Chronic pain
Osteoarthritis-associated pain management in patients with comorbidities

Diana (59 years old)

Diana is a 59-years-old physics professor who has been struggling with low back pain for 10 years.

In her medical record, the following is noted:

  • Former smoker (15 pack years)
  • No alcohol consumption
  • BMI: 32
  • Hypertension (treated with olmesartan 20 mg 1/day)
  • Lumbar facet joint OA with intervertebral disc degeneration (treated with paracetamol 1 g, as needed)

She presents to your clinic with worsening and continuous low back pain (VAS: 7/10). Paracetamol insufficiently alleviates the pain, leaving her unable to resume daily activities.

She feels increasingly frustrated about the pain, so she asks for help.

In addition to dietary support, which of the following options would you choose for this patient?