Skip to main content

Joint Health: A Comprehensive Approach for General Practitioners

Nearly one-third (30%) of all GP appointments can be attributed to musculoskeletal (MSK) conditions1, making it a frequent cause of primary care consultations. Capacity constraints and knowledge gaps among GPs mean that MSK conditions do not always receive the attention needed to optimise care and empower patients to take a more active role in managing their own health and well-being.

Unless further investigation or referral is required, analgesics are typically recommended for short-term relief. However, even painkillers are not without risk and the potential long-term side-effects of some popular analgesics were recently highlighted by the UK’s National Institute for Health and Care Excellence (NICE).

While use of simple analgesics and non-steroidal anti-inflammatories (NSAIDs) can be reassuring and effective for those with muscle and joint pain, both types of medicines may cause side effects. For example, some analgesics can lead to constipation and headaches, whilst NSAIDs may cause indigestion and peptic ulceration. These side-effects can be as a result of a long-term dependence on these types of medications which, in some cases, may lead to overt harm.

GPs play an essential role in supporting the prevention and management of joint health conditions by providing lifestyle advice and recommendations. To maximise the chances of relief in patients with musculoskeletal pain, lifestyle advice could include controlling excess body weight, engaging in aerobic exercise, strengthening muscles and caring for, and protecting damaged joints during daily activities. This approach is supported by NICE who suggest that GPs should offer therapeutic exercise, such as local muscle strengthening and general aerobic fitness, to all people with osteoarthritis (OA).2

Alongside exercise and weight management, complimentary treatment options, such as anti-inflammatory supplements, are available over the counter. When advising on potential supplement use, it would be reasonable for GPs to advise patients according to the available evidence. The most consistent and robust research has been undertaken on extracts from a specific species of rose-hip called Rosa canina, which has been found to contain a natural anti-inflammatory compound called galactolipid (or GOPO® for short).

GOPO® has been investigated in several well-designed studies conducted in Scandinavia and Germany involving individuals with either osteoarthritis or rheumatoid arthritis. These studies found that GOPO® can rapidly reduce joint pain, stiffness and swelling and improve joint mobility.3 In one combined analysis of all GOPO® studies, the researchers concluded that GOPO® may be more effective than either paracetamol or glucosamine in the treatment of OA. 4

As primary care providers, GPs are often the first point of contact for patients experiencing joint pain or dysfunction. Whether managing acute injuries, chronic conditions, or preventive care, understanding the nuances of joint health is essential for effective diagnosis, treatment, and referral. Empowering patients with knowledge about joint health and preventive strategies is a critical component of long-term care, particularly in an ageing population where joint issues become increasingly common.

Additionally, maintaining an integrated approach to joint health, including lifestyle modifications, medical management, and, when necessary, referrals to specialists, ensures that patients receive comprehensive care to preserve their mobility and well-being.

1 Edge Health. Closing the GP Workforce Gap: Not All About GPs. Available at: https://www.edgehealth.co.uk/news-insights/closing-the-gp-workforce-gap-not-all-about-gps/ (Accessed: October 20204).

2 The BMJ. GPs should prescribe tailored exercise for osteoarthritis, NICE says. 2022. Available at: https://www.bmj.com/content/377/bmj.o1099.full. (Accessed: October 2022).

3 Winther, K et al. “A powder made from seeds and shells of a rose-hip subspecies (Rosa canina) reduces symptoms of knee and hip osteoarthritis: a randomized, double-blind, placebo-controlled clinical trial.” Scandinavian journal of rheumatology vol. 34,4 (2005)