Non-analgesic effects of opioids: the interaction of opioids with bone and joints.

Opioid consumption is associated with a wide range of side effects. Potential interference of opioids with bone and joint activity has emerged in the last few years. Opioids increase the risk of fracture, especially in elderly patients. Moreover, opioids interfere with the endocrine system, and their chronic use is a recognized risk factor for osteoporosis. Pathogenetic mechanisms at the basis of the interference of opioids with bones and joints are analysed in this review.