Effects of Analgesics on Self-Reported Physical Function and Walking Ability in People with Hip or Knee Osteoarthritis: A Systematic Review and Meta-Analysis

Author:

Sveaas Silje H1ORCID,Smedslund Geir2,Walsh David A3,Dagfinrud Hanne2

Affiliation:

1. Department of Nutrition and Public Health , Faculty of Health and Sport Sciences, University of Agder, P.O. Box 422, 4604 Kristiansand , Norway

2. Norwegian National Advisory Unit on Rehabilitation in Rheumatology , Department of Rheumatology, Oslo , Norway

3. Co-Director Pain Centre Versus Arthritis and Director Advanced Pain Discovery Platform , Professor of Rheumatology, Academic Rheumatology, University of Nottingham, Nottingham, NG5 1PB , UK

Abstract

Abstract Objective Hip and knee osteoarthritis are among the leading causes of global disability and one of the main aims of the management is to improve physical function. The objective of this review was to investigate the effect of analgesics on physical function (self-reported physical function and walking ability). Method A systematic review and meta-analysis of the findings were performed. Randomized controlled trials (RCTs) investigating the effect of analgesics on self-reported physical function and walking ability were included. Analgesics were orally administered acetaminophen, nonsteroidal antiinflammatory drugs (NSAIDs), or opioids. Data were pooled in a random-effects model and the standardized mean difference (SMD) with 95% CI was calculated (SMDs: 0.2–0.4 = small, 0.5–0.7 = medium, and ≥ 0.8 = large effect sizes). The quality of the evidence was evaluated according to the Grading of Recommendations Assessment, Development and Evaluation approach. Results A total of 1454 studies were identified, of which 33 were included. On self-reported physical function, the results showed low- to moderate-quality evidence for a small beneficial effect of acetaminophen (SMD = −0.13 [95% CI = −0.26 to 0.00]), NSAIDs (SMD = −0.32 [95% CI = −0.37 to −0.27]), or opioids (SMD = −0.20 [95% CI = −0.32 to −0.09]). There was moderate-quality evidence for a small effect of NSAIDs on pain during walking (SMD = −0.34 [95% CI = −0.45 to −0.23]). Conclusion In people with hip or knee osteoarthritis, there was low- to moderate-quality evidence for small beneficial effects of analgesics on physical function and walking ability. Impact Analgesics may improve physical function by reducing pain during exercise and walking.

Publisher

Oxford University Press (OUP)

Subject

Physical Therapy, Sports Therapy and Rehabilitation

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