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Control of non‐malignant chronic pain conditions in Japan and the possible future role of tramadol
Author(s) -
Itoh Tatsuo
Publication year - 2001
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1053/eujp.2001.0287
Subject(s) - medicine , tramadol , osteoarthritis , chronic pain , analgesic , rheumatism , pain ladder , diclofenac , adverse effect , anesthesia , opioid , surgery , physical therapy , alternative medicine , receptor , pathology
Pharmacological treatment is the most common treatment for non‐malignant chronic pain diseases such as lumbar and/or cervical spondylosis and osteoarthritis of the knee or hip joint. In Japan, opioid analgesics cannot be used for non‐malignant chronic pain syndromes because of the strict regulations for opioid use by the Ministry of Health and Welfare. Non‐steroidal anti‐inflammatory drugs (NSAIDs) do not have sufficient effect as analgesics for some painful conditions as well as having possible serious side‐effects on the gastrointestinal tract and kidneys. According to the Japanese Rheumatism Foundation report on NSAID‐induced gastrointestinal lesions in 1991, gastric ulcers were found in 15.5% of 1008 patients who underwent endoscopic examinations. In multicentric questionnaire research, it was discovered that 63% received NSAIDs for longer than 3 months. New drugs having stronger effects for chronic pain and less severe adverse side‐effects are expected within the decade. Tramadol hydrochloride controlled‐release is a long‐ and centrally‐acting analgesic without serious side‐effects for which we are currently going on to the phase II trial in collaborative studies between Japan and the United States for non‐malignant chronic pain diseases.