Alcohol Intake and Osteoarthritis: Impact on Risk and Management
Low levels of alcohol consumption are unlikely to negatively impact osteoarthritis outcomes, but moderate alcohol consumption may increase the risk of developing hip osteoarthritis in women and should be discussed with healthcare providers. 1
Effects of Alcohol on Osteoarthritis Risk
- While there have been relatively few research studies on alcohol and rheumatic and musculoskeletal diseases (RMDs), the available evidence suggests that low levels of alcohol consumption are generally unlikely to have negative impacts on osteoarthritis-specific outcomes 1
- However, higher alcohol consumption has been associated with increased risk of total hip replacement due to hip osteoarthritis in women in a dose-dependent manner, with those consuming ≥20 grams/day having a 34% higher risk compared to non-drinkers 2
- A meta-analysis of observational studies initially suggested a potential protective effect of alcohol on osteoarthritis, but this association disappeared when adjusted for confounding factors 3
- Recent Mendelian randomization studies found no significant genetic causality between alcohol intake and arthritis, suggesting that any observed associations may be due to confounding factors rather than direct causal effects 4
Alcohol Consumption and Osteoarthritis Management
- The European League Against Rheumatism (EULAR) recommends that alcohol consumption should be discussed between people with RMDs (including osteoarthritis) and healthcare professionals, particularly when starting new treatments 1
- Healthcare providers should make patients aware of the potential negative health consequences of overconsumption of alcohol, and steps should be taken to curtail unhealthy alcohol usage 1
- Some studies have found that radiological knee osteoarthritis (rather than symptomatic knee OA) may be associated with higher alcohol consumption, though the clinical significance remains unclear 5
- Interestingly, historical studies have noted differences in alcohol consumption patterns between patients with osteoarthritis and rheumatoid arthritis, with OA patients more likely to have been heavy drinkers at some point in their lives 6
Clinical Recommendations for Patients with Osteoarthritis
- Healthcare providers should initiate discussions about alcohol consumption with osteoarthritis patients, especially when starting new treatments that may interact with alcohol 1
- While low levels of alcohol consumption are unlikely to negatively impact osteoarthritis outcomes, patients should be advised about the potential risks of moderate to heavy alcohol consumption 1, 2
- Patients with osteoarthritis should be encouraged to focus on evidence-based management strategies, particularly exercise, which has strong and consistent effects on reducing pain and improving function 1
- Both aerobic and strengthening exercises aiming for at least moderate intensity are recommended for people with osteoarthritis 1
Special Considerations and Caveats
- Alcohol consumption recommendations should be considered alongside other lifestyle modifications for osteoarthritis management, including maintaining a healthy weight and balanced diet 1
- Patients with comorbid conditions such as gout should be particularly cautious about alcohol consumption, as moderate alcohol intake is associated with increased risk of gout flares 1, 7
- For patients with osteoarthritis who are taking medications, potential interactions between alcohol and these medications should be discussed with healthcare providers 1
- The focus of osteoarthritis management should remain on evidence-based interventions, with lifestyle modifications (including alcohol consumption guidance) seen as complementary to medical treatments rather than replacements 1