Review of medicines for relieving pain in sickle cell disease

Some people with sickle cell disease get pain. The pain usually occurs in episodes but it can be chronic. Pain is often poorly managed. This review studied different types of pain-relieving medicines. There were no studies on chronic pain. Seven papers were found on pain episodes treated with anti-inflammatories, morphine and related medicines, and steroids. No papers could be found on other pain-relieving medicines, such as paracetamol (acetaminophen), in people with sickle cell disease. The trials had small numbers of patients and the results could not be compared together. There was some evidence that anti-inflammatory medicines given by injection can reduce pain. One study in children demonstrated that morphine given by mouth was as effective as morphine by injection. Side-effects were no different between the two groups. Steroids may shorten a pain episode and reduce the need for pain-relieving medicines. The long-term effects of this treatment have not been studied. Further studies are needed, especially for chronic pain in sickle cell disease.