Osteoarthritis: a leading cause of chronic pain

Osteoarthritis (OA) is a leading cause of chronic pain and disability resulting from structural changes to the joint.1 According to the 2017 Global Burden of Disease study, worldwide an estimated 303 million people live with OA of the hip or knee, and experience considerable pain almost daily. In the UK, nearly 28 million people are affected by chronic pain,2 and musculoskeletal (MSK) conditions including OA account for a third of all General Practice (GP) appointments in England alone.3 Importantly, patients with OA who suffer pain can experience a loss of function that impacts their daily life, which can lead to social and economic isolation as well as poor physical and mental health.4,5

People with OA-related pain deserve better; there has been little change in the treatment of OA in the last decade, and patients often suffer inadequate pain relief and have to navigate a disjointed and complex healthcare system. We need to do better. Furthermore, many patients find they are not suitable for current treatments due to intolerances or contraindications. There is a clear imperative to improve both the treatment and the experience of patients suffering from chronic pain; accordingly, organisations such as Public Health England (PHE) have now outlined a 5-year strategy to improve musculoskeletal health and support people to be free from pain and disability.6 Inequalities do exist; poor housing and type of employment are two significant predicators of chronic pain in the community.7 There are also inequalities by deprivation in the prevalence of long-term MSK conditions such as OA.6 Certainly, there is action we can take nationally, locally and at the level of each practice; What Is Chronic Pain? is a website dedicated to supporting you with information and resources – to help you be a driver of this change.


In the UK alone, an estimated 8.75 million people aged 45 years and older have sought treatment for OA.6 Across the UK, over 1 in 10 people aged over 45 years have OA of the hip, and almost 1 in 5 have OA of the knee.8
OA is sometimes considered a ‘natural condition’ of the elderly, but the chronic pain of OA often impacts patients from early middle age9,10 – with key barriers to healthy ageing including pain and limitations on a patient’s ability to work.11 Women frequently experience a significantly higher prevalence of MSK conditions than men (19% vs 14.9%, respectively).6

OA prevalence in England.12

OA in patients aged 45 and over Prevalence (%)
Knee OA 18.2
Severe knee OA 6.1
Hip OA 10.9
Severe hip OA 3.2

The prevalence of OA is predicted to rise in the UK from approximately 8.75 to 17 million cases by 2030.6 This increase will be driven primarily by an ageing population, a predicted rise in obesity, and a lack of improvement in physical activity levels.6 To counter this predicted rise in patient suffering, it is key that we better understand OA-related chronic pain, and how to better implement and engage with people with OA through a patient-centred and multidisciplinary team (MDT) approach.

What can I do now?

Learn more about how many people are increasingly affected by OA-related chronic pain in the UK and beyond – and why there is a need for change.

1. Rice D, McNair P, Huysmans E, Letzen J, Finan P. Best Evidence Rehabilitation for Chronic Pain Part 5: Osteoarthritis. Journal of Clinical Medicine. 2019;8:1769. 2. Fayaz A, Croft P, Langford RM, Donaldson LJ, Jones GT. Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies. BMJ Open. 2016;6:e010364. 3. NHS. The NHS Long Term Plan. January 2019. https://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf. Accessed February 26, 2020. 4. BMA. Chronic pain: supporting safer prescribing of analgesics. March 2017. https://www.bma.org.uk/media/2100/analgesics-chronic-pain.pdf. Accessed August 3, 2020. 5. Arthritis and Musculoskeletal Alliance. Chronic Pain – This Is How It Feels. October 2019. http://arma.uk.net/wpcontent/uploads/2019/10/Chronic_Pain_Report_V8_APPROVED-07102019.pdf. Accessed February 26, 2020. 6. Public Health England. Musculoskeletal Health: A 5 year strategic framework for prevention across the lifecourse. June 2019. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/810348/Musculoskeletal_Health_5_year_strategy.pdf. Accessed August 1, 2020. 7. British Pain Society. National Pain Audit Final Report 2010–2012. 2012. https://www.britishpainsociety.org/static/uploads/resources/files/members_articles_npa_2012_1.pdf. Accessed March 18, 2020. 8. Versus Arthritis. The State of Musculoskeletal Health 2019. 2019. https://www.versusarthritis.org/media/14594/state-of-musculoskeletal-health-2019.pdf. Accessed August 3, 2020. 9. Osteoarthritis Research Society International. Osteoarthritis: A Serious Disease. December 2016. https://www.oarsi.org/education/oarsi-resources/oarsi-white-paper-oa-serious-disease. Accessed March 4, 2020. 10. Neogi T. The epidemiology and impact of pain in osteoarthritis. Osteoarthritis Cartilage. 2013;21:1145-1153. 11. AIHW. Impact of osteoarthritis. August 2019. https://www.aihw.gov.au/reports/chronicmusculoskeletalconditions/osteoarthritis/contents/impact-of-osteoarthritis. Accessed August 3, 2020. 12. Public Health England Fingertips 2012. https://fingertips.phe.org.uk/. Accessed August 11, 2020.

In the UK alone, nearly 28 million people are affected by chronic pain2

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Further reading
Key osteoarthritis risk factors, comorbidities and progression
Osteoarthritis (OA)-related pain is caused by structural joint changes and other complex factors that affect how the body processes and experiences pain.1 Persistent pain and functional limitations from OA occur predominantly in the knees and hips of middle-aged and…
What explains osteoarthritis pain physiology?
Nearly 3 out of every 4 patients with osteoarthritis (OA) report that their pain is constant or chronic.1 There is, however, only a weak correlation between radiographic evidence for OA progression and the extent of OA-related pain: for example, the range of people who…

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PP-INT-GBR-0205 February 2021