New Draft NICE Guidelines Advise Exercise for Managing Osteoarthritis - Arthritis Action

New Draft NICE Guidelines Advise Exercise for Managing Osteoarthritis

3 May 2022

NICE (The National Institute for Health and Care Excellence) has published updated draft guidelines on the management of osteoarthritis (also commonly known as ‘wear and tear’ arthritis). These guidelines suggest an important change in the treatment of people with osteoarthritis, emphasising the importance of self-management by supported exercise and weight management to help with the symptoms of osteoarthritis – advice which is strongly backed up by research evidence.

Commenting on the new guidelines, Dr Wendy Holden, Arthritis Action’s Medical Advisor and Honorary Consultant Rheumatologist, says:

“For the first time, NICE have suggested that lifestyle changes such as exercise and weight management are more effective than conventional pain-relieving medicines used for osteoarthritis. The  draft guidelines advise people affected by osteoarthritis to avoid regular opioids such as codeine and co-codamol, if possible, and paracetamol, as neither of these medicines have been shown to be particularly effective for osteoarthritis pain. In addition, opioids are associated with significant risks of addiction and dependence. NICE has advised that non-steroidal anti-inflammatory medicines (NSAIDs) such as ibuprofen and naproxen, if essential, should be used at the lowest possible dose for the shortest possible time, because NSAIDs can have harmful side effects such as gastrointestinal bleeding and ulcers, high blood pressure and cardiovascular disease as well as harmful effects on the kidneys.

“The advice on reducing painkillers such as codeine and paracetamol does not apply to other medicines such as methotrexate, which is used for inflammatory arthritis and is not a painkiller. Of course, if painkillers are necessary for managing your arthritis pain then these can be continued after discussion with your GP or healthcare provider. Opioids such as codeine should not be stopped suddenly as this can lead to unpleasant withdrawal effects.”

This draft guidance only applies to osteoarthritis management. There are other forms of arthritis (such as rheumatoid arthritis and psoriatic arthritis) which are not covered by this guidance.

For more information about the importance of exercise for someone living with arthritis, visit our Exercise and Arthritis page. If you have any further questions or queries about how this new guidance affects you and your personal arthritis management, please consult a healthcare professional to discuss further.