How is chronic pain treated in patients with sickle cell disease (SCD)?

Updated: May 12, 2021
  • Author: Joseph E Maakaron, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Chronic pain is managed with long-acting oral morphine preparations, acetaminophen, and NSAIDs. NSAIDs are particularly effective in reducing bone pain.

Many patients may require breakthrough oral opiates as well. The weak opiates (eg,codeine and hydrocodone) are commonly used first. Sustained-release long-acting oral morphine is reserved for more severe cases. Hydromorphone may also be used but is considerably more expensive than morphine. Meperidine is not recommended for pain treatment because of CNS toxicity related to its metabolite, normeperidone.


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