People with arthritis are being told that exercise and losing weight are a better therapy than painkillers such as paracetamol.
Pain can be reduced if overweight people shed the pounds, according to new NHS guidance from the UK's National Institute for Health and Care Excellence (Nice).
It advises that aerobic exercise and strength training can ease symptoms and improve quality of life.
Starting exercise programmes may initially make the pain worse, but this should settle down, the guidance suggests.
Nice also gives recommendations on the use of medicines, such as offering non-steroidal anti-inflammatory drugs (NSAIDs) but not offering paracetamol, glucosamine or strong opioids.
It said there was a risk of addiction with strong opioids, while new evidence suggests little or no benefit from some medicines when it comes to quality of life and pain levels.
In the guidance, doctors are told to diagnose osteoarthritis — the most common form of arthritis — themselves, without further investigation in people aged 45 or over who have activity-related joint pain.
Patients should also have no morning joint-related stiffness, or morning stiffness that lasts no longer than 30 minutes, to be diagnosed this way.
Tailored exercise programmes should be offered, with an explanation that “doing regular and consistent exercise, even though this may initially cause discomfort, will be beneficial for their joints”.
Exercising in the long term also increases its benefits, the guidance says.
When it comes to weight loss, people will be told that “any amount of weight loss is likely to be beneficial, but losing 10% of their body weight is likely to be better than 5%.”
Patients can also be referred for hip or knee replacement if their condition cannot be managed in other ways, and referrals should not be held off due to age, sex or obesity.
Dr Paul Chrisp, director of the centre for guidelines at Nice, said: “Osteoarthritis can cause people discomfort and prevent them from undertaking some of their normal daily activities.
“However, there is evidence which shows muscle strengthening and aerobic exercise can have an impact on not just managing the condition, but also providing people with an improved quality of life.
“Beginning that journey can be uncomfortable for some people at first, and they should be supported and provided with enough information to help them to manage their condition over a long period of time.
“Whilst topical and sometimes oral NSAIDs remain an important treatment option for osteoarthritis, we have taken the decision to not recommend some painkillers, such as paracetamol and some opioids, for osteoarthritis.
“This is because new evidence has shown there was little or no benefit to people’s quality of life, pain or psychological distress and particularly in the case of strong opioids, there was evidence that they can cause harm in the longer term, including possible addiction.”
In the UK, more than 10 million people have arthritis or other similar conditions that affect the joints.
The most affected areas are the knees, hips and small hand joints.
Tracey Loftis, head of policy and public affairs at the charity Versus Arthritis, said: “We’ve seen first-hand the benefits that people with osteoarthritis can get in being able to access appropriate physical activity, especially when in a group setting. Something like exercise can improve a person’s mobility, help manage their pain and reduce feelings of isolation.
“But our own research into the support given to people with osteoarthritis showed that far too many do not have their conditions regularly reviewed by healthcare professionals, and even fewer had the opportunity to access physical activity support.
“The lack of alternatives means that, in many cases, many people are stuck on painkillers that are not helping them to live a life free from pain.
“While we welcome the draft Nice guidelines, healthcare professionals need further resources and support to better understand their role in promoting treatment like physical activity for people with osteoarthritis.
“There is clearly a need for people with arthritis to be given a bigger voice so that their health needs are not ignored.”
GAC GS8 Specs
Engine: 2.0-litre 4cyl turbo
Power: 248hp at 5,200rpm
Torque: 400Nm at 1,750-4,000rpm
Transmission: 8-speed auto
Fuel consumption: 9.1L/100km
On sale: Now
Price: From Dh149,900
Tips to stay safe during hot weather
- Stay hydrated: Drink plenty of fluids, especially water. Avoid alcohol and caffeine, which can increase dehydration.
- Seek cool environments: Use air conditioning, fans, or visit community spaces with climate control.
- Limit outdoor activities: Avoid strenuous activity during peak heat. If outside, seek shade and wear a wide-brimmed hat.
- Dress appropriately: Wear lightweight, loose and light-coloured clothing to facilitate heat loss.
- Check on vulnerable people: Regularly check in on elderly neighbours, young children and those with health conditions.
- Home adaptations: Use blinds or curtains to block sunlight, avoid using ovens or stoves, and ventilate living spaces during cooler hours.
- Recognise heat illness: Learn the signs of heat exhaustion and heat stroke (dizziness, confusion, rapid pulse, nausea), and seek medical attention if symptoms occur.
The biog
Family: He is the youngest of five brothers, of whom two are dentists.
Celebrities he worked on: Fabio Canavaro, Lojain Omran, RedOne, Saber Al Rabai.
Where he works: Liberty Dental Clinic
Sole survivors
- Cecelia Crocker was on board Northwest Airlines Flight 255 in 1987 when it crashed in Detroit, killing 154 people, including her parents and brother. The plane had hit a light pole on take off
- George Lamson Jr, from Minnesota, was on a Galaxy Airlines flight that crashed in Reno in 1985, killing 68 people. His entire seat was launched out of the plane
- Bahia Bakari, then 12, survived when a Yemenia Airways flight crashed near the Comoros in 2009, killing 152. She was found clinging to wreckage after floating in the ocean for 13 hours.
- Jim Polehinke was the co-pilot and sole survivor of a 2006 Comair flight that crashed in Lexington, Kentucky, killing 49.
Killing of Qassem Suleimani
More from Rashmee Roshan Lall
Timeline
1947
Ferrari’s road-car company is formed and its first badged car, the 125 S, rolls off the assembly line
1962
250 GTO is unveiled
1969
Fiat becomes a Ferrari shareholder, acquiring 50 per cent of the company
1972
The Fiorano circuit, Ferrari’s racetrack for development and testing, opens
1976
First automatic Ferrari, the 400 Automatic, is made
1987
F40 launched
1988
Enzo Ferrari dies; Fiat expands its stake in the company to 90 per cent
2002
The Enzo model is announced
2010
Ferrari World opens in Abu Dhabi
2011
First four-wheel drive Ferrari, the FF, is unveiled
2013
LaFerrari, the first Ferrari hybrid, arrives
2014
Fiat Chrysler announces the split of Ferrari from the parent company
2015
Ferrari launches on Wall Street
2017
812 Superfast unveiled; Ferrari celebrates its 70th anniversary
Benefits of first-time home buyers' scheme
- Priority access to new homes from participating developers
- Discounts on sales price of off-plan units
- Flexible payment plans from developers
- Mortgages with better interest rates, faster approval times and reduced fees
- DLD registration fee can be paid through banks or credit cards at zero interest rates
<html><head><meta http-equiv="Content-Type" content="text/html" charset="UTF-8" /></head><body><!--PSTYLE=* Labels%3aFH Label 18 Sport--><p>Beach soccer</p><!--PSTYLE=BY Byline--><p>Amith Passela</p><p /></body></html>
UAE currency: the story behind the money in your pockets
MATCH INFO
Inter Milan 2 (Vecino 65', Barella 83')
Verona 1 (Verre 19' pen)
PREMIER LEAGUE FIXTURES
Tuesday (UAE kick-off times)
Leicester City v Brighton (9pm)
Tottenham Hotspur v West Ham United (11.15pm)
Wednesday
Manchester United v Sheffield United (9pm)
Newcastle United v Aston Villa (9pm)
Norwich City v Everton (9pm)
Wolves v Bournemouth (9pm)
Liverpool v Crystal Palace (11.15pm)
Thursday
Burnley v Watford (9pm)
Southampton v Arsenal (9pm)
Chelsea v Manchester City (11.15pm)
BRAZIL%20SQUAD
%3Cp%3EGoalkeepers%3A%20Alisson%2C%20Ederson%2C%20Weverton%3Cbr%3E%3Cbr%3EDefenders%3A%20Dani%20Alves%2C%20Marquinhos%2C%20Thiago%20Silva%2C%20Eder%20Militao%20%2C%20Danilo%2C%20Alex%20Sandro%2C%20Alex%20Telles%2C%20Bremer.%3Cbr%3E%3Cbr%3EMidfielders%3A%20Casemiro%2C%20Fred%2C%20Fabinho%2C%20Bruno%20Guimaraes%2C%20Lucas%20Paqueta%2C%20Everton%20Ribeiro.%3Cbr%3E%3Cbr%3EForwards%3A%20Neymar%2C%20Vinicius%20Junior%2C%20Richarlison%2C%20Raphinha%2C%20Antony%2C%20Gabriel%20Jesus%2C%20Gabriel%20Martinelli%2C%20Pedro%2C%20Rodrygo%3C%2Fp%3E%0A
The specs: 2018 Mercedes-AMG C63 S Cabriolet
Price, base: Dh429,090
Engine 4.0-litre twin-turbo V8
Transmission Seven-speed automatic
Power 510hp @ 5,500rpm
Torque 700Nm @ 1,750rpm
Fuel economy, combined 9.2L / 100km
Saturday's results
West Ham 2-3 Tottenham
Arsenal 2-2 Southampton
Bournemouth 1-2 Wolves
Brighton 0-2 Leicester City
Crystal Palace 1-2 Liverpool
Everton 0-2 Norwich City
Watford 0-3 Burnley
Manchester City v Chelsea, 9.30pm
Conflict, drought, famine
Estimates of the number of deaths caused by the famine range from 400,000 to 1 million, according to a document prepared for the UK House of Lords in 2024.
It has been claimed that the policies of the Ethiopian government, which took control after deposing Emperor Haile Selassie in a military-led revolution in 1974, contributed to the scale of the famine.
Dr Miriam Bradley, senior lecturer in humanitarian studies at the University of Manchester, has argued that, by the early 1980s, “several government policies combined to cause, rather than prevent, a famine which lasted from 1983 to 1985. Mengistu’s government imposed Stalinist-model agricultural policies involving forced collectivisation and villagisation [relocation of communities into planned villages].
The West became aware of the catastrophe through a series of BBC News reports by journalist Michael Buerk in October 1984 describing a “biblical famine” and containing graphic images of thousands of people, including children, facing starvation.
Band Aid
Bob Geldof, singer with the Irish rock group The Boomtown Rats, formed Band Aid in response to the horrific images shown in the news broadcasts.
With Midge Ure of the band Ultravox, he wrote the hit charity single Do They Know it’s Christmas in December 1984, featuring a string of high-profile musicians.
Following the single’s success, the idea to stage a rock concert evolved.
Live Aid was a series of simultaneous concerts that took place at Wembley Stadium in London, John F Kennedy Stadium in Philadelphia, the US, and at various other venues across the world.
The combined event was broadcast to an estimated worldwide audience of 1.5 billion.
Killing of Qassem Suleimani
The specs
Engine: 4.0-litre flat-six
Torque: 450Nm at 6,100rpm
Transmission: 7-speed PDK auto or 6-speed manual
Fuel economy, combined: 13.8L/100km
On sale: Available to order now
PREMIER LEAGUE RESULTS
Bournemouth 1 Manchester City 2
Watford 0 Brighton and Hove Albion 0
Newcastle United 3 West Ham United 0
Huddersfield Town 0 Southampton 0
Crystal Palace 0 Swansea City 2
Manchester United 2 Leicester City 0
West Bromwich Albion 1 Stoke City 1
Chelsea 2 Everton 0
Tottenham Hotspur 1 Burnley 1
Liverpool 4 Arsenal 0
CONFIRMED%20LINE-UP
%3Cp%3EElena%20Rybakina%20(Kazakhstan)%0D%3Cbr%3EOns%20Jabeur%20(Tunisia)%0D%3Cbr%3EMaria%20Sakkari%20(Greece)%0D%3Cbr%3EBarbora%20Krej%C4%8D%C3%ADkov%C3%A1%20(Czech%20Republic)%0D%3Cbr%3EBeatriz%20Haddad%20Maia%20(Brazil)%0D%3Cbr%3EJe%C4%BCena%20Ostapenko%20(Latvia)%0D%3Cbr%3ELiudmila%20Samsonova%0D%3Cbr%3EDaria%20Kasatkina%E2%80%AF%0D%3Cbr%3EVeronika%20Kudermetova%E2%80%AF%0D%3Cbr%3ECaroline%20Garcia%20(France)%E2%80%AF%0D%3Cbr%3EMagda%20Linette%20(Poland)%E2%80%AF%0D%3Cbr%3ESorana%20C%C3%AErstea%20(Romania)%E2%80%AF%0D%3Cbr%3EAnastasia%20Potapova%E2%80%AF%0D%3Cbr%3EAnhelina%20Kalinina%20(Ukraine)%E2%80%AF%E2%80%AF%0D%3Cbr%3EJasmine%20Paolini%20(Italy)%E2%80%AF%0D%3Cbr%3EEmma%20Navarro%20(USA)%E2%80%AF%0D%3Cbr%3ELesia%20Tsurenko%20(Ukraine)%0D%3Cbr%3ENaomi%20Osaka%20(Japan)%20-%20wildcard%0D%3Cbr%3EEmma%20Raducanu%20(Great%20Britain)%20-%20wildcard%3Cbr%3EAlexandra%20Eala%20(Philippines)%20-%20wildcard%3C%2Fp%3E%0A
Ferrari 12Cilindri specs
Engine: naturally aspirated 6.5-liter V12
Power: 819hp
Torque: 678Nm at 7,250rpm
Price: From Dh1,700,000
Available: Now
Key changes
Commission caps
For life insurance products with a savings component, Peter Hodgins of Clyde & Co said different caps apply to the saving and protection elements:
• For the saving component, a cap of 4.5 per cent of the annualised premium per year (which may not exceed 90 per cent of the annualised premium over the policy term).
• On the protection component, there is a cap of 10 per cent of the annualised premium per year (which may not exceed 160 per cent of the annualised premium over the policy term).
• Indemnity commission, the amount of commission that can be advanced to a product salesperson, can be 50 per cent of the annualised premium for the first year or 50 per cent of the total commissions on the policy calculated.
• The remaining commission after deduction of the indemnity commission is paid equally over the premium payment term.
• For pure protection products, which only offer a life insurance component, the maximum commission will be 10 per cent of the annualised premium multiplied by the length of the policy in years.
Disclosure
Customers must now be provided with a full illustration of the product they are buying to ensure they understand the potential returns on savings products as well as the effects of any charges. There is also a “free-look” period of 30 days, where insurers must provide a full refund if the buyer wishes to cancel the policy.
“The illustration should provide for at least two scenarios to illustrate the performance of the product,” said Mr Hodgins. “All illustrations are required to be signed by the customer.”
Another illustration must outline surrender charges to ensure they understand the costs of exiting a fixed-term product early.
Illustrations must also be kept updatedand insurers must provide information on the top five investment funds available annually, including at least five years' performance data.
“This may be segregated based on the risk appetite of the customer (in which case, the top five funds for each segment must be provided),” said Mr Hodgins.
Product providers must also disclose the ratio of protection benefit to savings benefits. If a protection benefit ratio is less than 10 per cent "the product must carry a warning stating that it has limited or no protection benefit" Mr Hodgins added.
