Pain relief is the main treatment aim of OA. Paracetamol, taken regularly if required, and/or topical non-steroidal antiinflammatory drugs (NSAIDs) should be used first-line, as well as topical capsaicin for knees or hands that continue to be painful. If these measures prove ineffective, opioids may be considered, or an oral NSAID or COX-2 inhibitor may be added or used as a substitute, although only at the lowest effective dose for the shortest possible time period and with a proton pump inhibitor taken concurrently.

For moderate to severe pain, injectable corticosteroids or surgical options may be used. Treatments that are not recommended on the NHS include rubefacients, glucosamine, chondroitin and acupuncture, although patients may choose to fund one or more of these themselves. Transcutaneous electrical nerve stimulation (TENS) and/or thermotherapy may be beneficial to some patients alongside other treatments.

All patients with symptomatic OA should be reviewed regularly to monitor symptoms, the effectiveness and tolerability of treatments, and any concerns or questions the sufferer has about their condition, as well as to highlight any relevant services they could access. Patients should also be aware that they can seek help at a time earlier than the next allotted appointment if they experience any problems with their condition or treatments, or have any other concerns.

Useful websites

• NHS Choices: Osteoarthritis and Rheumatoid Arthritis is a good starting point for anyone looking for more information on osteoporosis and rheumatoid arthritis
• Patient groups have a wealth of information on diseases and treatments, and often have advice lines and online forums. Arthritis Research UK and Arthritis Care have a broad offering, with the National Rheumatoid Arthritis Society being more specialised.