) and Alto Palancia (Castellon), Spain. Participants. Three-hundred and twenty users of the above centres with chronic osteomuscular pain. Method. Systematic random sampling of the patients. Data collected from clinical histories and personal interviews. Results. Thirty-eight percent (38.7%) of the patients did not take medication to control pain or did so at insufficient doses; 54.7% used drugs of the first step of the WHO; and 6.6%, of the second. There were no patients in treatment with strong opioids, Significant differences at the time of prescribing the different analgesic treatments existed, depending on sex, educational background and patients' job. The characteristics of chronic pain (aetiology and duration of symptoms) also affected the therapy decision. There was a tendency to prescribe more analgesic as pain intensified. Conclusions. There is a high percentage of the population without any treatment for chronic osteomuscular pain. Opioid analgesics are under-used to treat pain.