loxetine in the management of chronic musculoskeletal pain Review (1962) Total Article Views Authors: Smith HS, Smith EJ, Smith BR Published Date June 2012 Volume 2012:8 Pages 267 - 277 DOI: http://dx.doi.org/10.2147/TCRM.S17428 Received: 14 February 2012 Accepted: 03 March 2012 Published: 19 June 2012 Howard S Smith,1 Eric J Smith,2 Benjamin R Smith2 1Department of Anesthesiology, Albany Medical College, Albany, NY; 2The Pharmaceutical Research Institute, Albany College of Pharmacy and Health Sciences, Rensselaer, NY, USA Abstract: Chronic musculoskeletal pain is among the most frequent painful complaints that healthcare providers address. The bulk of these complaints are chronic low back pain and chronic osteoarthritis. Osteoarthritis is the most common form of arthritis in the United States. It is a chronic degenerative disorder characterized by a loss of cartilage, and occurs most often in older persons. The management of osteoarthritis and chronic low back pain may involve both nonpharmacologic (eg, weight loss, resistive and aerobic exercise, patient education, cognitive behavioral therapy) and pharmacologic approaches. Older adults with severe osteoarthritis pain are more likely to take analgesics than those with less severe pain. The pharmacologic approaches to painful osteoarthritis remain controversial, but may include topical as well as oral nonsteroidal antiinflammatory drugs, acetaminophen, duloxetine, and opioids. The role of duloxetine for musculoskeletal conditions is still evolving.