A study was performed to describe the treatment of knee pain in older adults in primary care and to compare reported practice with published evidence. A semi-structured interview was performed of older adults with knee pain about their use of 26 interventions for knee pain.
201 adults were interviewed. A median of six interventions had been advised for each participant:
- heat and ice (84%) the most frequently advised
- followed by paracetamol (71%)
- compound opioid analgesics (59%)
- non-selective non-steroidal anti-inflammatory drugs (59%)
- Surgery
Three core treatments for knee pain consists of self care:
- written information (16%)
- exercise (46%)
- weight loss( 39%)
Most core treatments had not been initiated before second-line interventions had been used, paracetamol being the exception. Referral to surgery was commonly initiated before more conservative options had been tried.
The conclusions were that interventions recommended as core treatment for knee pain in older adults were underused-in particular, exercise, weight loss and the provision of written information. There appeared to be early reliance on pharmacological treatments with underuse of non-pharmacological interventions in early treatment choices. Self care played an important role in the management of this condition.
The study provides clear evidence on the need to improve the delivery of core treatments for osteoarthritis and highlights the need to support and encourage self care.
(Porcheret M. Jordan K. Jinks C. Croft P. Primary Care Rheumatology Society. Primary care treatment of knee pain–a survey in older adults. [Journal Article] Rheumatology. 46(11):1694-700, 2007)