From the Guidelines
The most effective approach to managing osteoarthritis involves a combination of non-pharmacological and pharmacological therapies, with a strong emphasis on exercise and weight management, as supported by the most recent and highest quality study 1.
Key Components of Osteoarthritis Management
- Non-pharmacological modalities:
- Regular low-impact exercise such as swimming, cycling, or walking for 30 minutes daily to strengthen supporting muscles and maintain joint flexibility 1
- Weight management, as each pound lost reduces knee stress by four pounds 1
- Physical therapy to improve function through targeted exercises and techniques 1
- Heat and cold therapy (20 minutes several times daily) to reduce pain and inflammation 1
- Assistive devices like braces, canes, or shoe inserts to redistribute weight and reduce joint stress 1
- Pharmacological modalities:
- Acetaminophen (500-1000mg every 6 hours, not exceeding 4000mg daily) as the first-line medication for mild pain 1
- Topical NSAIDs like diclofenac gel (apply to affected joint 4 times daily) for localized relief with fewer systemic effects 1
- Oral NSAIDs like ibuprofen (400-800mg three times daily with food) or naproxen (250-500mg twice daily) for moderate to severe pain, with consideration of their potential gastrointestinal, cardiovascular, and renal side effects 1
Considerations for Treatment
- The treatment of osteoarthritis should be tailored according to individual patient factors, including knee risk factors, general risk factors, level of pain intensity and disability, signs of inflammation, and location and degree of structural damage 1
- Intra-articular corticosteroid injections may be considered for patients with persistent pain due to osteoarthritis of the knee inadequately relieved by other interventions 1
- Joint replacement surgery may be considered for severe cases unresponsive to conservative treatment 1
From the FDA Drug Label
In patients with osteoarthritis, the therapeutic action of naproxen has been shown by a reduction in joint pain or tenderness, an increase in range of motion in knee joints, increased mobility as demonstrated by a reduction in walking time, and improvement in capacity to perform activities of daily living impaired by the disease The answer to the question about osteoarthritis is that naproxen has been shown to be effective in reducing joint pain or tenderness, increasing range of motion, and improving mobility and capacity to perform daily activities in patients with osteoarthritis 2.
- Key benefits of naproxen in osteoarthritis include:
- Reduction in joint pain or tenderness
- Increase in range of motion in knee joints
- Increased mobility
- Improvement in capacity to perform daily activities
From the Research
Osteoarthritis Management
- Osteoarthritis (OA) management recommendations focus on core treatments, including education for self-management and lifestyle interventions such as increased physical activity, therapeutic exercise, and weight loss (if indicated) 3.
- Lifestyle changes, including exercise therapy, weight reduction, and footwear, are gaining recognition in the management of OA, with an emphasis on evidence for effectiveness and maintenance of adherence 4.
Treatment Options
- Acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and opioids are common pharmacologic treatments for OA, with varying levels of efficacy and safety 5, 6.
- Acetaminophen has been found to be effective in alleviating pain in patients with OA, with a favorable safety profile compared to NSAIDs 6.
- Antibodies directed against nerve growth factor (NGF-Abs) are a new class of agents under clinical investigation for the treatment of OA 5.
Lifestyle and Behaviour-Change Interventions
- Lifestyle- and behaviour-change interventions, such as weight management, physical activity, and medication adherence, are important in the management of OA 7.
- A comprehensive theory-based approach to behaviour-change, including a patient-centred approach, can be effective in promoting lifestyle changes in patients with OA 7.