Two-thirds of Older Adults with Arthritis Use OTC Treatments, yet Many Do not Consult with Clinician about Medication Risks

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A new survey of US adults reveals that 80% of older Americans with arthritis or joint pain are confident that they could manage their symptoms on their own without physician assistance and 66% say they use over-the-counter pain relievers like aspirin or acetaminophen.

The survey also found, however, that the majority of respondents who use 2 or more substances for their pain hadn’t received counsel from a health care provider on potential risks associated with using them.

Findings from the University of Michigan National Poll on Health Aging showed that 70% of adults aged 50-80 years reported currently experiencing symptoms of arthritis or joint pain, and 60% reported ever being told by a health care professional that they have arthritis. Among adults with symptoms of arthritis or joint pain, 55% rated symptoms as moderate or severe, 49% said symptoms limited their usual activities, 45% experienced symptoms daily, and 36% reported symptoms interfered with their day-to-day lives.

In addition, among adults with joint pain, 80% were confident (24% very, 56% somewhat) that they could manage their symptoms on their own. Results showed that the majority of adults with arthritis (66%) used OTC pain relievers, such as non-steroidal anti-inflammatory drugs (NSAIDs, eg, aspirin or ibuprofen) or acetaminophen for symptoms during the past year. More than a quarter (26%) of adults with arthritis said they take supplements, (eg, glucosamine or chondroitin) while 11% reported using cannabidiol (CBD, derived from marijuana) and 9% used marijuana.

A smaller portion of adults reported using prescription-based treatments, including prescription-only non-opioid pain relievers (18%), oral steroids (14%), opioids (14%), and disease-modifying antirheumatic drugs (4%), according to the results of the poll.

“There are sizable risks associated with many of these treatment options, especially when taken long-term or in combination with other drugs. Yet 60% of those taking two or more substances for their joint pain said their health care provider hadn’t talked with them about risks, or they couldn’t recall if they had. And 26% of those taking oral steroids hadn’t talked with a provider about the special risks these drugs bring,” said Beth Wallace, MD, MS, rheumatologist, VA Ann Arbor Healthcare system, in a University of Michigan press release.

“This suggests a pressing need for providers to talk with their patients about how to manage their joint pain, and what interactions and long-term risks might arise if they use medications to do so,” added Wallace.

Wallace also noted in the release that the American College of Rheumatology in its latest clinical guidelines, highlights an evidence-based approach to pain management in osteoarthritis, which the survey showed 30% of adults reported receiving a diagnosis of in the past year.

The guideline emphasizes nonpharmacologic therapies such as weight loss; exercise; tai chi; self-management programs with arthritis educators; braces, splints, and kinesiotaping; acupuncture or acupressure; cognitive behavioral therapy; and applying heat, cold, or topical pain relievers on aching joints.

To manage symptoms, the current survey showed that 64% of adults with arthritis used exercise, 24% used physical therapy, 13% used braces or splints, and 5% used acupuncture or acupressure.

In addition, the survey showed that certain groups of older adults were more likely to experience worse joint pain, especially at a level that interfered with their lives or activities.

“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 nearly as great between those who say their mental health is fair or poor than those who reported better mental health,” said poll director, Preeti Malani, MD, a Michigan Medicine physician with training in infectious diseases and geriatrics, in the release.

“And older adults with fair or poor physical or mental health were much more likely to agree with the statement that there’s nothing that someone with joint pain can do to ease their symptoms, which we now know to be untrue. Health providers need to raise the topic of joint pain with their older patients, and help them make a plan for care that might work for them,” continued Malani.

The National Poll on Health Aging survey was administered online and via phone in January and February 2022 to a randomly selected, stratified group of US adults aged 50-80 years (n=2277). The sample was weighted to reflect population figures from the US Census Bureau.