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Wednesday, 1 April 2015

Alternatives to paracetamol for managing osteoarthritis

Professors Christian Mallen and Elaine Hay have an editorial published in the BMJ today (Mallen & Hay 2015) discussing the importance of non pharmacological treatments in light of the publication on the potential adverse effects of paracetamol for low back pain and osteoarthritis (OA) (Machado et al 2015). Professor Mallen also added on BBC Health that treatment choices other than drugs should be the "cornerstone" of managing these health conditions.

Our research studies on exercise (Uthman et al 2013) for knee and hip OA and joint protection for hand OA (Dziedzic et al 2015; RACGP guidance) support the benefit of such approaches in osteoarthritis. Christine Walker, a former trial participant and now member of our Research Users Group added, "My daily life with hand osteoarthritis has improved dramatically after being shown, on the SMOOTH study trial, some new ways to perform everyday tasks. I was told about some inexpensive gadgets that helped me around the house. For me taking regular simple exercise for the osteoarthritis in other areas of my body is far more effective than taking a pill.” 

Another publication (Roberts et al 2014) had previously described the safety considerations for paracetamol from observational studies.

Managing OA is a combination of pharmacological and non pharmacological approaches. Core treatments (written information, exercise & weight loss if overweight) should be offered to all irrespective of age, comorbidity and severity. Exercise and Topical NSAIDs can provide pain relief for those with OA. Such approaches may reduce the need for paracetamol.

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