Managing osteoarthritis and joint pain at work: helping the primary care physician educate patients who rely on non-prescription NSAIDs

Abstract

Aims: To inform physicians who utilise over-the-counter (OTC) analgesics to treat osteoarthritis (OA) pain on differences among agents and to guide decisions in therapy selection.

Methods: A search of medical literature was conducted to identify articles on the treatment of OA published between 1990 and 2009. MEDLINE, EMBASE and SCISEARCH databases were searched using the terms: OTC NSAIDs, NSAIDs, naproxen, low-dose aspirin, ibuprofen, acetaminophen and COX-2-selective NSAIDs. A total of 396 publications were identified. After a review of the literature, 63 publications were considered sufficiently relevant for inclusion in the manuscript.

Results: The majority of working patients with OA pain will require exercise, weight control but above all pharmacotherapy. OTC analgesics, including acetaminophen and NSAIDs, provide an effective option for pain management but vary in regard to their safety and efficacy profiles. Selection of an appropriate agent should be based on an evaluation of pain severity, comorbidities and concomitant medications, as well as efficacy and safety of the individual agents.

Conclusion: The key to effective OTC therapy for OA pain at work is to suggest exercise and weight control but above all to select an agent that will optimally provide effective clinical benefits with a good safety and tolerability profile.