The Management of Acute Pain for Musculoskeletal Conditions: The Challenges of Opioids and Opportunities for the Future

Abstract

Opioid use for chronic and acute musculoskeletal pain is common.Orthopaedic surgeons are frequent opioid prescribers.Opioids are commonly prescribed for acute pain, with high variation.Opioid alternatives for acute pain are effective, and the incorporation of multimodal pain management in the perioperative period can decrease opioid use.Although opioids are effective for the management of acute musculoskeletal pain, the morbidity and mortality related to opioid analgesics reinforce the need for robust, evidence-based guidelines.Providers should evaluate patient risk preoperatively, should prescribe judiciously with multimodal pain management plans, and should integrate a preoperative discussion on opioid usage.Future research should include procedure-specific pain management strategies, as well as the comparative efficacy of pharmacologic and nonpharmacologic methods of pain management.