Letters: There's more to arthritis treatment than steroids

A few weeks ago you published a precis from a journal (J Am Acad Orthop Surg 2009; 17: 638-46) saying there was little place for corticosteroids in osteoarthritis, the final sentence of which said: 'This is disappointing, as we have little to offer these patients until they need a knee replacement.' (GP, 6 November).

I would strongly argue that this is misleading, because there is a choice of primary or intermediate care options, namely viscosupplementation and prolotherapy, which are poorly promoted to our colleagues.

Links for prolotherapy in particular, which is extremely cost-effective, can be found at www.bimm.org.uk or by Googling 'prolotherapy'. GP would be doing patients a favour by including an article on it.

Dr Peter Skew, GPSI in musculoskeletal medicine, past president and current honorary treasurer of the British Institute of Musculoskeletal Medicine

Editor's note: Thank you for the feedback. We take on board your comments and will look to commission an article on these therapies for the new year.

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