Encourage Self-Care Measures for Prevention and Management of Osteoarthritis

Pain is one of the most common symptoms for which patients seek medical care and use OTC analgesics. Every day, millions of Americans deal with the challenges associated with osteoarthritis (OA), a chronic, progressive, degenerative joint disease that contributes to significant pain and disability. It can affect health-related quality of life and productivity depending on disease severity and affected joint(s).^1-3

The Arthritis Foundation notes that, historically, OA was characterized simply as a "wear and tear" condition of aging; however, OA is now recognized as a complex, whole-joint disease involving the cartilage, subchondral bone, synovium, ligaments, and periarticular soft tissues.² Research has demonstrated that disease progression is driven by the interplay of cartilage degradation, aberrant bone remodeling, and synovial inflammation, collectively resulting in the hallmark clinical features of continual or episodic pain, stiffness, swelling, tenderness, decreased range of motion, and progressive loss of mobility and function.² While OA can affect any joint, it most commonly impacts the fingers and hands, back, hips, knees, and ankles.^1-3

OA is the most common form of arthritis in the US, affecting approximately 32.5 to 33.2 million adults, with women and those aged 45 and older bearing a disproportionate share of the disease burden.^1-5 OA also affects an estimated 528 million individuals worldwide.⁵ OA is a leading cause of disability, reducing the ability to work in 66% of affected US patients and contributing to an estimated 180.9 million lost workdays annually.^1-5 Other projections indicate that more than 78 million Americans will be living with some degree of arthritis by 2040 due to the growing aging population and the ongoing obesity epidemic, with OA expected to remain the most prevalent type of arthritis.^1-5

Incidence of OA generally increases with age, particularly after age 50. Several well-established risk factors have been identified, including a family history of arthritis, postmenopausal women, overweight or obesity, repetitive joint use or injury related to occupational demands or athletic activity, and underlying musculoskeletal abnormalities.^1,2,6

The clinical presentation and severity of OA may vary considerably from patient to patient. Research consistently shows that OA-related symptoms can negatively impact health-related quality of life and daily productivity, cause varying degrees of pain and discomfort, disrupt sleep, and impair both work performance and social functioning.^1-3 Emerging evidence also suggests that severe pain, diminished physical functioning, the number of joints involved, and mobility limitations may contribute to elevated rates of depression, stress, and anxiety.⁷

Treatment, Management, and Prevention

In general, the primary objectives of OA management are to alleviate pain and maintain functional capacity through a patient-centered care plan integrating nonpharmacologic and pharmacologic therapies.⁸ Pharmacists can be instrumental in aiding patients in the appropriate selection of nonprescription products, evaluating the suitability of self-treatment, recognizing drug interactions and contraindications, and ensuring prompt referral to a primary care provider for diagnostic confirmation and the initiation of patient-centered interventions. These interventions aim to slow disease progression and optimize symptom management, with treatment planning informed by symptom type and severity, comorbidities, medication history, allergies, and patient preferences.

Nonprescription pharmacologic options for OA symptom management include both oral and topical analgesic formulations and should be individualized to each patient's needs and preferences.⁸ Factors that are often considered in treatment selection include route of administration, frequency of administration, costs, and potential adverse effects.

Oral nonprescription analgesics include acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), specifically ibuprofen, naproxen sodium, and aspirin. There are also joint health supplements containing glucosamine and chondroitin, which are widely marketed for joint health; however, current evidence supporting their efficacy remains mixed, and major clinical guidelines do not universally endorse their benefit.⁸

Topical nonprescription analgesics are available as gels, creams, lotions, ointments, sprays, and patches containing active ingredients such as menthol, camphor, capsaicin, methyl salicylate, trolamine salicylate, lidocaine, or diclofenac sodium that exert their pharmacological effects via local analgesic, anesthetic, antipruritic, and/or counterirritant mechanisms.⁸ Some topical agents include a combination of active ingredients. Diclofenac sodium 1% gel (Voltaren Arthritis Pain; Haleon), which was transitioned from prescription to OTC status through the FDA's Rx-to-OTC switch process in 2020, is the first and only FDA-approved OTC topical NSAID indicated for the temporary relief of OA pain.⁸^,9

Recommended nonpharmacological measures include the following^1,2,8:

• Rest, ice, compression, and elevation
• Avoidance of activity that can cause or worsen pain or swelling
• Weight loss, if needed
• Use of braces or support devices if appropriate
• Exercise, physical and occupational therapy
• Heat therapy when appropriate

Conclusion

As a progressive disease, OA can lead to significant mobility issues, decreased productivity, and reduced health-related quality of life, underscoring the importance of patient education, early identification, and clinical intervention to slow the progression of joint damage.

Pharmacists play a pivotal role in advancing patient education by ensuring individuals are well-informed about appropriate OTC product selection, proper dosing, duration of use, contraindications, potential adverse effects, and when to seek further medical care, empowering patients to make informed decisions regarding both the pharmacologic and nonpharmacologic management of OA to optimize outcomes, and preserve joint health, mobility, and quality of life.

REFERENCES

1. Osteoarthritis. CDC. January 26, 2024. Accessed May 18, 2026. https://www.cdc.gov/arthritis/osteoarthritis/index.html

2. Osteoarthritis. Arthritis Foundation. Accessed May 18, 2026. https://www.arthritis.org/diseases/osteoarthritis

3. Osteoarthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Reviewed September 2023. Accessed May 18, 2026. https://www.niams.nih.gov/health-topics/osteoarthritis

4. Foster AL, Boring MA, Lites TD, Croft JE, Odom EL, Fallon EA. Distribution of arthritis subtypes among adults with arthritis in the United States, 2017–March 2020. Prev Chronic Dis. 2025;22:E28. doi:10.5888/pcd22.240393

5. Langworthy M, Dasa V, Spitzer AI. Knee osteoarthritis: disease burden, available treatments, and emerging options. Ther Adv Musculoskelet Dis. 2024;16:1759720X241273009. doi:10.1177/1759720X241273009

6. Fallon EA, Boring MA, Foster AL, et al. Prevalence of diagnosed arthritis – United States, 2019–2021. MMWR Morb Mortal Wkly Rep. 2023;72(41):1101–1107. doi:10.15585/mmwr.mm7241a1

7. Alwhaibi M, Alhawassi TM. Mental health and health-related quality of life among adults with osteoarthritis: a national population-based study. PLoS One. 2025;20(6):e0325780. doi:10.1371/journal.pone.0325780

8. Olenak J, Pezzino N. Musculoskeletal injuries and disorders. In: Krinsky DL, Berardi RR, Ferreri SP, et al eds. Handbook of Nonprescription Drugs: An Interactive Approach to Self-Care. 17th ed. American Pharmacists Association; 2020.

9. FDA approves GSK's Voltaren Arthritis Pain for over-the-counter use in the United States. News release. GlaxoSmithKline. February 17, 2020. Accessed May 2026. https://us.gsk.com/en-us/media/press-releases/fda-approves-gsk-s-voltaren-arthritis-pain-for-over-the-counter-use-in-the-united-states/