Britons with arthritis are being urged to lose weight and exercise more than rely on painkillers as the main treatment for their condition.
NHS guidelines from National Institute for Health and Care Excellence Ness says overweight people should be told their pain can be reduced if they shed pounds.
Aerobic exercises such as walking, in addition to strength training, can relieve symptoms and improve quality of life. The directions say that exercise programs may make the pain worse at first, but this should stabilize.
The guidelines also make recommendations on medication use, such as offering non-steroidal anti-inflammatory drugs (NSAIDs) but not offering paracetamol, glucosamine, or strong opioids.
Ness said there is a risk of addiction to strong opioids, while evidence suggests little or no benefit from some medications when it comes to quality of life and pain levels.
In the guidelines, clinicians are asked to diagnose osteoarthritis – the most common form of arthritis – without further investigation in people over 45 with activity-related joint pain.
Patients must not have morning stiffness, or morning stiffness lasting more than 30 minutes, to be diagnosed in this way.
The draft guidelines state that people can be submitted Tailor-made exercise programs“Doing regular and consistent exercise, although this may cause discomfort at first, will be beneficial for their joints,” he explained.
The guideline adds that long-term exercise also increases health benefits.
When it comes to weight loss, people will be told “any amount of weight loss is likely to be beneficial, but a 10% loss of body weight is likely to be better than 5%”.
People may also be referred for hip or knee replacement if their condition cannot be managed in other ways, and referrals should not be deferred due to age, gender or obesity.
Dr Paul Crisp, director of the Guidance Center in Nice, said: “Arthritis can cause discomfort and prevent people from carrying out some of their normal daily activities.
“However, there is evidence to show that muscle strengthening and aerobic exercise can have an impact not only on managing the condition, but also on providing people with a better quality of life.
“Starting that journey may be uncomfortable for some people at first, and they need to be supported and provided with enough information to help them manage their condition over a long period of time.
While topical and oral NSAIDs sometimes remain an important treatment option for osteoporosis, we have made the decision not to recommend certain pain relievers, such as paracetamol and some opioids, for osteoporosis.
“This is because new evidence has shown that there is little or no benefit to people’s quality of life, pain or psychological distress, and especially in the case of strong opioids, there has been evidence that they can cause long-term harm, including potential addiction.”
Over 10 million people in the UK suffer from arthritis or other similar conditions that affect the joints. The areas most affected are the knees, hips, and small joints of the hand.
“We have seen first-hand the benefits that people with arthritis can have in being able to access appropriate physical activity, especially when they are in a group environment,” said Tracy Loftis, head of policy and public affairs at the charity Against Arthritis. Something like exercise can improve It increases a person’s ability to move, helps control his pain and reduces feelings of isolation.
“But our own research on support for people with osteoarthritis has shown that many of them do not have regular review of their cases by healthcare professionals, and even less have had the opportunity to access physical activity support.
“The lack of alternatives means, in many cases, that many people are stuck taking painkillers that don’t help them lead a pain-free life.
“While we welcome the draft Nice Guidelines, healthcare professionals need more resources and support to better understand their role in promoting treatment such as physical activity for people with osteoporosis.
“There is clearly a need for those with arthritis to give a bigger voice so that their health needs are not ignored.”