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NSAIDs should be first choice for osteoarthritis

Topical NSAIDs should be offered as the first-line treatment to osteoarthritis patients ahead of COX-2 inhibitors, according to latest guidelines from NICE.

Nurses should consider offering topical NSAIDs and/or paracetamol for pain relief, the institute said its first guideline on osteoarthritis. These should be considered ahead of stronger drugs such as oral NSAIDs, COX-2 inhibitors or opioids, it added.

If oral NSAIDs and COX-2 inhibitors are used they should be co-prescribed with a proton pump inhibitor in order to reduce the risk of any gastro-intestinal complications.

Guideline development group member Susan Oliver, a nurse consultant in rheumatology, said: ‘For the first time, patients can be reassured that they will be offered core symptom-relieving therapies to help them take control of their condition.

‘If patients are able to deal with pain confidently and quickly, they will be able to maintain the best possible quality of life,’ she added.

Additionally, NICE said exercise should be a core treatment for people with osteoarthritis, irrespective of age, other illnesses or conditions, pain or disability. This should include local muscle strengthening, and general aerobic fitness, the institute said.

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