Osteoarthritis (OA) affects approximately 21 million individuals in the United States and is the leading cause of disability. While OA can affect individuals at any age, 70% of individuals older than the age of 70 have evidence of the condition, and OA is considered to be the most prevalent form of arthritis.¹

Possible Causes of Osteoarthritis

There are a variety of causes of OA; examples include²:

• Age: Incidence increases with age
• Obesity: Weight gain increases the stress on an individual's joints
• Injury or overuse: Risk increases in athletes or individuals whose jobs require repetitive motions that can put stress on or injure the joint area
• Genetics: Ongoing research suggests that certain genes may be associated with developing OA. Some individuals have an inherited defect in one of the genes that make cartilage.
• Other medical conditions or other types of arthritis: Individuals with rheumatoid arthritis have a greater probability of developing OA. Individuals who have a history of gout are also at a greater risk.

Treating Osteoarthritis

The goals of treating OA include relief of pain, improving the mobility of joints, and improving the patient's quality of life by minimizing the effects of the condition. Treatment of OA depends on the severity of the condition and may include the use of pharmacological agents, physical therapy, and surgery, if needed. Nonprescription analgesics such as nonsteroidal anti-inflammatory drugs or acetaminophen are typically used for this condition to treat mild-to-moderate pain (Tables 1 and 2). In addition to the use of these agents, other therapies include the use of topical analgesic products (Table 3), low impact exercise, weight loss, physical therapy, and heat and cold therapy.

Alternative Therapies

Results from a study published in the February 23, 2006, issue of The New England Journal of Medicine demonstrated that a combination of supplements such as glucosamine and chondroitin sulfate seem to offer significant pain relief for patients with moderate-to-severe arthritis of the knee³ (Table 4). Individuals with preexisting medical conditions or those on other medications should always check with their health care provider before taking any of these agents.

The Role of the Pharmacist

Before recommending any nonprescription analgesic products, pharmacists should assess the appropriateness of therapy by evaluating the patient's current medical history, current drug profile as well as allergy history and screen for drug-drug interactions and possible contraindications associated with the use of these products. Patients should always be counseled on the proper use of these agents and should be encouraged to seek further evaluation from their primary health care provider when warranted. In addition, pharmacists can make recommendations about nonpharmacologic measures that patients affected by OA can incorporate into their treatment regimen.

Ms. Terrie is a clinical pharmacy writer based in Haymarket, Va.

References

1. Osteoarthritis. American College of Rheumatology Web site. Available at: www.rheumatology.org/public/factsheets/index.asp?aud=pat.

2. Osteoarthritis. Arthritis Foundation Web site. Available at: www.arthritis.org.

3. Glucosamine, Chondroitin Sulfate, and the Two in Combination for Painful Knee Osteoarthritis. New England Journal of Medicine Web site. Available at: http://content.nejm.org/cgi/content/abstract/354/8/795.