OBJECTIVES: Recent findings have suggested an analgesic effect of beta-blockers in reducing osteoarthritis (OA) related pain. We aimed to estimate the effect of beta blocker use on joint pain and analgesic use in participants with symptomatic radiographic knee OA.

METHODS: We identified participants with symptomatic radiographic knee OA, defined as with frequent knee pain and Kellgren-Lawrence grade ≥2 from the Osteoarthritis Initiative (OAI), a longitudinal cohort study. Outcome measures included the Western Ontario & McMaster University Osteoarthritis Index (WOMAC) pain score, Knee Injury and Osteoarthritis Outcome Score (KOOS) pain subscale, knee pain severity in the past 7 days, presence of widespread pain, and use of analgesics (i.e.,opioids, prescription non-steroidal anti-inflammatory medications[NSAIDs], or over-the-counter NSAIDs). We compared beta-blocker users, other anti-hypertensive users, and participants without anti-hypertensive use in terms of joint pain outcomes and analgesic use over 8 years. We used multivariate mixed effects models to estimate adjusted mean pain scores of WOMAC, KOOS, and pain severity in the past 7 days and relative risk (RR) of widespread pain and analgesic use, adjusting for sociodemographics and health status factors.

RESULTS: Among 1,168 participants (58% female, 68% white, mean age: 62 years), 179(15%) reported beta blocker use at baseline. Beta blocker users had similar mean pain scores (WOMAC: 5.6, 95%CI=5.2-6.0; KOOS: 67.1, 95%CI=65.0-69.3; knee pain severity: 4.9, 95%CI=4.6-5.2) as other anti-hypertensive users and participants without anti-hypertensives. Beta blocker users did not have a lower rate of widespread pain (RR: 0.95, 95%CI=0.84-1.07) or analgesic use (RR:1.03, 95%CI=0.92-1.14), compared to other anti-hypertensive users. Sensitivity analyses restricted to the new users of beta-blockers yielded similar findings.

CONCLUSIONS: Beta blocker use was not associated with reduction in joint pain or analgesic use among OAI participants with symptomatic radiographic knee OA. Our findings do not support beta blocker use for joint pain in patients with knee OA.