Treating osteoarthritis

Osteoarthritis cannot be cured, but treatment for the condition can ease your symptoms and prevent them from affecting your everyday life.

However, if your osteoarthritis is mild or moderate, you may not need to have any treatment. Your healthcare professional will be able to provide you with advice about managing your symptoms by making changes to your lifestyle, which may be enough to keep the condition under control.

Medical treatments for osteoarthritis

There are several medicines, treatments and pieces of equipment that can make living with osteoarthritis easier. Some of these are available from your GP or Community Pharmacist, such as painkillers, medicines that are injected into your joints and thermotherapy (warm and cold packs).

Analgesics (painkillers)

The type of analgesic (painkiller) that your GP or Community Pharmacist,  may recommend for you will depend on the severity of your pain and any other conditions or health problems that you may have.


If you have pain that is caused by osteoarthritis, to begin with your GP or Community Pharmacist,  may suggest taking paracetamol, which is available over the counter (OTC) in pharmacies without a prescription. It is best to take it regularly rather than waiting until your pain becomes unbearable.

However, when taking paracetamol, you should always make sure that you follow the dosage that your GP or Community Pharmacist,  recommends, and that you do not exceed the maximum dose that is stated on the pack.

Non-steroidal anti-inflammatories (NSAIDs)

If paracetamol proves ineffective in controlling the pain of your osteoarthritis, your GP or Community Pharmacist,  may prescribe a stronger painkiller. This may be a non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen, aspirin or diclofenac.

Some NSAIDs are available as creams (topical NSAIDs) that you apply directly to the affected joints. Some topical NSAIDs are available over the counter (OTC) without a prescription. They can be particularly effective if you have osteoarthritis in your knees or hands, and as well as helping to ease pain, they can also help to reduce any swelling that you have in your joints.

Sometimes, NSAIDs may not be suitable for you if you have certain conditions, such as asthma or a peptic ulcer. If you are unsure about whether NSAIDs are suitable for you, you should speak to your GP or Community Pharmacist,. They will be able to discuss any potential risks or benefits of taking NSAIDs with you. Children who are under 16 years of age should not take aspirin. If you are pregnant you should not take NSAIDS.

If your GP or Community Pharmacist, recommends or prescribes an NSAID to be taken by mouth, they will usually also prescribe a medicine known as a proton pump inhibitor (PPI) for you to take alongside it. This is because taking an NSAID can break down the lining in your stomach that protects against stomach acid. However, PPIs reduce the amount of acid by blocking the tiny ducts (or pumps) in your stomach that produce it, reducing the risk of damage to your stomach lining.


Opioids, such as codeine, are another type of analgesic that may help to ease your pain if paracetamol does not work. Opioids can help to relieve severe pain, but they can also cause side effects such as drowsiness, nausea, and constipation.

If you need to take an opioid regularly, your GP or Community Pharmacist,  may prescribe a laxative for you to take alongside it.

Capsaicin cream

If you have osteoarthritis in your hands or knees, and topical NSAIDs have not been effective in easing your pain your GP or Community Pharmacist, can provide more information

Capsaicin cream works by blocking the nerves that send pain messages, although you may have to use it for a while before it has an effect. You should experience some pain relief within the first two weeks of using the cream, but it may take up to a month before the treatment is fully effective.

You should apply a pea-sized amount of capsaicin cream to your affected joints four times a day, but not more than every four hours. Do not use capsaicin cream on skin that is broken or inflamed, and always wash your hands after applying it.

You should also be careful not to get any capsaicin cream on delicate places, such as your eyes, mouth, nose and genitals. Capsaicin is made from chillies, so if you get it on sensitive areas of your body, it is likely to be very painful for a few hours. However, it will not cause any damage.

You may notice a burning sensation on your skin after applying capsaicin cream. This is nothing to worry about, and the more you use it, the less it should happen. However, avoid using too much cream or having a hot bath or shower before or after applying it, because it can make the burning sensation worse.

You should not just use capsaicin cream as a stand alone treatment. It should be used in addition to other interventions such as weight loss, exercise and painkillers.

Intra-articular injections

If your osteoarthritis is severe, treatment using analgesics (painkillers) may not be enough to control your pain. If this is the case, you may be able to have a type of treatment where medicine is injected into the parts of your body that are affected by osteoarthritis. This type of treatment is known as intra-articular, because it is injected inside your affected joints.

If you need to have intra-articular injections, it is likely that you will have injections of corticosteroid, which is a medicine that reduces swelling and pain. However, the National Institute for Health and Clinical Excellence (NICE) do not recommend intra-articular injections of hyaluronic acid for osteoarthritis.

As too many intra-articular injections can damage your joints, you will have to wait at least three months between treatments, and each joint should not be treated more than three times a year.

Injections are normally part of a treatment programme and are used alongside other interventions such as weight loss, exercise and painkillers

Ice or heat?

If you have had an injury or a flare-up of an old problem in the last two days, wrap crushed ice in a damp towel and hold it for five to ten minutes against the part of your knee that hurts. You can do this every two to three hours. Make sure you use a damp towel between the ice and the skin to avoid ice burn. Alternatively, you could try sports sprays and gel packs, which do a similar job.

After two days, you may find that heat is more relaxing. You could use a heat pad or a hot water bottle with an insulated cover on it. Make sure this is not too hot and not directly touching your skin. You should do this for 10 to 15 minutes, three to four times a day.

You should not just use ice or heat as a stand alone treatment. They should be in addition to other interventions such as weight loss, exercise and painkillers.


Physiotherapy can help your osteoarthritis by helping you with muscle strengthening exercises, pain relief, gait re-education and stretching/strengthening exercises.

Physiotherpaists can also advise you on when you may need to see an orthopaedic doctor. They may let you have a trial of a TENS (transcutaneous electrical nerve stimulation) machine which might help your symptoms


Looking after your feet is very important if you have osteoarthritis in your feet, hips, knees or ankles.

Assistive devices

If your osteoarthritis causes mobility problems, or performing everyday tasks is difficult, there are a number of devices available which may be able to help. Ask your healthcare professional for advice.

If you have osteoarthritis in your lower limbs, such as your hips, knees or feet, your healthcare professional may suggest special footwear or insoles for your shoes and discuss these in more detail.

If you have osteoarthritis in your hip or knee that affects your mobility, you may need to use a walking aid, such as a stick or cane. When going upstairs reduce the strain on your knee by leading with your good leg. When going downstairs reduce the strain on your knee by leading with your problem leg. If there is a handrail, In both cases, if there is a handrail, you should make use of it.

If your hands are affected by osteoarthritis, you may also need assistance with hand-operated tasks, such as turning on a tap. Special devices, such as tap turners, can make performing these tasks far more manageable. Your healthcare professional will be able to provide you with help and advice about using these devices in your home or workplace.

You should not just use assistive devices ice or heat as a stand alone treatment. They should be in addition to other interventions such as weight loss, exercise and painkillers.


Surgery for osteoarthritis is only needed in a small number of cases. It can sometimes be helpful for osteoarthritis that affects your hips, knees or joints, particularly those at the base of your thumb. Your healthcare professional may suggest surgery for your condition if other treatments have been ineffective, or if one of your joints is severely damaged.

If you need to have surgery for osteoarthritis, your healthcare professional will refer you to an orthopaedic clinic before your symptoms become severe enough to cause permanent damage, or very severe pain.

There are a number of different types of surgery for osteoarthritis. You may have surgery to smooth the surfaces of your joints or restore cartilage (an arthroscopy), or you may have surgery to replace your whole joint, or to fuse it into position.


Joint replacement therapy, also known as an arthroplasty, is most commonly carried out to replace hip and knee joints.

In an arthroplasty, your surgeon will remove your affected joint and replace it with an artificial joint that is made of special plastics and metal (prosthesis). An artificial joint can last for up to 20 years. However, it may eventually need to be replaced.


If joint replacement is not suitable for you, your surgeon may suggest an operation known as an arthrodesis, which fuses your joint in a permanent position. This means that your joint will be stronger and much less painful, although you will no longer be able to move it.

Having surgery for osteoarthritis can greatly improve your symptoms, mobility and quality of life, and can also help to prevent further damage to your joints. However, surgery cannot guarantee to get rid of your symptoms altogether, and you may still experience pain and stiffness as a result of your condition.


If you have osteoarthritis in your knees, but you are too young for knee replacement surgery (arthroplasty), you may be able to have an operation called an osteotomy. This type of surgery involves your surgeon adding or removing a small section of bone either above or below your knee joint.

This helps to re-align your knee so that your weight is no longer focused on the damaged part of your knee. An osteotomy can greatly relieve your symptoms of osteoarthritis, although you may still need knee replacement surgery eventually.

Last updated: 28 May 2014

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