1. Joint Pain Survey Results April 22, 2008

2. 2 Methodology Interviewing  Leger Marketing conducted this survey online. Data was collected between February 11 and 18, 2008. In total 2161 interviews were completed; 433 of which were respondents who said they have been diagnosed with Osteoarthritis. Respondent Qualification  A random selection was achieved by inviting male and female respondents to complete the survey. A total of 2161 interviews were completed. The margin of error for a sample of this size is +/-2.1%,19 times out of 20. Booster Sample  A booster sample was employed to ensure at least 400 of the interviews were completed among Canadians who say they have been diagnosed with Osteoarthritis by a healthcare professionals. Quality Control  Leger Marketing’s experience and expertise in public opinion and market research extend to the quality and standards of every research project. Detailed verification and validation procedures at each stage of the process ensure data accuracy.

3. 3 One in seven Canadians say they have been diagnosed with Osteoarthritis Fourteen per cent of Canadians said they have been diagnosed by a healthcare professional with osteoarthritis. As suspected, more older Canadians than younger say they have been diagnosed with this condition. More females than males say they have been diagnosed with osteoarthritis. Q13: Have you ever been diagnosed by a healthcare professional with any type of condition which affects joints causing pain, loss of mobility, deformity and/or dysfunction? Total Canadians: n=2161 Significantly higher at the 95% confidence level

4. 4 Many believe that aches and pains are a natural part of aging Nationally, three quarters believe aches and pains are a natural part of aging. One third would be more active if it didn’t cause pain. Six in ten disagree that medication – prescription or OTC – is the best treatment for pain. One third (29%) of those who mange their pain with prescription drugs do no think it is the best treatment for pain. Almost half (49%) who mange their joint pain with OTC drugs do not agree that it is the best treatment for pain. Q32: To what extent do you agree or disagree with the following statements? Total Canadians: n=2161

5. 5 Seven in ten with osteoarthritis would be more active if it didn’t cause them pain Half of those with osteoarthritis think prescription medication is the best treatment for pain while one third agree that OTC meds are the best this may be related to how those with osteoarthritis manage their joint pain: Half of those who take prescription medication say they have been diagnosed with osteoarthritis and on third of those who take OTC meds say they have been diagnosed with osteoarthritis. Q32: To what extent do you agree or disagree with the following statements? Osteoarthritis sample: n=433

6. 6 Two thirds of Canadians anticipate an increase in joint pain as they age One in five (14%) 18 to 24 year olds expect joint pain to not occur at all as they get older. The majority of people with Osteoarthritis (81%) expect joint pain to increase as they age. Eight in ten (80%) Canadians who say they have no control over their joint pain expect their pain to increase as they get older. Two in five (43%) of those who expect their joint pain to increase as they get older manage their pain with OTC drugs. Q30: In regards to joint pain (joint pain may be described as aches, pain or soreness in one or more of your joints), whether you currently experience it or not, what do you expect to happen as you get older? Do you expect joint pain to… Total Canadians: n=2161 Increase: 65% Decrease: 2% 30% 51% 15% 3% 1% Osteoarthritis

7. 7 Of Canadians who think their joint pain will increase as they age more than half believe it is the natural aging process Q31: Why do you say you say you expect joint pain to as you get older? Total Canadians n=2161

8. 8 A quarter of Canadians say they are inactive Most Canadians consider themselves to be active to some degree whether it be very or somewhat active. Q4: Overall, in terms of your physical activity level, keeping in mind your daily activities at home, work, etc., would you describe yourself as being… Total Canadians: n=2161 73% ACTIVE 28% INACTIVE 15% 56% 25% 4% Osteoarthritis

9. 9 Inactive Canadians acknowledge possible consequences down the road Q6: You said that you are… Do you think your current level of physical activity will affect you later in life? These may be positive or negative results such as joint pain (causing or relieving), mobility limitations or maintaining/improving flexibility and balance, or any other physical outcomes such as weight control, breathing/lung capacity, blood pressure, or disease. ? Total Canadians: n=2161 Sixty-five per cent of Canadians who describe themselves as being not at all active think their current inactivity level will affect them negatively later in life. Not at all ActiveSomewhat Inactive Somewhat Active Very Active 7 in 10 Canadians who are very active believe this current level of activity will have a positive impact later in life.

10. 10 About one in five Canadians do not consider themselves physically active The majority of Canadians consider themselves physically active throughout the week and those who have Osteoarthritis are no different. Q5: Which of the following statements best describes you? Typically…Total Canadians: n=2161 2% 11% 55% 14% 18% Osteoarthritis

11. 11 Eight in ten Canadians who are 65 and over describe themselves as being physically active More than half (57%) of Canadians who experience joint pain daily describe themselves as physically active. Two in five (45%) Canadians who say they have no control over their joint pain describe themselves as physically inactive. Younger and older Canadians are less likely to be inactive than those 25 to 44. The Atlantic provinces seem to be more likely to describe themselves as physically active than any other province Q4: Overall, in terms of your physical activity level, keeping in mind your daily activities at home, work, etc., would you describe yourself as being… Total Canadians: n=2161 73% ACTIVE 28% INACTIVE Significantly higher at the 95% confidence level

12. 12 Almost two thirds of Canadians engage in at least one physical activity daily About two thirds (60%) of Canadians engage in at least one physical activity daily. Housework/chores and walking are the most frequently engaged in activities. More women than men engage in at least one physical activity daily (64% vs. 55% respectively). More than two thirds (68%) of Osteoarthritis suffers engage in at least one physical activity every day. Q3: How often do you engage in each of the following physical activities? Total Canadians: n=2161

13. 13 Many Canadians who are unhappy with their activity level are not very active Q7: Overall, how satisfied or dissatisfied are you with your current physical activity level? Total Canadians: n=2161 Very Somewhat Somewhat Not at all Active Active Inactive Active 52% SATISFIED 48% DISSATISFIED Satisfaction with activity level is almost evenly split. Nine in ten of those who are satisfied with their activity level say they are somewhat or very physically active. A large proportion of people who are dissatisfied with their activity level are somewhat inactive or report not being active at all. 9% 44% 37% 11% Osteoarthritis

14. 14 Physical problems are a barrier to exercise and cause dissatisfaction Twelve percent of Canadians who are dissatisfied with their current physical activity level say the reason is due to health or physical problems that keep them from exercising. Q8: Why do you ay you are with current physical activity level? Total Canadians: n=2161

15. 15 For one quarter of Canadians pain limits physical activity Time presents the greatest barrier to being physically active. One quarter of Canadians reported pain as something that limits the amount of physical activity they are currently engaged in. Q12: What, if anything, limits the amount of physical activity you are currently engaged in? Total Canadians: n=2161 38% say that pain and/or physical limitations restricts their physical activity 30% 26% 62% 47% 13% 27% 7% 8% 2% Osteoarthritis Seven in ten (72%) people with Osteoarthritis said that pain and/or physical limitations restricts the amount of physical activity they are presently engaged in.

16. 16 One tenth of Canadians who have not been diagnosed with joint pain say that pain limits their physical activity Time presents the greatest barrier to being physically active for Canadians who have not been diagnosed with joint pain as well as money. Q12: What, if anything, limits the amount of physical activity you are currently engaged in? Canadians who have not been diagnosed with any type of condition which affects joints causing pain, loss of mobility, deformity and/or dysfunction: n=1325 17% say that pain and/or physical limitations restricts their physical activity

17. 17 For many Canadians pain is a regular interference More than one in ten Canadians experience pain on a daily basis that prevents them from partaking in certain physically activities. 55% of Canadians experience pain at some time or another that prevents them from engaging in certain physical activities. Nine in ten Osteoarthritis sufferers (94%) experience pain that interferes with certain physical tasks. Q14: How often do you experience pain that prevents you from partaking in certain physical activities (includes daily household tasks, planned exercise, gardening, etc)? Joint pain may be described as aches, pain or soreness in one or more of your joints. Total Canadians: n=2161 24% experience pain on a daily or weekly basis 42% 11% 16% 8% 16% 6% Osteoarthritis

18. 18 Fifteen per cent of Canadians live with chronic pain Older Canadians are more likely to report experiencing chronic or recurrent pain while acute pain is more prevalent among 18 to 35 year olds. As would be expected, almost everyone who said they have been diagnosed with osteoarthritis define their pain as chronic or recurrent. Q15: There are 3 main classifications of pain. How would you define your usual experience with joint pain? Total Canadians: n=2161 45% 8% 2% Osteoarthritis 10% 22% 25% 43% Non- Osteoarthritis

19. 19 Many Canadians say that joint pain interferes with their day to day activities On a daily basis at least one in ten Canadians, who ever experience joint pain, feel the impact of this pain on their day-to-day activities, quality of sleep and ability to do chores. About one in four say that pain interferes with family and friend relationships. Q16: How often does joint pain, regardless of the type or intensity, interfere in any way with the following aspects of your life? Canadians who experience joint pain: n=1424

20. 20 Of those who say they have been diagnosed with osteoarthritis one third say joint pain impacts their day to day activities on a daily basis One quarter of those who say they have been diagnosed with osteoarthritis say that their joint pain effects their relationship with their family and a similar proportion say it impacts their mood. Overall, those who say they have been diagnosed with osteoarthritis say they are effected by joint pain on a higher daily occurrence than joint pain suffers who say they have not been diagnosed with osteoarthritis. Q16: How often does joint pain, regardless of the type or intensity, interfere in any way with the following aspects of your life? Canadians who experience joint pain: n=1424 OsteoarthritisNon-Osteoarthritis

21. 21 Overall, one third of Canadians expect to be less physically active 20 years from now Age and attitudes toward aging and physical activity level are related. Half of those 18 to 24 expect to be just as physically active (as they are now) when they are older compared to one fifth of Canadians who are 65+. People with Osteoarthritis are less optimistic about their level of physical activity 20 years from now. Q9a: How physically active do you expect to be 20 years from now? Total Canadians: n=2161 7% 26% 53% Osteoarthritis

22. 22 Some Canadians expect to be more physically active 20 years from now because they will have more time Q10: Why do you say you expect to be in the next 20 years? Total Canadians: n=2161 Almost one third of Canadians who expect to be more physically active 20 years from now say this because they think they will have more time to exercise.

23. 23 Many Canadians expect to be less physically active 20 years from now because they will simply “be very old” One in ten of Canadians who expect to be less physically active 20 years from now say the reason is because of health or physical problems. Q10: Why do you say you expect to be in the next 20 years? Total Canadians: n=2161

24. 24 Half of those who expect to be physically in active 20 years from now are dissatisfied with this expectation Almost everyone who says they expect to be more or just as physically active 20 years from now is satisfied with this expectation. The level of satisfaction is almost evenly split when it comes to expecting a lower or non-existent physically active lifestyle 20 years from now. Q11: You said you expect to be 20 years from now. How do you feel about your expectation? Total Canadians: n=2161

25. 25 Half of those who expect to not be physically active 20 years from now are dissatisfied with this expectation While it is surprising that anyone would be satisfied with the idea of being less or not at all active 20 years down the road, it is illustrated below the link between satisfaction with this possible outcome and age. Seven in ten of those 65 and older are satisfied with their expectation of being less physically active 20 years from now (when they are 85 and older). Q11: You said you expect to be 20 years from now. How do you feel about your expectation? Total Canadians: n=2161 53% of those who expect to be less physically active are satisfied with this expectation 49% of those who expect to not be at all active are satisfied with this expectation * *Caution: this is based on 3 respondents 18-24.

26. 26 One third are as physically active as they thought they would be 20 years ago Forty percent say they are less physically active today than they thought they would be 20 years ago. More than half of those who have been diagnosed with osteoarthritis believe they are less physically active today then what they thought they would be 20 years ago compared to one third of those who have not been diagnosed with osteoarthritis. Women are more likely than men to say they are less physically active now than they anticipated 20 years ago. A greater proportion of men than women feel they are just as active as they expected to be. Q33a: Are you as physically active today as you thought you would be 20 years ago? Canadians 40+: n=1439 26% 20% 54% Osteoarthritis 36% 25% 38% Non- Osteoarthritis Significantly higher at the 95% confidence level 39% males vs. 29% females 46% females vs. 37% males

27. 27 Many Canadians in their 60’s and older are less physically active than they thought they would be Forty percent say they are less physically active than they thought they would be 40 years ago. More than half of those who have been diagnosed with osteoarthritis say they are less physically active today then they thought they would be 40 years ago compared to one third of those who have not been diagnosed with osteoarthritis. Q33b: Are you as physically active today as you thought you would be 40 years ago? Canadians 60+: n=433 22% 25% 53% Osteoarthritis 29% 34% 37% Non- Osteoarthritis Significantly higher at the 95% confidence level

28. 28 More than one third of Canadians have not sought medical help for their joint pain Many Canadians experience joint pain but have not sought medical help. A quarter of those with Osteoarthritis seek medical help when they first start or started to experience joint pain. Q17: When do you or did you seek medical help for your joint pain? Canadians with joint pain: n=1424 25% 8% 10% 26% 16% 7% 9% Osteoarthritis 36% of Canadians with joint pain said they have not sought medical help. However, when asked who they turn to first to manage joint pain: 13% GP 5% Chiropractor 4% Physiotherapist 6% Massage Therapist 4% friend/family 4% pharmacist

29. 29 One in five of those who experience chronic pain waited a few months before seeking medical help Ten per cent of Canadians with chronic pain have not sought medical help, nor have a third of those with recurrent pain. 26% of Canadians who experience chronic or recurrent pain have not sought medical help. Q17: When do you or did you seek medical help for your joint pain? Canadians with joint pain: n=1424 ChronicRecurrentAcute

30. 30 Two in five Canadians turned to a GP first to help them manage their joint pain Q18: When it comes to helping you manage your joint pain, who/what did you turn to first? Canadians with joint pain: n=1424 70% 5% 6% 2% 4% 1% 2% 1% 3% 2% 3% 4% Osteoarthritis Seven in ten people with Osteoarthritis would or have turned to a GP first.

31. 31 For half of Canadians who experience pain rest is the most common choice for management Q24:How do you normally manage your joint pain? Canadians with joint pain: n=1424 38% 40% 35% 16% 20% 18% 15% 12% 8% 9% 2% Sixty-two per cent of Canadians with joint pain include some type of physical activity as part of their pain management. Among those with joint pain, 47% use drugs/ medication as part of their pain management. In general, people who have been diagnosed with Osteoarthritis are using similar methods to manage their pain. Highlighted in blue are methods used where the Osteoarthritis sample differ.

32. 32 One in seven Canadians suffering from joint pain use prescription drugs to manage their joint pain Q24:How do you normally manage your joint pain? Canadians with joint pain: n=1424 41% Use Over The Counter Drugs 14% Use Prescription Drugs More than half (54%) use some type of drug – OTC or prescription – to mange their joint pain. More older Canadians (45 to 65+) tend to use OTC drugs to manage their join pain than those aged 18-44 (45% vs. 33% respectively). One third (34%) of those who say the have no control over their joint pain mange it with OTC drugs. Half (51%) of those who say they have exhausted all pain management options use OTC drugs to manage their joint pain More women than men claim to manage their joint pain with OTC drugs (44% vs. 37% respectively). One third (32%) of those who classify their joint pain as Chronic say they use prescription drugs to manage the pain. One third (32%) of those who say they have been diagnosed with osteoarthritis say they use prescription drugs to manage their joint pain.

33. 33 One third feel that adapted physical activity programs would help them better manage their joint pain One in five believe better professional healthcare would help them manage their joint pain better. There is also desire for better medications and information sources. One quarter believe nothing would make a difference. One third of Osteoarthritis sufferers feel that better or new medication would help them better manage joint pain. Q24b: Which of the following would help you to better manage your joint pain? Canadians with joint pain: n=1424 31% 22% 34% 19% 15% Osteoarthritis

34. 34 About one in ten Canadians who experience joint pain say they have no control over it Many pain sufferers believe they have at least some control over it. Almost half (46%) of those who manage their joint pain with non-drug approaches feel they have control over their joint pain More than half (53%) of those who manage their pain with drugs (OTC and prescription) feel they have some control over their joint pain. Q25: Based on all the things you do to cope or deal with pain in general, overall how much control do you feel you have over joint pain? Canadians with joint pain: n=1424 5% 34% 54% 8% Osteoarthritis Control: 46%

35. 35 “It doesn’t work, nothing can be done, it always hurts” One third of Canadians who do not have control over their joint pain say they feel this way because they believe nothing can be done. Almost a quarter of Canadians who say they have some control over their joint pain say this because they believe that medication, treatment and exercise ease the pain. Q26: Why do you feel you have over joint pain? n=1424

36. 36 One in five Canadians with joint pain say they “can live with it” Q26: Why do you feel you have over joint pain? n=1424 The explanations for why people who have joint pain feel they can control it are related to knowing what causes the aggravation and thus avoiding the cause, feeling able to live with it because it is minimal and knowing how to alleviate it.

37. 37 One in ten are not comfortable with the way they manage their joint pain Twelve per cent of Canadians who experience joint pain are uncomfortable with how they are managing their joint pain. Among joint pain sufferers who say they are uncomfortable with how they are managing joint pain, the proportions of people who report using various types of physical activity to help manage the pain are smaller than those who are comfortable with how they are managing joint pain. Q27: How comfortable are you with the way you manage your joint pain? Canadians with joint pain: n=1424 Q29: To what extent do you agree or disagree with the following statements? Canadians with joint pain: n=1424 88% Comfortable 12% Uncomfortable Significantly higher at the 95% confidence level Comfortable with how managing joint pain Uncomfortable with how managing joint pain People who are uncomfortable are less likely to be using physical activity to help manage joint pain than those who are comfortable with their method(s) of joint pain management.

38. 38 One in ten are uncomfortable with the way they manage their joint pain because they do not like to take drugs One third (34%) of Canadians who take medication (OTC and prescription drugs) for their joint pain said they are uncomfortable with the way they manage their pain because the pain is still there, nothing helps. Q28: Why do you feel you have uncomfortable with the way you manage your joint pain? n=163

39. 39 A third of Canadians ignore their pain altogether Many Canadians wait until the pain is unbearable before taking any action. One in four of those who say they have been diagnosed with Osteoarthritis believe they have exhausted all options in terms of pain management. Q29: To what extent do you agree or disagree with the following statements? Canadians with joint pain: n=1424 I see my physician regularly At the end of the day I am responsible for my own health I sometimes wait until my pain is unbearable before I take action I follow my doctors treatment instructions as best as possible I sometimes seek a second opinion after meeting with my regular doctor I know my body better than anyone I ignore my pain altogether I have exhausted all options in terms of pain management At the first sign of pain I take appropriate action Canadians with Joint Pain Osteoarthritis Sample

40. Joint Pain Survey Results March 13, 2008