Why Pain is Undertreated in Nigeria – MD, Superior Pharmaceuticals


Pharm. Ike Okeke is the managing director and chief executive officer of Superior Pharmaceuticals Limited, a private indigenous pharmaceutical distribution company founded in 2011 and specialising in importation and distribution of pharmaceutical and personal hygiene products. In this exclusive interview with Pharmanews at his office in Lagos, Okeke, who is also president of Superior Medical Clinics, in Florida, USA, discusses the factors responsible for rising cases of pain, arthritis and rheumatism in the Nigeria, as well as ways to prevent and manage the conditions. EXCERPTS:

How would you describe pain caused by arthritis and rheumatism?

Pain is the number one reason people seek medical attention. Pain can be acute or chronic in nature. It can be a result of nerve damage, spine abnormalities, joint degeneration, organ damage or just pain due to the aging process.

Pain is undertreated in Nigeria. Stronger pain medications that can alleviate the agonising pain arising from cancer is hard to come by. We need access.

Arthritis is, by far, one of the chronic diseases of aging and affects men and women over the age of 50 years. Osteoarthritis is the commonest form of arthritis and the single most important risk factor for knee replacement in the elderly.

Pharm. Ike Okeke

Arthritis is undertreated, with many sufferers being disabled and unable to walk in later years of life. Novel treatments, like viscosupplementation, are unavailable and the cost of partial knee replacement is beyond the realm of most Nigerians.

What causes rheumatism and arthritis? 

Rheumatoid arthritis is an auto immune disease whereby the body attacks itself. An example is lupus, whereby the body makes antibodies that attack the joints and organs in the body. It is thought to be hereditary.

Environmental factors and processed food are implicated in rheumatism. Osteoarthritis on the other hand is a result of wear and tear of the joints, overuse of the joints, lack of Vitamin D, insufficient dietary calcium or disease of the bone.

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How can these conditions be avoided?

Rheumatoid arthritis is mostly genetic and thereby hereditary. It can be triggered by processed food and environmental factors, like food and water contaminants in our environment.

The overuse and inhalation of anti-mosquito aerosols, like Sheltox can be a trigger for auto immune disorders, including rheumatoid arthritis. Avoiding such toxic products, polluted and contaminated water and processed food can prevent rheumatoid arthritis.

On the other hand, osteoarthritis is wear and tear. If you live long enough, you will get a degree of osteoarthritis. Your lifestyle will dictate the degree of osteoarthritis. Athletes are more prone to osteoarthritis in later life due to the degree of stress that is put on their joints during their active years. For similar reasons, blue collar workers and artisans are more prone to joint degeneration in later years in life.

What is the remedy/cure to pain, rheumatism and arthritis?

While there is no cure for rheumatism and arthritis, arthritis can be managed and controlled. Among the remedies for arthritis are diet and exercise, physical therapy, Paracetamol Supergesic and a combination of anti-inflammatory (diclofenac), Paracetamol and muscle relaxant.

Injectables, like Panache (Ketorolac injection); steroid injections to the knee or joints,  like  Depo Medrol and Lidocaine, Viscosupplementation, using Hyaluronic acid derivatives; narcotics, like Hydromorphone, morphine or oxycodone; partial knee replacement surgery and total knee replacement surgery.

Do analgesics have side-effects on a patient?

Analgesics have side-effects, depending on the class of analgesics used. A common side-effect will range from nausea and vomiting to kidney damage and ulcers, with the non-steroidals; to constipation and addiction, with narcotics.

These side effects can however be managed. As with any medication, there are risks but the rule of thumb is that the benefits must outweigh the risks.