Patients with osteoarthritis (OA) should continue to take paracetamol as a first-line analgesic treatment, Nice has announced in a u-turn on previous advice.

Healthcare professionals should continue to prescribe paracetamol for pain relief while Nice carried out a review of drug treatment for the degenerative joint disease, according to guidelines published on Tuesday (February 11).

The guidelines were released six months after Nice launched a consultation into the management of OA. Paracetamol should not be routinely offered and prescribers should be aware of its "limited benefit" and "potential side effects", Nice advised at the time.

However, following feedback from stakeholders, it had decided a restriction on paracetamol would be of "limited clinical application" without a review of current evidence on treating OA, Nice said this week.

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	It planned to commission a review once the MHRA had completed its examination of over-the-counter analgesics, it said. "Until that update is published, the original recommendations (from 2008) on the pharmacological management of osteoarthritis remain current advice," it warned.

Nice stressed that a review by its guideline development group had "identified a reduced effectiveness of paracetamol in managing OA compared with what was previously thought", which should be taken into account when prescribing.

Nice also recommended general aerobic fitness and muscle strengthening exercise, in line with its 2008 guidance.