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Osteoarthritis - new NICE guidelines

(50 Posts)
JessM Tue 18-Feb-14 09:09:02

This is the press release. The main document looks like several days of reading.
Key point is that exercise and weight loss are the preferred first recommendations. And that there is no evidence that glucosamine or chondritin any use.

www.nice.org.uk/newsroom/pressreleases/OsteoarthritisGuidelinePublished.jsp

celebgran Wed 19-Feb-14 22:41:40

My knees are very painful after acquacise but I do enjoy hit and seems best to keep moving while you can it too read about strengthening muscles to supports problem joints. Here's hoping!

annodomini Wed 19-Feb-14 19:42:17

Nudge, nudge,wink wink

Iam64 Wed 19-Feb-14 19:10:06

Anno grin

Aka Wed 19-Feb-14 12:43:46

envy

annodomini Wed 19-Feb-14 12:23:28

petallus, after my hip operation, I wondered about the breast stroke kick, but haven't had any adverse effects and the physio approved it. It's very good for the hip and thigh muscles. Walking or jogging through water is also excellent exercise. One Sunday morning, some years ago, I was swimming up and down the pool when a group of very hunky young men came in and started walking up and down. It turned out that they were the Sale Sharks rugby team.

Ariadne Wed 19-Feb-14 11:05:29

I am doing the isometric exercises prescribed by the physio, in order to strengthen my leg muscles before the knee replacement. Amd I have learned, and am learning, how much walking I can do without aggravating everything!

Elegran Wed 19-Feb-14 10:50:15

The breast stroke is not obligatory, Petallus. Other brands of swimming are available.

tanith Wed 19-Feb-14 10:46:25

Petallus any kind of swimming is good even floating on your back and kicking your feet. Honestly I heard the same thing about breast stroke kick but since my first hip-replacement 8/9yrs ago I have been swimming once or twice a week doing 50 lengths of breast stroke and my second hip is only marginally worse than it was 8yrs ago so I believe that keeping the muscles strong is helping stabilise the failing joint as I'm sure if I'd done no excercise it would be much less mobile than it is. Give it a try even if its gentle walking or swimming on your back or buy a flotation board that you hold out in front of you and just kick with your legs in the pool if you are worried about the 'froggie' legs grin

petallus Wed 19-Feb-14 09:47:13

tanith i would like to start swimming again but heard somewhere that the froggie leg movement that goes with the breast stroke could make a dodgy hip even worse.

tanith Wed 19-Feb-14 09:12:59

I have multiple joint O/A and have had one hip replaced so far, the reason excercise is so important, walking and swimming being best for those in pain, strengthening the muscles around the affected joints is so important, the less you move them the more the muscle wastes its a vicious cycle . You need to keep the muscle strong to support the failing joints as the saying goes 'use it or lose it', its very apt for O/A... I know it hurts but if it keeps you able to move and maintain muscle strength you just have to do it .

Aka Wed 19-Feb-14 09:04:19

It's very curious I agree, but pleased you find it works for you too. I see you also have osteopenia of the spine. Have you read the research in Vit K2 for improving bone? It works well with Vit D and calcium.

Iam64 Wed 19-Feb-14 08:56:42

I was recently found to have osteopina in my hips. I'm on meds for inflammatory arthritis, so I'm also prone to osteo arthritis. My GP is now prescribing Calcium/vitD, and advised me to go back to taking glucosamine/chondriatin supplements, thought she can no longer prescribe them. I have now been taking them 12 weeks, and it may be placebo, but the foot/knee and hip pain are definitely improved. I took G/C years ago, and like Aka, found it worked for me. Dog training/breeding pals tell me they find its effective in helping old dogs with joint pain. My vet recommended it for our old rescue dog last year. Curious isn't it

D0LLIE Wed 19-Feb-14 08:49:32

glucosamine and chondroitin is no good if you have a shellfish allergy...i did try them some years ago and they made me really ill...

JessM Wed 19-Feb-14 08:39:25

The link summarises perfectly aka

janeainsworth Wed 19-Feb-14 01:52:57

There was a bit of a kerfuffle a couple of months ago when NICE told GPs not to prescribe paracetamol for OA, and didn't want them to prescribe anything else either. The doctors apparently supposed to pat people on the head and tell them to put up with the pain.
I think they've now withdrawn that, but this latest thing is probably just their latest wheeze for annoying the doctors.

Tegan Tue 18-Feb-14 17:11:40

Well, two of my doctors used to advise people to take it [one used to give it to his dog and his horses as well]; a couple said it was rubbish and the other one just told everyone that went to see him to go jogging [no matter what you went to see him about]! Mind you, not many people went to see that one....

jinglbellsfrocks Tue 18-Feb-14 17:04:59

Glucosamine isn't an anti-inflammatory. It's a food supplement, not a drug.

If you are going to try it, for goodness sake get it combined with chondroitin. It won't work on its own.

annodomini Tue 18-Feb-14 16:57:35

My medic sister said that glucosamine was worth trying as there was some evidence that it could work.

Tegan Tue 18-Feb-14 16:57:26

Isn't that true of all pharmaceutical companies wink. Maybe the people who make glucosamine don't have the backing of huge companies that can pay for research that will come up with the correct result [or am I just old and cynical sad]. It's funny how some medication becomes 'flavour of the month' when the GP's are offered a good deal on it hmm.

Aka Tue 18-Feb-14 16:54:35

arthritis research uk

JessM Tue 18-Feb-14 16:53:05

I guess NICE feel there is not enough evidence. There are some studies that say it helps but they are nearly all based on just one brand. (Rotta) - i am guessing that maybe they financed the studies??

Aka Tue 18-Feb-14 16:51:24

It works for me Tegan smile

Tegan Tue 18-Feb-14 16:42:35

What I don't understand is that glucosamine is supposed to be an anti inflammatory and, if you see your doctor with arthritis they tend to prescribe anti inflammatories, so why does glucosamine not help if ibuprofen [shouldn't take after a certain age] aspirin [can cause bleeding in some cases] and diclofenac [pretty bad for you all round] do?

JessM Tue 18-Feb-14 16:21:33

Wow galen I have never heard that one before!
There are degrees of OA obviously. My MIL is a long way down the road (both hips and both knees replaced and now well past sell by dates) and to suggest exercise to her would be laughable, given her heart condition as well. Rubbing on painkilling gels - you'd have to rub it all over her - I think her morphine patches take the edge off as far as one can tell.
(on one occasion i called the doctor because of her severe angina and he sat there, with a wheelchair in the room, and said exercise was good for angina. Bless his little unobservant socks.)

Mishap Tue 18-Feb-14 16:14:27

I love the way they say exercise is good for arthritis - have they not grasped the basic principle that IT IS PAINFUL!!!??