Pain in the Knee: How to Minimize the Impact of Osteoarthritis

We all know the feeling. Creaky knees. A sore shoulder. Pain in your hips. It comes after sitting too long, or walking for a while, or from doing just about anything, really. Usually, we’ll just chalk that kind of pain up to a particularly intense game, long run, or some other physical activity. Maybe even just getting old. Certainly, those things can contribute to how we’re feeling, but it may be something more specific:

Osteoarthritis.

Osteoarthritis occurs when the protective cartilage in your joints wears away1 due to the wear and tear on your joints from physical activity. This wear and tear can eventually lead to pain, swelling, tenderness, loss of flexibility, and even bone spurs.2 Typically, these symptoms develop slowly and over time, depending on your level of physical activity.2 High-impact exercises like running and jumping can take a toll, whether you’re a young adult, athlete or “weekend warrior.” Osteoarthritis can happen to anyone. How you manage your osteoarthritis symptoms—and whether those symptoms get worse—can be the difference between hanging up your equipment or staying in the game as long as possible. For those who want to stay in the game, choosing the right interventions is key. This might include lifestyle changes, surgery, oral treatment or topical creams/gels, like PENNSAID (diclofenac sodium topical solution) 2%. It’s a reality Dr. Jake Zarah, a board-certified orthopedic surgeon and a specialist in the treatment of osteoarthritis, sees every day when speaking to his patients. He says the importance of early attention to symptoms of osteoarthritis, and in particular the knees, can be the key to minimizing the impact it can have on your joints— and life. This can be particularly important as we get older. There are several things one can do to delay the impact of osteoarthritis. The first thing he suggests is to change the kinds of physical activity you’re engaging in that causes the symptoms of osteoarthritis. That may mean less basketball, running and football, but more swimming, elliptical, biking, and strength exercises like yoga.2 “Weight loss can help slow the progression of arthritis and its symptoms, minimizing the wear and tear on your joints,” says Dr. Zarah. He points out that every one pound of body weight lost equals about a five-pound reduction of force on your joints. So, even a minimal amount of weight loss can mean a huge difference, especially for your knees and hips. Eventually, though, mitigating measures are just not enough. You have to find the right way to manage your symptoms. That can range from something as simple as over-the-counter pain medicine to anti-inflammatory treatments, injections and even surgery, which is often a last resort.

“When experiencing osteoarthritic symptoms, your first step may be to try over-the-counter anti-inflammatory treatments,” says Dr. Zarah. “It’s by far the most common treatment for most patients. But that doesn’t mean it’s the right treatment for everyone.” Anti-inflammatory treatments that patients can administer themselves come in two forms. The first is an oral medication, like a pill, and is more of a systemic treatment. Oral antiinflammatory properties affect the entire body systemically. It can also be risky to take oral anti-inflammatories with blood thinners, which athletes sometimes use, and they can cause side effects in the stomach and intestines that can significantly impact athletes while they’re training or performing. The second option is a topical gel or cream, that offers targeted anti-inflammatory osteoarthritis treatment benefits. Dr. Zarah explains, “Some of my patient-athletes and their doctors prefer topical anti-inflammatory treatments because it lets them apply treatment directly to the affected area—reducing systemic exposure that may prevent them from performing at their peak ability.” In Dr. Zarah’s practice, he prescribes PENNSAID 2%, a topical nonsteroidal anti-inflammatory drug (NSAID) designed to target osteoarthritis knee pain by delivering relief directly at the site.3 It can be applied to the front, back, and sides of the knee(s) where it is absorbed through the skin.4 This allows it to target the source of pain while reducing the amount of medicine that reaches other parts of the body.4 In a study, patients reported an improvement in their OA knee pain with the treatment.4 “I believe that PENNSAID 2% is a good choice for several reasons: It is effective in treating the symptoms of osteoarthritis, and it can be added to an athlete’s routine so easily, applied twice a day for possible symptom relief,” Dr. Zarah advises. If you’re an athlete or just like to stay active and suffer from knee pain, it may be helpful to discuss PENNSAID 2% with your doctor today. Learn more about OA and PENNSAID at pennsaid.com.

“Weight loss can help slow the progression of arthritis and its symptoms, minimizing the wear and tear on your joints” — Dr. Zarah.

INDICATIONS AND USAGE What is PENNSAID ® (diclofenac sodium topical solution) 2% w/w? PENNSAID ® (diclofenac sodium topical solution) 2% w/w is a nonsteroidal anti-inflammatory drug (NSAID) applied to the skin, used for treating the pain of osteoarthritis of the knee(s). IMPORTANT SAFETY INFORMATION What is the most important information I should know about PENNSAID? • NSAIDS can cause an increased risk of a heart attack or stroke that can lead to death. This risk may occur early in treatment and may increase with longer use and with increasing doses. • NSAIDS can cause an increased risk of bleeding, ulcers, and tears (perforation) of the esophagus, stomach and intestines. These events can occur at any time during use, without warning symptoms and may cause death. Elderly patients and patients with a history of ulcer disease or stomach or intestine bleeding are at greater risk for getting an ulcer or bleeding. • You should take PENNSAID exactly as prescribed, at the lowest dose possible and for the shortest time needed. PENNSAID can cause serious side effects. Stop taking PENNSAID and call your doctor or go to your emergency department right away if you get: • Difficulty breathing, swelling of the face or throat. These could be signs of a serious allergic reaction. • Chest pain, shortness of breath, weakness in one part or side of your body, or slurring of speech. These could be signs of a serious blood clotting event. • Upper stomach pain, upset stomach, black, tarry stools, or vomiting of blood. These could be signs of an esophagus, stomach, or intestinal ulcer, bleed, or tear. Note: if you are also taking low-dose aspirin, you are at increased risk for esophagus, stomach, or intestinal bleeding. • Nausea, more tired or weaker than usual, itching, yellowing of the skin or eyes, right upper abdomen tenderness, and “flu-like” symptoms. These could be signs of a liver problem. • Shortness of breath, unexplained weight gain, or swelling of the arms, legs, hands or feet. These could be signs of a serious heart problem. • Any type of rash. This could be a sign of a serious skin reaction. These are not all of the possible side effects of PENNSAID. Please talk to your doctor if you experience any symptoms that bother you or that do not go away. Who should not use PENNSAID? DO NOT USE PENNSAID if you • are in the hospital for a certain heart surgery called coronary artery bypass graft surgery. • know you are allergic to diclofenac or any other ingredient of PENNSAID. • have experienced asthma, hives, or allergic-type reactions after taking aspirin or other NSAIDS. Serious allergic reactions to NSAIDS, including death, have been reported in such patients. • are in the 30th week of pregnancy until delivery How should I use PENNSAID? PENNSAID is applied directly to the front, back, and sides of your knee(s). Avoid contact of PENNSAID with the eyes, nose, and mouth. If eye contact occurs, immediately wash out the eye with water and contact your health care provider if irritation persists for more than an hour. Avoid skin-to-skin contact between other people and the knee(s) to which PENNSAID was applied until the knee(s) is completely dry. DO NOT apply PENNSAID to open wounds, infections, or rashes. DO NOT shower for at least 30 minutes after applying PENNSAID or wear clothing over the PENNSAID treated knee(s) until the treated knee(s) is dry. DO wash and dry hands before and after use, protect your treated knee(s) from natural or artificial sunlight, and wait until the treated knee(s) is completely dry before applying sunscreen, insect repellant, lotion, moisturizer, cosmetics, or other topical medication. What are the possible side effects of PENNSAID? The most common side effects of PENNSAID are application site reactions, such as dryness, peeling, redness, itching, pain, skin hardening, rash, blisters, and scabbing. Other side effects are bladder infection, bruising, sinus congestion, nausea, upset stomach, stomach pain, gas, constipation, and diarrhea. What other medications might interact with PENNSAID? Avoid using PENNSAID while taking other NSAIDS unless your doctor says it is OK. NSAIDS may be present in over-thecounter medications for treatment of colds, fever, or insomnia; refer to the label of over-the-counter medications you are taking or ask your pharmacist. Do not use PENNSAID and lowdose aspirin until you talk to your health care provider. Tell your doctor about all of the medicines you take as some medicines can react with NSAIDS and cause serious side effects. What should I tell my health care provider? Before starting PENNSAID, tell your health care provider if you have a history of ulcer disease or esophagus, stomach, or intestine bleeding, liver or kidney problems, high blood pressure, asthma, or are pregnant, trying to become pregnant, or breast feeding. Taking NSAIDS, such as PENNSAID, at about 20 weeks of pregnancy or later may harm your unborn baby. If you need to use PENNSAID for more than 2 days when you are between 20 and 30 weeks of pregnancy, your healthcare provider may need to monitor the amount of fluid in your womb around your baby. You should not use PENNSAID after about 30 weeks of pregnancy. Also tell your doctor about all of the medicines you take, including prescription or over-the-counter medicines, vitamins, or herbal supplements. Do not start taking new medicines without talking to your health care provider first. Please see the Medication Guide and Prescribing Information or visit Pennsaid.com for additional information. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

References:

1. Centers for Disease Control and Prevention. Osteoarthritis (OA). Centers for Disease Control and Prevention website. https://www.cdc.gov/arthritis/basics/osteoarthritis.htm. Accessed May 26, 2022 2. Arthritis Foundation. Osteoarthritis. Arthritis Foundation website. https://www.arthritis.org/diseases/osteoarthritis. Accessed May 25, 2022.

3. PENNSAID (diclofenac sodium topical solution) 2% [prescribing information] Horizon.

4. PENNSAID website. www.pennsaid.com. Accessed June 9, 2022.