Exercise is the new front runner for treating osteoarthritis ahead of surgery and medications state new Australian guidelines.
Released today by the Royal Australian College of General Practitioners (RACGP), the guidelines outline changes to best practice for managing patients suffering knee and hip osteoarthritis, including new ways to diagnose and manage the illness.
Osteoarthritis (OA) is a common type of arthritis that occurs when the protective tissue at the ends of bones wears down, and is associated with joint pain and stiffness, reduced mobility and reduced quality of life.
With an ageing population in Australia and increasing rates of obesity, the numbers of Australians with OA is expected to increase from an estimated 2.1 million in 2015 to an estimated 3.1 million (12 per cent of the population) by 2030.
"General Practitioners in the past have often recommended glucosamine or anti-inflammatories to manage osteoarthritis, but evidence now shows that exercise is the safest and most effective treatment," said lead author of the guidelines, world-leading osteoarthritis expert Professor David Hunter from University of Sydney and Royal North Shore Hospital.
"Many cases of osteoarthritis can be assisted with diet and lifestyle changes such as increasing physical activity and losing weight.
"Obesity increases the risk of developing knee osteoarthritis, as well as accelerating disease progression, so weight management is a key focus.
"The new guidelines outline the importance of long-term management of the condition, with a focus on non-surgical interventions, and recommend that medication and surgery should only be used as a last resort.
"Studies have shown that surgeries can provide little gain for the patient, with risks and high costs, and opioids can be ineffective for pain management but have side effects and risk of dependency.
"Osteoarthritis can be diagnosed clinically and the new guidelines emphasise less use of imaging for diagnosis and arthroscopy for treatment. By reducing unnecessary imaging and surgery there will also be financial savings to the health system.
"This change in direction of how to manage osteoarthritis will provide the opportunity for people to live healthy and active lifestyles for years longer than before."
Changes to the way people may experience their treatment include:
- An emphasis on exercise and weight management for patients suffering with knee and hip osteoarthritis
- Strong advice to turn away from using opioids in the treatment of the condition
- Knee replacement surgery should only be considered when a patient’s symptoms fail to respond to non-surgical treatments, and
- A reduction in the use of diagnostic imaging.
"People living with osteoarthritis are encouraged to have informed conversations with their GP about preventive care like physical exercise and weight loss," added Professor Hunter, who is University of Sydney's Florance and Cope chair of Rheumatology.
"Every patient in coordination with their caring health professional should have an individually tailored management plan developed for this chronic disease.
"Be proactive about OA management – don’t take it lying down."
The Guidelines for the management of knee and hip osteoarthritis will be rolled out in general practices across the country today.
The new guidelines have been endorsed by the National Health Medical Research Council and included a working group of leading clinicians, consumer organisations and industry experts.
