Chronic pain
Osteoarthritis-associated pain management in patients with comorbidities

Morty (51 years old)

Morty is a 51-year-old stand-up comedian who is suffering from OA in the lower back area and in the right hip since several years. The pain, particularly in his hip, heavily hinders his work and gets worse towards the end of the day. Paracetamol (3 g/day) is insufficient for pain management, so Morty occasionally takes ibuprofen, which helps but causes heartburn.

In his medical record, the following is noted:

  • Injuries and traumas from rugby played in his youth
  • Hip X-ray: impingement of the superior-external coxo-femoral space
  • BMI: 30, waist circumference: 121 cm
  • Hypertension, managed with enalapril 20 mg + chlortalidone 25 mg/day
  • Lifestyle: frequent alcohol consumption, non-smoker, moderate physical activity

Which of the following options would you prescribe for this patient?