Stop taking painkillers for arthritis, NHS patients told
Push for exercise instead could save billions
Millions of patients with arthritis will be told to exercise and lose weight instead of taking painkillers under new NHS guidance.
The National Institute for Health and Care Excellence (Nice) said physical activity was a better option for relieving pain caused by osteoarthritis than drugs such as paracetamol.
The guidelines could save the health service billions of pounds by reducing the number of painkiller prescriptions and helping patients to avoid expensive joint replacements.
Osteoarthritis affects about 8.5 million people in the UK and is the most common type of arthritis. It causes joints to become stiff and painful.
Arthritis costs the NHS £10 billion a year, with eight in ten patients prescribed painkillers, and is the primary cause of 98 per cent of knee replacements, costing £10,000 per joint.
Doctors will be encouraged to offer tailored exercise programmes, stretches and details of group classes such as yoga and tai chi.
People with arthritis can sometimes be put off exercising because movement can cause a temporary flare-up of joint pain.
But there is a wealth of evidence showing that regular physical activity is vital to managing the condition, both by relieving pain and reducing stiffness.
Exercise has been proven to increase muscle strength and reduce stiffness for arthritis patients, while weight loss reduces pressure on joints and relieves inflammation.
Nice said paracetamol and glucosamine, a nutritional supplement, should not be offered as they do little to relieve pain, while opioids should be avoided because they are addictive. Previous arthritis guidelines said doctors should consider offering opioids such as codeine, morphine, tramadol and fentanyl.
However, the new guidelines say ibuprofen gel applied directly to the joint can be helpful for relieving pain, and ibuprofen pills can also be taken.
Doctors have been told to explain to patients that “doing regular and consistent exercise, even though this may initially cause discomfort, will be beneficial for their joints”.
When it comes to weight loss, arthritis patients who are overweight will be encouraged to set a target. They will be told that “any amount of weight loss is likely to be beneficial, but losing 10 per cent of their body weight is likely to be better than 5 per cent.”