12th February 2014 – People with osteoarthritis should be encouraged to take more exercise to help manage their condition and reduce pain, says the NHS drugs and treatment regulator for England.
Updated guidance from the National Institute for Health and Care Excellence (NICE) also recommends that those with osteoarthritis should be referred for possible joint replacement surgery before their pain becomes severe or the condition imposes long-term physical disability.
Osteoarthritis is a common condition with associated pain, joint stiffness and reduced quality of life.
It affects the joints, most commonly the knees, hips, spine and small joints of the hands, but it can also occur in other joints. Damage and loss of joint-lining cartilage, damage to adjacent bone, and inflammation of the tissues around the joint are the main characteristics of the condition.
Osteoarthritis is the most common form of arthritis, with around 1 million people seeing their GP about it every year. It accounts for 115,000 hospital admissions in the UK each year. The condition can affect people’s ability to undertake daily activities, and is one of the leading causes of pain and disability worldwide.
Professor Mark Baker, Centre for Clinical Practice director at NICE, says in a statement: "There’s a common but mistaken belief that osteoarthritis is an inevitable part of ageing and that it will get worse, but that’s not the case. This updated guidance provides evidence-based recommendations on the most effective ways of diagnosing and managing osteoarthritis, to help improve the lives of people affected by it.
The new guidance from NICE builds on previous recommendations drawn up in 2008.
The new guidance
The new, or updated, recommendations include:
Offer advice on these core treatments to all people with clinical osteoarthritis: access to appropriate information, activity and exercise, interventions to lose weight if the person is overweight or obese.
Diagnose osteoarthritis clinically without investigations if a person is 45 or over and has activity-related joint pain and has either no morning joint-related stiffness or morning stiffness that lasts no longer than 30 minutes.
Refer for consideration of joint replacement surgery before there is prolonged and established functional limitation and severe pain. Referral should be made irrespective of a person's age and sex or whether they smoke or are obese.
Offer regular reviews to all people with symptomatic osteoarthritis, which should cover monitoring the long-term course of the condition, reviewing the effectiveness and tolerability of treatments and other points. Annual reviews should be considered if the person has health complications, troublesome joint pain, more than one joint affected, or they are taking any medications for their osteoarthritis.
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