EVERY year the NHS spends an estimated £1billion on knee replacement surgery for patients with osteoarthritis.
Thousands more take painkillers and anti-inflammatory drugs to try to control the condition which affects at least six million people in Britain.
However new evidence suggests vast sums of money could be saved and pain levels slashed if patients were encouraged to lose weight rather than pop pills.
Two recent studies revealed pain can be at least halved, the use of drugs drastically curtailed and knee surgery potentially avoided if patients lose significant amounts of weight.
In fact some experts now believe shedding fat may be a much better form of pain relief than relying on medicines.
Being overweight is a major risk factor for osteoarthritis. As we age joints such as the hips, knees and wrists naturally suffer wear and tear particularly if they are being asked to carry an excess load.
Inside the joints is a layer of cartilage which is a kind of shock absorber that soaks up the impact from walking, running or lifting so the bones do not rub together and disintegrate.
In osteoarthritis the cartilage starts to break down and as bones come into contact the friction makes joints swollen and painful.
There are no drugs to cure osteoarthritis and sufferers may rely on anti-inflammatory painkillers to alleviate their suffering. Although such drugs help ease the pain they can damage the stomach if used over long periods.
More extreme treatments include steroid injections to reduce inflammation. About 60,000 people a year in the UK end up needing a knee replacement because their joints are so badly eroded.
A recent Danish study looked at 175 patients who were overweight and suffered from arthritis in the knee. FOR 16 weeks they followed a form of the Cambridge Weight Plan which relies on a very low calorie intake of as little as 440 calories a day compared with the recommended 2,500 for a man and 2,000 for a woman.
Specially-formulated shakes, soups, bars and porridge were given to patients who also took mineral and vitamin supplements to ensure they got the nutrients missing from their diet.
The results were published in the European Journal Of Clinical Nutrition. They showed volunteers lost huge amounts of fat but without suffering reduced bone density which is one of the major side effects of some extreme diets.
Research Bliddal from Frederiksberg Hospital in Copenhagen said that the results of the study were a revelation.
He added: “It was a fantastic surprise that patients with little or no mobility could lose that amount of weight.
“They had very bad knees and some could not even walk. The usual advice to people with osteoarthritis is to exercise and eat a healthy diet but these people would never have been able to exercise enough to shed weight.
“Yet thanks to the diet they were able to reduce their dependence on painkillers and anti-inflammatory drugs.”
A separate study carried out recently at Wake Forest University in the United States found strict dieting and moderate exercise slashed knee pain in osteoarthritis sufferers by half.
Researchers studied 454 patients who dieted for 18 months with the aim of losing at least 10 per cent of their body weight. They concluded the combination of controlling eating habits and keeping mobile was potentially one of the best treatments for zapping knee pain.
Lin Smith from Norwich has now been able to stop taking her osteoarthritis medication after 20 years thanks to losing 8st on the Cambridge Weight Plan.
HER weight ballooned to a peak of nearly 20st after the disease was diagnosed in her spine in her early 40s and in her knees about seven years ago.
“I suffered a prolapsed disc in 1986 and that’s when my problems started,” says healthcare worker Lin, 62, a divorced mother of two.
“It was so painful I could not exercise and gradually started putting on weight. Eventually I couldn’t even get in or out of the bath.”
As the arthritis spread Lin became almost completely immobile and needed walking aids just to get around.
She was heading for a knee replacement although doctors said she was too young for such an operation.
After trying a succession of diets, in April 2010 she switched to the Cambridge Weight Plan.
As well as the formulated foods she was allowed a high-protein evening meal of chicken or fish with vegetables. Her daily intake was restricted to 810 calories a day which is less than half the recommended amount for a woman.
“I did feel very hungry during the day but soon got used to that and in the first week I lost 11lb which was a tremendous boost,” says Lin.
“From then on I lost about a stone a month and soon found I had a lot more energy. I had been on tablets for high blood pressure but the doctor took me off them because it had come back down. Now I don’t take anything at all for my osteoarthritis.
“I don’t feel any stiffness in my knees or any pain. “I am even able to crawl around on the floor with my young grandson.
“It’s over a year since I had to go to the doctor. I used to be there every few weeks.” Although the Cambridge Weight Plan proved successful Professor Bliddal warns that it is not meant for long-term use.
“Patients are very close to starving in the first few weeks and you cannot go on like that for very long,” he says.
“They need to follow the diet up with a sensible eating plan.”