Joint pain and osteoarthritis: Management
Managing joint pain and osteoarthritis
Joint pain can impinge on all areas of a person’s life, particularly in older individuals.
Together with education, a range of pharmacological and non-pharmacological techniques is available to help manage pain and flare-ups1,2 and help keep patients moving.
Guideline recommendations for treating joint pain and osteoarthritis
Guidelines recommend a stepped approach to management2,4–6
Management of osteoarthritis may require a combination of non-pharmacological and pharmacological modalities.2,6
Guidelines recommend a stepwise strategy for the pharmacological management of osteoarthritis.2,4–6
More than one pain treatment might be needed
Additional support might be needed to cover pain flares
Chronic joint pain is often accompanied by acute inflammatory flares.7
During this flare-up pain, patients may require additional short-term pain relief.7
Patient education around disease progression and management issues is helpful to encourage proactive self-management.2,5,8–11
Guidance from NICE for the holistic management of patients with osteoarthritis includes:12
- Weight management for patients who are overweight or obese
- Exercise to include local muscle strengthening and general aerobic fitness
- Adaptations to the home and workplace
Patient support groups specifically for patients with osteoarthritis can provide practical and emotional advice and support, enabling patients to cope with their condition, feel more positive and live life more fully on a daily basis.13,14
Exercise is a key part of maintaining healthy joints and should be a core recommendation as part of the holistic management of osteoarthritis.15 It builds stamina, strengthens muscles that support the joint, and helps to reduce fatigue.16 It can also help patients to maintain a healthy weight, which reduces the burden on weight-bearing joints.16
However, the type and amount of exercise must be tailored to each individual patient's capabilities and needs; putting excess strain on a joint or doing too much exercise can worsen symptoms.16 Contact sports are not advisable, but swimming, cycling and low-resistance strengthening exercises may be appropriate.16
Physical therapy is used in osteoarthritis management approaches and includes strengthening and aerobic exercises, supports and orthotics and heat/cold therapy.5,6,8–11,12
TENS is recommended for knee and hip osteoarthritis.4–6,16
Topical NSAIDs are a first line treatment option for patients with osteoarthritis.
According to NICE guidance, topical NSAIDs are the first line treatment for pain relief for people with knee or hand osteoarthritis in addition to core treatments.12
Topical NSAIDs and/or paracetamol should be considered as first line treatment options for patients with osteoarthritis, ahead of oral NSAIDs, COX-inhibitors or opioids.12
Rubefacients should not be offered for treating osteoarthritis.12
Surgical interventions for severe joint pain and osteoarthritis include partial or total joint replacements.2,5,6,8,9
How can Nora and Wendy be helped?
Nick, 70, wakes with pain and stiffness each morning, but does not want this to control his life or his choices.
He already receives multiple oral medications and is concerned that adding more will increase his risk of side effects.
Nick tries to stay active by gardening and going for walks but this can sometimes be a struggle.
He wants sustained relief from his pain so that he can do the things he enjoys such as playing with his grandchildren.
Voltarol Max Strength Pain Relief 2.32% Gel provides clinically proven joint pain relief in a convenient, twice-daily application, without the worry associated with drug-drug interactions.
Wendy has experienced intermittent knee pain for 5 years. The pain disrupts her sleep and limits her previously active lifestyle and social life making her feel anxious and depressed.
Her doctor recommended weight loss and exercise as a remedy. But chronic pain creates a lack of motivation and she feels her pain prevents her from exercising.
Voltarol Osteoarthritis Joint Pain Relief 1.16% Gel is as effective as oral ibuprofen with a reduced risk of systemic side effects.13
Understanding joint pain and osteoarthritis
Helping pharmacy teams manage joint pain effectively
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