Beta-blocker Prescription Associated with Reduced Consultation for Knee OA

Sarfaroj Khan 


March 17, 2021


  • Beta-blocker prescription was associated with reduced primary care consultation for knee osteoarthritis (OA), knee pain and hip pain.

  • Atenolol could be considered for patients with OA and cardiovascular co-morbidities, while propranolol may be suitable for patients with OA and co-morbid anxiety.

Why this matters

  • Findings suggest that commonly used beta-blockers have analgesic properties for musculoskeletal pain.

  • A confirmatory randomised controlled trial is needed before clinical practice is changed.

Study design

  • This study included 223,436 participants (age, ≥40 years) from the UK Clinical Practice Research Datalink (CPRD; 1990-2017).

  • 111,718 beta-blockers–exposed participants were (1:1) propensity score matched to unexposed participants.

  • Main outcome: first primary care consultation for knee OA, hip OA, knee pain and hip pain.

  • Funding: National Institute for Health Research.

Key results

  • Beta-blocker prescription was associated with reduced cumulative risk of primary care consultations for (adjusted HR [aHR]; 95% CI):

    • knee OA (0.90; 0.83-0.98);

    • knee pain (0.88; 0.83-0.92); and

    • hip pain (0.85; 0.79-0.90).

  • Propranolol and atenolol were associated with a lower incidence of primary care consultations for (aHR; 95% CI):

    • knee OA (0.78; 0.63-0.97 and 0.91; 0.82-1.00, respectively); and

    • knee pain (0.78; 0.69-0.87 and 0.86; 0.81-0.91, respectively);

  • Beta-blockers were associated with reduced cumulative risk of primary care consultation for large-joint lower-limb OA and/or pain, defined as the earliest of knee OA, knee pain, hip OA or hip pain (aHR, 0.87; 95% CI, 0.84-0.90).


  • Researchers could not undertake multiple imputations to account for missing smoking status and body mass index data because these were missing in 50.5% and 60.3% of participants, respectively.


Nakafero G, Grainge MJ, Valdes AM, Townsend N, Mallen C, Zhang W, Doherty M, Mamas M, Abhishek A. β-blocker prescription is associated with lower cumulative risk of knee osteoarthritis and knee pain consultations in primary care: a propensity score matched cohort study. Rheumatology (Oxford). 2021 Mar 12 [Epub ahead of print]. doi: 10.1093/rheumatology/keab234. PMID: 33710319.  View abstract 

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


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