Earlier this year, NICE (National Institute for Health & Care Excellence) published draft guidelines for healthcare professionals on assessment and management of osteoarthritis. Published just ahead of Arthritis Awareness Month in May, it spurned articles from the BBC, The Guardian and Sky News, each focusing on the key outtake of the NICE guidelines: exercise is the best medicine for osteoarthritis.
Scans aren't needed to diagnose it and strong painkillers are not recommended in the treatment of osteoarthritis
More than 10 million people in the UK suffer from an arthritic condition and osteoarthritis is the most common form of arthritis, affecting around 8.5 million according to Versus Arthritis, the largest charity in the UK supporting those with arthritis.
Arthritis care costs the NHS in excess of £10bn per year and most patients are prescribed painkillers. The cost of treatment and care by NHS and our healthcare system is estimated to reach around £118bn across the next decade.
In 2000, osteoarthritis was responsible for 3 million GP consultations and 115,000 hospital admissions. In 2010 there were 116,000 hip and knee joint replacements in the UK, at a cost of £890 million pounds. According to research by statistica.com in 2021 women aged 75 – 79 had a hip replacement at a rate of 271 per 100,000 population, and men 186 per 100,000. This figure is set to increase.
While it’s not possible to prevent osteoarthritis altogether, the risk of developing the condition and hindering long-term effects such as surgery can be achieved through positive lifestyle choices.
According to Versus Arthritis, the government healthcare system is designed to make prescribing medication the easiest form of early-stage treatment for osteoarthritis, but those with chronic pain need more than just medication to manage it, including a complete network of support that covers mental health, physical activity, exercise and peer-support.
Synovial fluid, the thick liquid that lubricates joints and helps keep them moving smoothly, depletes if joint movement is not maintained. Overtime, without enough lubricating fluid, our cartilage can wear away causing bones in the joints to rub together. This can be very painful and impede any aspiration to keep moving. A vicious circle!
To help reduce arthritic pain longer term, there are simple, daily exercises that help strengthen muscles around joints, designed to get joints moving. Additionally, exercise can help people maintain a healthy weight, which is also important for managing osteoarthritis.
Arthritis Action said it hoped the guidelines would reassure people with osteoarthritis that exercise is a good intervention.
The NICE draft guidelines give the following advice:
- For those with osteoarthritis, a treatment programme of therapeutic exercise such as local muscle strengthening and general aerobic fitness is advised
- Educating those with osteoarthritis that joint pain may increase when they start therapeutic exercise.
- Explanation that doing regular and consistent exercise, even though this may initially cause discomfort, is beneficial longer term for joint health
- Combining therapeutic exercise with an education programme or behavioural lifestyle changes in a structured treatment programme will deliver the best results
As Mark Twain said:
The secret of getting ahead is getting started
At The Core we have a range of treatments and therapies to help you jump start your musculoskeletal health journey – from nutrition and exercise advice to soft tissue and physiotherapy. If your chronic pain is debilitating and inflammation is inhibiting your mobility, then MBST therapy might be a useful adjunct to a physiotherapy and as part of a physiotherapy treatment and exercise programme, it has helped several of our patients get back to regular exercise free from pain.