Introduction: People with
hemophilia (PWH) commonly experience acute and chronic
musculoskeletal pain during childhood and young adulthood, but their treatment is often inadequate.Areas covered: From 1 September 2020 to 15 April 2021, authors performed a literature search in PubMed and the Cochrane Library using '
hemophilia AND
pain' as keywords. Authors found 1082 articles, 51 of which were chosen because we considered them to be intimately connected with the topic of this report. Multimodal
pain treatment, including multimodal
analgesia, physical and rehabilitation medicine (PRM), and psychological
therapies (imagery or relaxation,
hypnosis), is currently the most recommended treatment for PWH. In acute
hemarthrosis, in addition to hematologic treatment and joint aspiration,
paracetamol/
acetaminophen should be prescribed if the
pain is mild,
metamizole if the
pain is moderate, and soft
opioids (
codeine or
tramadol) if the
pain is severe. In cases of chronic
musculoskeletal pain due to hemophilic
arthropathy,
paracetamol/
acetaminophen,
COX-2 inhibitors, PRM,
intra-articular injections of some drugs (
corticosteroids,
hyaluronic acid, platelet-rich plasma, mesenchymal stem cells), radiosynovectomy and behavioral
therapies are advised.Expert opinion: Management of
musculoskeletal pain in children and young adults with
hemophilia should employ multimodal
pain treatment (multimodal analgesia, PRM, and psychological strategies).