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Arthritis patients told to lose weight and exercise more

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The guidance for doctors has come from the National Institute for Health and Care Excellence (Nice). Doctors are told to diagnose osteoarthritis – the most common form of arthritis – themselves without further investigation in people aged 45 or over who have activityrelated joint pain.

Patients should have no morning joint-related stiffness or morning stiffness that lasts no longer than 30 minutes, according to Nice.

The draft guideline says people can be offered tailored “low impact” aerobic exercise programmes, such as walking and swimming. But it should be explained to them that “doing regular and consistent exercise, even though this may initially cause discomfort, will be beneficial for their joints”.

Dr Paul Chrisp, the director for the centre for guidelines at Nice, said: “Beginning the journey can be uncomfortable for some people at first and they should be supported and provided with enough information to help them to manage their condition over a long period of time.”

When it comes to losing weight, patients 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 five”.

The guidelines also give recommendations on the use of medicines, such as offering non-steroidal antiinflammatory drugs (Nsaids) but not paracetamol, glucosamine or strong opioids.

Nice said there was a risk of addiction with opioids, while the latest evidence suggests little or no benefit for some medicines when it comes to quality of life and pain levels.

People can also be referred for hip or knee replacement if their condition can’t be managed in other ways, Nice added.

In Britain, more than 10 million have arthritis or similar conditions that affect joints. The most affected areas are the knees, hips and hands.

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