Many older people use drugs to block arthritis pain

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Taking a pill may provide short-term relief from arthritis-related joint pain, but many older people may not realize that what they swallow can increase their risk of other health problems, according to a new survey.

Even if managing pain on their own, people over 50 should talk to their health care providers about what they’re taking and get advice about potential drug risks and non-drug options. could also ease their pain and improve their movement, the survey authors say.

New results from the University of Michigan’s National Healthy Aging Survey show that 70% of people over 50 experience joint pain at least occasionally, and 60% have been told they have some form of of arthritis.

Almost half of people with arthritis symptoms reported having pain every day (45%). About half of people with joint pain say the pain at least somewhat limits their usual activities (49%), while more than a third (36%) say it interferes with their daily life.

The vast majority (80%) of people with joint pain said they were at least somewhat confident in their ability to manage it on their own. The survey shows that many are doing it with over-the-counter remedies: 66% of people with joint pain take over-the-counter pain relievers such as aspirin, acetaminophen, ibuprofen or naproxen. More than a quarter (26%) say they take supplements (such as glucosamine or chondroitin) while 11% have turned to cannabidiol (CBD, derivative of marijuana) and 9% use marijuana.

The AARP website has some tips and exercises for joint care after age 50.

But a significant minority turned to prescription treatments, including prescription-only non-opioid painkillers (18%), steroid joint injections (19%), oral steroids (14%), opioids (14% ) and disease-modifying drugs. anti-rheumatic drugs (4%).

“There are considerable risks associated with many of these treatment options, particularly when taken long-term or in combination with other medications. Yet 60% of those who take two or more substances for their pain joints said their health care provider didn’t tell them about the risks, or they couldn’t remember if they had.

“And 26% of those taking oral steroids had not spoken with a provider about the particular risks these drugs carry,” says Beth Wallace, rheumatologist and VA Ann Arbor Healthcare system researcher at the VA Center for Clinical Management Research, and Michigan Medicine which studied drug interactions in arthritis.

“This suggests an urgent need for providers to talk with their patients about how to manage their joint pain, and the long-term interactions and risks that might arise if they use medications to do so.”

The American College of Rheumatology’s latest guidelines for the treatment of osteoarthritis – the most common form of arthritis – and the rarer rheumatoid arthritis both emphasize an evidence-based approach to pain that clinicians and patients need to track, she notes.

The guidelines aim to reduce the risk of the drugs affecting patients’ stomach, liver, blood pressure, blood sugar, mood or sleep. These risks increase with long-term use and in people taking multiple medications or certain supplements, as well as those who drink alcohol regularly.

For osteoarthritis, sometimes called “wear and tear” or degenerative arthritis, the recommendation emphasizes weight loss; exercise; self-management programs with arthritis educators; Tai chi; yoga; braces, splints and kinesiotaping; acupuncture or acupressure; cognitive behavioral therapy and the application of heat, cold, or topical pain relievers to painful joints.

The survey shows that 64% of people with joint pain exercise and 24% have had physical therapy, which is also in the osteoarthritis guidelines. But far fewer used non-drug options such as braces.

For medications, the OA guideline focuses on the short-term use of over-the-counter pain relievers, at the lowest possible dose, as well as joint injections of steroids in appropriate patients. But he advises against most supplements, as well as opioids and other prescription drugs due to a lack of evidence or evidence of risk.

The survey shows that certain groups of older adults seem more likely to experience more severe joint pain, particularly at a level that interferes with their life or activities, says survey director Preeti Malani, a Michigan physician with a background in infectious diseases and geriatrics.

“Those who say their overall health is fair or poor were twice as likely to say they have moderate or severe joint pain as those in better health. The difference was almost as large between those who say their mental health is fair or poor than those who report better mental health,” she says.

“And older people with fair or poor physical or mental health were much more likely to agree with the statement that there is nothing anyone with joint pain can do to relieve their symptoms, which is what we now know. be wrong. Health care providers need to bring up the topic of joint pain with their elderly patients and help them develop a plan of care that might work for them.”

“If you experience joint pain frequently or if it interferes with your normal activities, you don’t have to go it alone,” says Indira Venkat, senior vice president, AARP Research. “Discuss with your health care provider how you treat your joint pain and additional strategies that may help.”

The AARP website has some tips and exercises for joint care after age 50.

The survey report is based on the results of a nationally representative survey conducted by NORC at the University of Chicago for the IHPI, and administered online and by telephone in January and February 2022 to 2,277 adults aged 50 to 80. The sample was then weighted to reflect the US population.

Source: University of Michigan

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