NICE updates osteoarthritis recommendations

New guidance emphasises the importance of exercise in managing the condition.

Exercise is a core treatment in the management of osteoarthritis and should consist of a combination of local muscle strengthening and general aerobic fitness, irrespective of age, co-morbidity, pain severity or disability | SCIENCE PHOTO LIBRARY
Exercise is a core treatment in the management of osteoarthritis and should consist of a combination of local muscle strengthening and general aerobic fitness, irrespective of age, co-morbidity, pain severity or disability | SCIENCE PHOTO LIBRARY

NICE has updated its clinical guideline on the care and management of osteoarthritis in adults with new advice on diagnosing the condition, referral for joint surgery, follow-up and review.

NICE now advises that in people aged 45 years and over, osteoarthritis can be diagnosed without the need for clinical investigations if the activity causes joint pain but the person has either only brief or no joint stiffness in the mornings.

If a person continues to experience pain that interferes with their daily life despite symptom-relieving treatment and analgesics, the guideline recomends that joint surgery be considered before there is prolonged limitation of joint movement and severe pain.

Regular reviews should be offered to monitor the person's symptoms and the impact of the condition on everyday activities, with annual reviews for people with osteoarthritis in specific situations.

"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", said Professor Mark Baker, Centre for Clinical Practice Director at NICE. "The guidance highlights that the core treatment for osteoarthritis remains exercise - this not only helps relieve pain for some people but also improves function. For people with osteoarthritis who are overweight or obese, offering advice on ways to lose weight as part of helping them self-manage their condition, is another amended original recommendation."

The recommendations on pharmacological management of osteoarthritis remain unchanged pending the MHRA's review of over-the-counter analgesics.

The updated guidance is condensed in a quick-reference MIMS summary.


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