Abstract
Pain and stiffness at night and in the early morning play a major part in the suffering caused by the chronic rheumatic disorders, and other painful musculoskeletal disorders. Emotional factors may aggravate night pain. The more useful measures for the alleviation of nocturnal distress may be listed as follows: ( a) Local factors: mattress, pillows, local supports, and lambskin. ( b) Sensory "filters": earplugs, eyeshields, antacids. ( c) Anti-inflammatory agents: indomethacin, corticosteroids, phenylbutazone, oxyphenbutazone, aspirin. ( d) Analgesic drugs: paracetamol, codeine, dihydrocodeine, dextrapropoxyphene, pentazocine. ( e) Potentially addictive drugs: pethidine, dipipanone, diamorphine. ( f) Antidepressants: imipramine, trimipramine. ( g) Hypnotics, sedatives and tranquillisers: barbiturates, diazepam. In the individual patient pain at night must be noted and appropriate therapy prescribed. Research into analgesic and anti-inflammatory agents should provide information on their duration of action and suitability for use in the relief of night pain.
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