Joint pain and osteoarthritis: Management

Man holding knee

Managing joint pain

Joint pain can impinge on all areas of a person’s life, particularly in older individuals.

Together with education, a range of pharmacological and non-pharmacological techniques is available to help manage pain and flare-ups1,2 and help keep patients moving.

Guideline recommendations for treating joint pain and osteoarthritis

Stepwise management of Joint pain

Guidelines recommend a stepped approach to management2,3–5

Management of Joint pain may require a combination of non-pharmacological and pharmacological modalities.2,5

Guidelines* recommend a stepwise strategy for the pharmacological management of osteoarthritis.2,3–5

*From the National Institute for Health and Care Excellence (NICE), European League Against Rheumatism (EULAR) and American College of Rheumatology (ACR).

More than one pain treatment might be needed

Image of lady holding her knee

Additional support might be needed to cover pain flares

Chronic joint pain is often accompanied by acute inflammatory flares.6

During this flare-up pain, patients may require additional short-term pain relief.6

  • Patient education and lifestyle changes

    Patient education around disease progression and management issues is helpful to encourage proactive self-management.2,4,7–10

    Lifestyle changes for patients with joint pain and osteoarthritis may include9:

    • Weight management
    • Tackling depression and sleep disturbances
    • Vocational rehabilitation
    • Adaptations to the home and working environments

    Patient support groups specifically for patients with osteoarthritis can provide practical and emotional advice and support, enabling patients to cope with their condition, feel more positive and live life more fully on a daily basis.11,12

  • Exercise

    Exercise is a key part of maintaining healthy joints and should be a core recommendation as part of the holistic management of osteoarthritis.13 It builds stamina, strengthens muscles that support the joint, and helps to reduce fatigue.14 It can also help patients to maintain a healthy weight, which reduces the burden on weight-bearing joints.14

    However, the type and amount of exercise must be tailored to each individual patient's capabilities and needs; putting excess strain on a joint or doing too much exercise can worsen symptoms.14 Contact sports are not advisable, but swimming, cycling and low-resistance strengthening exercises may be appropriate.14

    Suitable excercises

  • Physical therapy

    Physical therapy is used in osteoarthritis management approaches and includes strengthening and aerobic exercises, supports and orthotics and heat/cold therapy.4,5,7–10

  • Pharmacological treatment

    Pharmacological treatment with oral paracetamol and/or topical non-steroidal anti-inflammatory drugs (NSAIDs)

    Following a stepwise approach to intervention for joint pain and osteoarthritis, oral paracetamol and/or topical NSAIDs such as diclofenac could be used as first-line pharmacological treatment options.3–5,15

    Long-term use of paracetamol may be required, and topical NSAIDs are appropriate for further pain relief or for treatment of pain flares.3,4,16 However, the risk–benefit ratio should be considered when using paracetamol for joint pain.17

    Oral NSAIDs can be considered as the next step in therapy for joint pain, but should be restricted to short-term use.2,4,5,7

Understanding joint pain and osteoarthritis

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