Move it or Lose it. Is it Reasonable for Older Adults with Osteoarthritis to Continue to Use Paracetamol in Order to Maintain Physical Activity?

Abstract

Osteoarthritis is a common progressive disease in older adults, and those affected often have impaired physical function, co-existing disease states, and reduced quality of life. In patients with osteoarthritis, pain is reported as a primary cause of mobility limitation, and guidelines recommend a mix of pharmacologic and non-pharmacologic strategies for pain management. The benefits of exercise in the management of osteoarthritis are well established; however, pain appears to be the biggest barrier to patients engaging in, and adhering to, physical activity programs. Attitudes towards the use of pain medications differ widely, and lack of efficacy or fear of side effects may lead to sub-therapeutic dosing. Furthermore, a recent review suggesting that short-term paracetamol use is ineffective for osteoarthritis has added to the confusion. This narrative review investigates limitations of current medications, summarizes patient attitudes toward the use of analgesics for osteoarthritis pain (with a focus on paracetamol), and explores the uptake of physical activity for osteoarthritis management. Evidence suggests that, despite clear guidelines, symptoms of osteoarthritis generally remain poorly managed. More research is required to investigate clinical outcomes in patients with osteoarthritis through optimized medication plans to better understand whether longer-term analgesic use in conjunction with physical activity can assist patients to overcome mobility limitations.

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Correspondence to Alison Shield.

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KL, JC, GC, and AS have no conflicts of interest.

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No funding was used to support the work described in this manuscript.

Appendix

Appendix

KL and AS conducted searches of PubMed and Google Scholar. ‘elderly’ or ‘older people’ were used in combination with the following search terms:
 exercise
 physical activity
 physical therapy
 pain
 chronic pain
 musculoskeletal
 osteoarthritis
 analgesics
 paracetamol/acetaminophen
 attitudes
 perceptions
 behaviours
Where possible, recent systematic reviews were included in our body of literature; references of the retrieved articles were also added where relevant (GC and JC also contributed to the identification of additional articles).

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Lee, K., Cooke, J., Cooper, G. et al. Move it or Lose it. Is it Reasonable for Older Adults with Osteoarthritis to Continue to Use Paracetamol in Order to Maintain Physical Activity?. Drugs Aging 34, 417–423 (2017). https://doi.org/10.1007/s40266-017-0450-1

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Keywords

  • Osteoarthritis
  • Paracetamol
  • Pain Management
  • Mobility Limitation
  • Physical Activity Program