Thousands with osteoarthritis left in severe pain and struggle to remain in work due to failures in treatment

LONDON 24 FEBRUARY 2022 – New report from charity Versus Arthritis reveals a failure to meet clinical guidelines for treating people with osteoarthritis is resulting in thousands experiencing pain and losing work and income.

Osteoarthritis – one of the fastest growing causes of pain and disability in the UK – affects around 8.5 million people and is estimated to double to 17 million by 2030, further increasing the burden on the health service, the workforce and the economy.

Through research carried out during the pandemic, commissioned and funded by Pfizer UK in 2020, the report ‘Not just ‘a touch of arthritis’ reveals a large disparity in how many people are being recommended or ‘prescribed’ non-drug treatments as opposed to medication.

The overwhelming majority of people with osteoarthritis were prescribed painkillers – more than eight in 10 people (84%) – compared to an intervention such as exercise, which only half (52%) of people had been recommended.

44% of people with osteoarthritis also said they do not have regular reviews to discuss their condition, raising fears many people are languishing in pain with ineffective treatments that are restricting their ability to live well with their condition.

This is in stark contrast to best practice guidelines on managing osteoarthritis produced by the National Institute for Health and Care Excellence (NICE). These recommendations advise taking a holistic approach to treating and supporting people, including exercise and mental health support, alongside regular reviews.

Of great concern was the severity of pain many people reported, with a third of people saying they experienced severe pain every day. If these survey results are representative of the UK population, it means millions of people are living with debilitating pain because of their osteoarthritis every single day of their lives.

Heather Martin, 67, has lived with osteoarthritis for many years but managed to work as a registered nurse until she took early retirement in her 50s. She said:

“Pain relief is a huge concern for me – where or what next? I’m limited in what medication I can use as I react badly to so many tablets. I found a nerve blocker worked for me with little side effects, but I have now reached the maximum dose I can take, and I am experiencing some unpleasant side effects.

“The restrictions that loom for my independence and enjoyment of a rich social life impacts on my mental wellbeing as it’s hard to keep positive, especially after losing at least one good year to lockdowns through the pandemic.

“I’m grateful for getting information through Versus Arthritis as the GPs are not as well informed as they could be. The options for pain control, for example, seem particularly limited to medication and no other therapeutic interventions have proved to be helpful.”

Exercise has been shown to reduce joint pain and improve mobility in people with osteoarthritis, and some studies have shown that exercise has additional benefits: it can boost emotional wellbeing and lead to greater self-reliance, reduced disability and helplessness.

Through physical activity programmes like Let’s Move, Versus Arthritis has seen first-hand the benefits to people with osteoarthritis engaging in appropriate physical activity, especially in peer group settings, to improve their mobility, help manage their pain and reduce their overall sense of isolation.

The condition also affects people’s careers and finances. The survey of people with osteoarthritis found:

around six out of 10 people (61%) still working thought they would, or might have to, retire early, because of their condition

• two out of 10 (19%) respondents reported that they had already reduced their working hours because of their osteoarthritis
• 17% of respondents said they had already retired early.

Tracey Loftis, Head of Policy and Public Affairs at Versus Arthritis, said:

“Living with osteoarthritis is not just about ‘having a touch of arthritis’ – for some, it can have a profound and far-reaching impact on life.

“While many were satisfied with their overall treatment, there are clearly many more who are not getting the support they need, either via an agreed care and support plan to help them manage their condition or receiving well-coordinated care across different services.

 “These failings in support are having major impact not just on their health but on their ability to stay in work – with many forced to take early retirement.

“GPs and primary care alongside the entire health service, are at breaking point. The report calls for a major re-think in how we approach osteoarthritis care and treatment as we move out of the pandemic, ensuring health care providers are supported to treat those in need.”

A personalised, holistic approach

Versus Arthritis is calling for a step-change in support for people with osteoarthritis in three key areas:

• Personalisation with a more holistic relationship developed between patient and healthcare professionals providing care, whereby the full range of treatments and support is offered, and guidance in being able to explore alternative routes is offered
• Innovation through improved diagnosis and coding of osteoarthritis in primary care. This is urgently needed to better understand the prevalence of osteoarthritis at a local level, as well as maximising latest technology
• Prevention of osteoarthritis, both before symptoms are present to prevent onset of the condition, and after people have symptoms to prevent rapid progression, must be a priority for healthcare providers.

Tracey Loftis concluded:

“Healthcare professionals need further resources and support to better understand their role in promoting physical activity for people with osteoarthritis.

“It is time that the condition was taken more seriously and given a far greater ‘voice’ in the NHS and beyond, given the impact that it has on people living with the condition and the demand it places on NHS services.

“More broadly, good musculoskeletal health is essential for good lifelong health: that message needs to be spread far and wide across society and health systems.”