Each year one in five consults their GP about a musculoskeletal condition, accounting for 30 million lost working days a year

The health service runs the risk of being overwhelmed by an arthritis epidemic unless we address the causes and encourage sufferers to seek treatment earlier, warns a new report by the organisation Arthritis Research UK.

Some 4.5 million people in the UK live with osteoarthritis of the knee and this is set to double by 2035. A further four million have forms of arthritis of the hip, ankle and hand. The increase in cases is blamed on rising obesity, an ageing population and sedentary lifestyles.

Link with obesity

One in four adults in the UK is obese and one in three people with osteoarthritis are either overweight or obese. ‘For every two points the BMI goes above normal weight, the risk of knee osteoarthritis increases by 50 per cent. It also increases the risk of hip and back arthritis. While osteoarthritis used to be mainly caused by joints ‘wearing out’ in old age, obesity is overwhelming joints far quicker and the excess load on joints interferes with the body’s repair process,’ says Dr Tom Margham at Arthritis Research UK.

Professor Philip Conaghan, professor of musculoskeletal medicine at University of Leeds and medical advisor to Arthritis Care, advises a 10 per cent reduction in overall weight to prevent and manage osteoarthritis. ‘Physical activity is vital in helping prevent osteoarthritis. Throughout life, regular physical activity impacts on bone health, especially in youth. As you get older, it helps keep joints healthy and flexible,’ says Dr Margham. ‘If a customer with arthritis says it will hurt when they exercise, explain that the more mobile they remain, the less it will hurt. It’s important to maintain muscle strength around joints. Advise starting slowly, wearing correct shoes, warming up and down properly. You can help by following up on how customers are getting on with exercise programmes.’

Lila Thakerar, independent pharmacist at Shaftesbury Pharmacy, Harrow, advises: ‘Posters and leaflets help build awareness of risk factors such as obesity and lack of exercise. Offer patients advice if they come in for weight loss medicines and tell them about things like local walking groups.’ 

At Numark, service development manager Amanda Bell says: ‘The pharmacy team are wellversed in providing and promoting healthy lifestyle advice to all patients. A weightmanagement service provides resources, support and advice on healthy eating and exercise.’

Jillian Watt, director of marketing and NPD at Mentholatum, says: ‘No one likes to feel they are being preached to, so getting to know customers will make it easier to say the things they know are true. Explain that even a small weight loss or a daily short walk can be beneficial.’

Managing arthritis pain

Some 70 per cent of people with arthritis experience constant pain, despite taking medication, according to Arthritis Care’s survey Arthritis Nation 2014. Just one in five said they didn’t usually have pain when on medication, 34 per cent described a dull, constant pain and 23 per cent said pain was ‘just bearable’ (www.arthritiscare.org.uk; www.arthritisresearchuk.org).

A new study by Arthritis Research UK found that many sufferers of rheumatoid arthritis fail to take expensive prescribed anti-TNF medicines. ‘If patients do not take their medicine as prescribed it is likely to have a significant effect on whether they respond to therapy and could mean their condition deteriorates more quickly, affecting their quality of life,’ says study author Dr Kimme Hyrich. Some 81 per cent of people with arthritis have used OTC medicines for pain, says the Arthritis Nation study: two in five used prescription medicines and 83 per cent had used one or more other therapies. Antiinflammatory gel was most commonly used – 47 per cent had tried it. More than one in three had physiotherapy and 15 per cent tried nutritional supplements.

However, people can be reluctant to seek timely advice. Some 48 per cent only visited a healthcare professional when their pain became unbearable. Of those who did seek advice on self-management, 78 per cent found this useful.

‘People often don’t take analgesia properly, but if it helps them move and exercise more it’s worth persisting. Customers may need to try stronger analgesia if they are not getting relief, but be alert to over-use of painkillers. Challenge the myth that nothing can be done to help arthritis – while there’s no ‘cure’ plenty can be done to improve pain and mobility of joints,’ says Dr Margham.

Lila Thakerar advises: ‘Having extra support for pain is important. As well as oral analgesics, recommend topical analgesics and joint supports, as well as heat and cold packs.’

At Numark, Amanda Bell says: ‘You can discuss side effects, interactions, appropriate drug dosage and frequency. Using these simple intervention services, you can manage patients’ expectations of their medication and use the opportunity to provide them with an understanding of the benefits of continued compliance.’

Jillian Watt adds: ‘If you know someone is in pain, perhaps buying increasing quantities of painkillers, offer a chat in the consulting room. If they’ve not been diagnosed with arthritis, explain once they have a diagnosis they will be able to discuss the best options for treatment.’

Dr Christine Haseler, GP advisor to Arthritis Care, says: ‘It’s not just about taking medication correctly but exploring their beliefs about what the medication is doing. People can be frightened they are doing more damage if they mask the pain but the evidence is that appropriate movement eases pain. Community pharmacists should be well versed in the pain mechanisms of osteoarthritis to help dispel this myth.’

If a customer with arthritis says it will hurt when they exercise, explain the more mobile they remain, the less it will hurt

 

Category campaigns

The number of product launches in the pain relief market increased by 31 per cent last year (data from Mintel, June 2014), with new topical pain relief products accounting for 29 per cent of launches. Some 21 per cent of consumers worry about the long-term effects of oral analgesics and one in 10 believes topical remedies are a better option. Mintel found that 42 per cent of people said they’d be encouraged to try a new product if their pharmacist or doctor recommended it.

Mentholatum is targeting sports enthusiasts with its winter campaign to highlight when to use hot or cold products. Advertising will run in consumer sports magazines. Deep Relief Pain Relief gel is being advertised in a campaign that targets women aged 55 plus. Radio adverts begin in November and run until February. Press adverts will appear in November to February issues of a range of women’s magazines. Deep Heat’s Muscle Rescue brand has been extended with a new warming patch to ease everyday muscular tension in the neck and shoulders.

BetterYou is offering point of sale materials, product discounts and staff training on the benefits of vitamin D and when to advise its use.

Movelat is being supported by a new pharmacy campaign to build consumer knowledge of the brand. The campaign is backed by a new website, trade press and consumer campaign and accredited pharmacy training.

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