PhysioUpdate 3rd May 2022


NICE draft guideline emphasises exercise and weight loss rather than drugs in osteoarthritis care

The potential benefits of exercise for people with osteoarthritis have been extolled in a new draft guideline issued today (29 April) by the National Institute for Care and Health Excellence (NICE).

Two physiotherapists – Nicky Wilson and Jonathan Quicke – sat on the 10-member core committee that drew up the draft guideline. Clinicians and members of the public have until 15 June to respond to the guideline.

The committee endorsed evidence showing that offering tailored exercises – such as muscle strengthening and aerobic exercise – to people with osteoarthritis can achieve good outcomes.

Evidence supports the use of muscle strengthening and aerobic exercise, NICE announces

Weight loss options

Clinicians should consider helping people with osteoarthritis who are overweight to choose a weight loss goal that will help them to help manage symptoms. Losing weight can have a significant impact on health outcomes for a range of conditions, but it can also help to reduce joint pain for people with osteoarthritis, the guidelines stresses.

there is evidence which shows muscle strengthening and aerobic exercise can have an impact on not just managing the condition, but also providing people with an improved quality of life [Paul Chrisp, NICE]

Paul Chrisp, director at the NICE Centre for Guidelines, said: ‘Osteoarthritis can cause people discomfort and prevent them from undertaking some of their normal daily activities.

'However, there is evidence which shows muscle strengthening and aerobic exercise can have an impact on not just managing the condition, but also providing people with an improved quality of life. Beginning that 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.’

Certain painkillers not recommended

Dr Chrisp said that though using non-steroidal anti-inflammatory drugs topically and, at times, orally remained an ‘important treatment option’ in cases of osteoarthritis, the draft guideline did not recommend using painkillers such as paracetamol and some opioids for osteoarthritis.

‘This is because new evidence has shown there was little or no benefit to people’s quality of life, pain or psychological distress and particularly in the case of strong opioids, there was evidence that they can cause harm in the longer term, including possible addiction,' Dr Chrisp noted.

The draft guideline also recommends diagnosing osteoarthritis clinically without the need for imaging in people who are aged 45 or over, have activity-related joint pain and, have either no morning joint related stiffness or morning stiffness lasting no longer than 30 minutes.

Manual therapy

The introduction to a section in the draft guideline on manual therapy states that the benefits of exercise for people with some forms of osteoarthritis is 'well established'. 'Manual therapy may also help provide a benefit for some joints by increasing mobility and reducing pain. There are a variety of techniques including passive stretching, soft tissue techniques and acupressure/trigger point therapy.'

The introduction adds: 'There is no standard current practice relating to the provision of manual therapy for people with osteoarthritis, the use of this management approach is left to the discretion and expertise of the treating healthcare professional. As manual therapy needs to be delivered in a face-to-face context, there is potentially a resource implication for offering manual therapy in a system in which remote consultations are employed.'

Factfile on osteoarthritis

  • it is caused by changes in the whole joint that can cause discomfort and pain
  • it is the most common form of arthritis, and one of the leading causes of pain and disability worldwide
  • about 7.4 million people in England aged over 45 identified have the condition
  • knees, hips and small hand joints are the most affected

Physiotherapist committee members

Physiotherapist committee member Nicky Wilson is a lecturer in physiotherapy at the University of Southampton and is a consultant physiotherapist at King’s College Hospital in south London.

Jonathan Quicke is described as being an academic clinical lecturer in physiotherapy: osteoarthritis and long-term conditions at Keele University. Dr Quicke is also listed as being a Haywood Foundation activity coordinator.

To see the full version of the draft guideline, titled Osteoarthritis: Care and Mangement (update), visit: https://www.nice.org.uk/guidance/indevelopment/gid-ng10127/consultation/html-content-2



Stop using words that 'belittle and infantilise' patients, clinicians urged in article in The BMJ

Attempts to form collaborative relationships will falter unless clinicians start using neutral terminology when they communicate with, or about, patients, according to an article in the latest issue of The BMJ (28 April).

Written by Caitríona Cox and Zoë Fritz from the Healthcare Improvement Studies (THIS) Institute at the University of Cambridge, the article stresses that shared decision making is backed by bodies such the National Institute for Health and Care Excellence (see link to NICE guideline below).

Despite this, medical language that undermines and blames patients for their health problems continues to be used in everyday clinical practice, the authors suggest.

Outmoded language such as 'non-compliance' negatively affects relationships with patients

Read More


Want to receive newsletters?


FREE membership

Join Us

Sign up today for membership and get...

✓ Regular newsletters
✓ Full website access
✓ Sponsor Benefits

We’ll keep you connected so you’ll NEVER MISS AN UPDATE!

Join Here

Previous newsletters


PhysioUpdate 24th May 2022
PhysioUpdate 19th May 2022
PhysioUpdate 17th May 2022
PhysioUpdate 12th May 2022
PhysioUpdate 10th May 2022
PhysioUpdate Supplier News 5th May 2022
PhysioUpdate Supplier News 28th April 2022
PhysioUpdate 26th April 2022
PhysioUpdate 19th April 2022
PhysioUpdate 14th April 2022
PhysioUpdate 12th April 2022
PhysioUpdate Supplier News 7th April 2022
PhysioUpdate 5th April 2022
PhysioUpdate 31st March 2022
PhysioUpdate 29th March 2022
PhysioUpdate 22nd March 2022
PhysioUpdate Supplier News 17th March 2022
PhysioUpdate 15th March 2022
PhysioUpdate 8th March 2022
PhysioUpdate 3rd March 2022
PhysioUpdate 1st March 2022
PhysioUpdate 22nd February 2022
PhysioUpdate 17th February 2022
PhysioUpdate 15th February 2022
PhysioUpdate Supplier News 10th February 2022
PhysioUpdate 8th February 2022
PhysioUpdate 3rd February 2022
PhysioUpdate 1st February 2022
PhysioUpdate 25th January 2022
PhysioUpdate Supplier News 20th January 2022
PhysioUpdate 18th January 2022
PhysioUpdate Supplier News 13th January 2022
PhysioUpdate 11th January 2022
PhysioUpdate 28th December 2021
PhysioUpdate 21st December 2021
PhysioUpdate Supplier News 16th December 2021
PhysioUpdate 14th December 2021
PhysioUpdate Supplier News 9th December 2021
PhysioUpdate 7th December 2021
PhysioUpdate 30th November 2021
PhysioUpdate Supplier News 25th November 2021
PhysioUpdate 23rd November 2021
PhysioUpdate Supplier News 18th November 2021
PhysioUpdate 16th November 2021
PhysioUpdate Supplier News 11th November 2021
PhysioUpdate 9th November 2021
PhysioUpdate 2nd November 2021
PhysioUpdate Supplier News 28th October 2021
PhysioUpdate 26th October 2021
PhysioUpdate Supplier News 21st October 2021
PhysioUpdate 19th October 2021
PhysioUpdate Supplier News 14th October 2021
PhysioUpdate 12th October 2021
PhysioUpdate Supplier News 7th October 2021
PhysioUpdate 5th October 2021
PhysioUpdate 28th September 2021
PhysioUpdate 21st September 2021
PhysioUpdate Supplier News 16th September 2021
PhysioUpdate 14th September 2021
PhysioUpdate Supplier News 9th September 2021
PhysioUpdate 7th September 2021
PhysioUpdate Supplier News 2nd September 2021
PhysioUpdate 24th August 2021
PhysioUpdate Supplier News 19th August 2021
PhysioUpdate 17th August 2021
PhysioUpdate 3rd August 2021
PhysioUpdate 27th July 2021
PhysioUpdate 20th July 2021
PhysioUpdate Supplier News 15th July 2021
PhysioUpdate 13th July 2021
PhysioUpdate 6th July 2021
PhysioUpdate 29th June 2021
PhysioUpdate 22nd June 2021
PhysioUpdate Suppliers News 18th June
PhysioUpdate 15th June 2021
PhysioUpdate 8th June 2021
PhysioUpdate 2nd June 2021
PhysioUpdate 4th May 2021
PhysioUpdate 27th April 2021
PhysioUpdate Supplier News 22nd April
PhysioUpdate 6th April 2021
PhysioUpdate 30th March 2021
PhysioUpdate Supplier News 25th March
PhysioUpdate 23rd March 2021
PhysioUpdate Supplier News 18th March 2021
PhysioUpdate 16th March 2021
PhysioUpdate 9th March 2021
PhysioUpdate 2nd March 2021
PhysioUpdate Supplier News 25th February
PhysioUpdate Supplier News 18th February
PhysioUpdate 16th February 2021
PhysioUpdate 2nd February 2021
PhysioUpdate Supplier News 21st January
PhysioUpdate 19th January 2021
PhysioUpdate 5th January 2021
PhysioUpdate 22nd December 2020
Industry News
9 December 2020
By using our site, you acknowledge that you have read and understand our Cookie Policy and Privacy Policy.