Priority 6 from the Bleeding Disorder PSP

UNCERTAINTY: What are the most effective treatments for acute and chronic pain in people with haemophilia? (JLA PSP Priority 6)
Overall ranking	6
JLA question ID	0078/6
Explanatory note	People with haemophilia experience pain on many occasions in their life. This can be from injecting their treatment, having a joint bleed or when a joint has had many bleeds, and a painful arthritis develops. The pain from this arthritis is there every day and can stay for many years – this is called chronic pain. Due to lack of treatment in their youth, many adults with severe haemophilia have chronically painful, multi-joint pain in the elbows, knees and ankles. Often people find it painful to do even day to day things like walk or go to work. In studies where people with haemophilia have been asked if they have chronic pain, 50% say that they do. Between 35-50% report that current treatments they have tried for chronic musculoskeletal pain are not very effective and this has significant debilitating personal and healthcare resource impacts.
Evidence	Schafer, G. S., et al. (2016). "Physical exercise, pain and musculoskeletal function in patients with haemophilia: a systematic review." Haemophilia 22(3): e119-129. https://dx.doi.org/10.1111/hae.12909
Health Research Classification System category	Blood

Extra information provided by this PSP
Original uncertainty examples	Is brufen a useful addition in the sub acute treatment of a joint bleed in children in the prevention of synovitis pain and mobility after bleeds ~ What is the most effective treatment for pain due to chronic haemophilia arthropathy?
Submitted by	Not available

PSP information
PSP unique ID	0078
PSP name	Bleeding Disorders
Total number of uncertainties identified by this PSP.	66 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	7 July 2018