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Pharmacists’ Guide to Joint Health: Optimising Treatment Strategies for Musculoskeletal Conditions

Joint health is a growing concern for patients across all age groups, from young athletes to the elderly. As a pharmacist, understanding the complexities of joint health can significantly impact patient care, particularly as sufferers may seek advice from their local pharmacy team as a first point of contact. This guide aims to support pharmacy teams by providing essential insights into musculoskeletal conditions, pain management options, supplements, and non-pharmacological interventions to support joint health

1. Common Joint Health Concerns

  • Osteoarthritis (OA): The most prevalent form of arthritis in the UK. Almost any joint can be affected by OA, but the condition most often causes problems in the knees, hips and small joints of the hands. 1 Further investigation from a GP is recommended if a patient is experiencing these symptoms but pharmacists can support with pain management strategies.
  • Rheumatoid Arthritis (RA): An autoimmune condition that leads to pain, swelling and stiffness in the joints, typically requiring more complex care. The condition usually affects the hands, feet and wrists.2 Further investigation from a GP is recommended if a patient is experiencing these symptoms but pharmacists can support with pain management strategies.
  • Sports Injuries & Overuse: Younger patients may experience strains, sprains, or tendinitis. Providing guidance on acute treatment and recovery is essential.
  • Gout: Often overlooked but common, especially in middle-aged and older populations. Patient education on flare prevention and medication adherence is crucial.

2. Over-the-Counter (OTC) Treatments

  • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Options such as ibuprofen can help reduce pain and inflammation in the short term. However, pharmacists should provide advice on potential side effects associated with prolonged use of NSAIDs, particularly gastrointestinal concerns.
  • Topical Analgesics: Topical analgesics may support in reducing localised pain and pharmacists are well placed to assist patients in choosing the right formulation. Pharmacists should encourage patients to find out the underlying cause of their pain to ensure issues are not being masked by using topical analgesics

3. Role of Supplements in Joint Health

  • GOPO®: A galactolipid found in rose-hips which can be used to help alleviate symptoms of joint health conditions. Extensive studies involving over 400 patients with chronic pain conditions, such as OA, have shown that GOPO® provides significant and consistent pain relief, as well as improved joint function. In one study, 8 out of 10 patients reported a significant reduction in pain after just 3 weeks of GOPO® . 3 The natural anti-inflammatory properties of GOPO® make it a viable alternative to painkillers,4 without the risk of harmful side effects. Pharmacists could encourage the use of supplements such as GOPO® Joint Health and advise on its benefits for joint health.
  • Omega-3 Fatty Acids: Omega-3s are well known for their anti-inflammatory effects. They help reduce the production of inflammatory molecules, such as prostaglandins and cytokines, which contribute to inflammation in joint disorders. This reduction in inflammation may alleviate joint pain, swelling and stiffness.
  • Turmeric: Turmeric, particularly its active compound curcumin, is widely recognised for its anti-inflammatory and antioxidant properties, which may benefit joint health. By lowering inflammation, curcumin may help to ease pain and discomfort associated with swollen or damaged joints.

4. Lifestyle and Non-Pharmacological Interventions

  • Weight Management: Excess weight places additional pressure on weight-bearing joints. One study found that weight-loss of one pound reduces pressure on the knees by four pounds per step.4 Pharmacists can advise patients on weight management strategies to help lessen the strain on joints.
  • Exercise and Physical Therapy: Joint-friendly exercises, such as swimming and cycling, can help to improve mobility and reduce stiffness. Pharmacists should recommend safe physical activities and collaborate with physiotherapists when necessary.

Conclusion

Pharmacists are uniquely positioned to support patients with joint health concerns, providing expertise in managing pain, recommending appropriate treatments, and fostering long-term well-being. While many people may rely on pain killers to ease symptoms of joint pain, the National Institute of Care and Excellence recently updated its guidance stating that chronic pain should not be treated with analgesics. As a result of this, pharmacists play a vital role in offering information and advice on self-management options to support long-term joint health, rather than recommending a 'quick fix'.

1 NHS. Osteoarthritis. Available at: https://www.nhs.uk/conditions/osteoarthritis/. (Accessed: September 2024).

2 NHS. Rheumatoid Arthritis. Available at: https://www.nhs.uk/conditions/rheumatoid-arthritis/. (Accessed: September 2024).

3 Winther, K et al. “A powder made from seeds and shells of a rose-hip subspecies (Rosa canina) reduces symptoms of knee and hip osteoarthritis: a randomized, double-blind, placebo-controlled clinical trial.” Scandinavian journal of rheumatology vol. 34,4 (2005)

4 Arthritis Action. Weight Management and Arthritis. Available at: https://www.arthritisaction.org.uk/living-with-arthritis/self-management/weight-management-and-arthritis/ (Accessed: September 2024)