Treatment and support
-Osteoarthritis
Contents
Overview
Symptoms
Treatment and support
Living with
There’s no cure for osteoarthritis, but the condition does not necessarily get any worse over time. There are a number of treatments to help relieve the symptoms.

The main treatments for the symptoms of osteoarthritis include:

lifestyle measures – such as maintaining a healthy weight and exercising regularly
medication – to relieve your pain
supportive therapies – to help make everyday activities easier
In a few cases, where other treatments have not been helpful, surgery to repair, strengthen or replace damaged joints may also be considered.

Lifestyle changes
Exercise
Exercise is one of the most important treatments for people with osteoarthritis, whatever your age or level of fitness. Your physical activity should include a combination of exercises to strengthen your muscles and exercises to improve your general fitness.

If osteoarthritis causes you pain and stiffness, you may think exercise will make your symptoms worse.

However, regular exercise that keeps you active, builds up muscle and strengthens the joints usually helps to improve symptoms.

Exercise is also good for losing weight, improving your posture and relieving stress, all of which will ease symptoms.

Your GP, or possibly a physiotherapist, will discuss the benefits you can expect from a exercise programme and can give you an exercise plan to follow at home.

It’s important to follow this plan because there’s a risk that doing too much exercise too quickly, or doing the wrong sort of exercise, may damage your joints.

Find out more about exercise guidelines including simple ways to exercise at home.

Losing weight
Being overweight or obese often makes osteoarthritis worse, as it places extra strain on some of your joints.

To find out if you are overweight or obese, use the healthy weight calculator.

If you’re overweight or obese, try to lose weight by doing more physical activity and eating a healthier diet.

Discuss any new exercise plan with your GP or physiotherapist before you start. They can help you plan a suitable exercise programme for you. Your GP and practice nurse can also advise about how to lose weight slowly and safely.

Find out more about managing your weight.

Pain relief medicines
Your doctor will talk to you about medicines to relieve pain from osteoarthritis.

Sometimes a combination of therapies, such as painkillers, exercise and assistive devices or surgery, may be needed to help control your pain.

The type of painkiller a GP may recommend for you will depend on the severity of your pain and other conditions or health problems you have. The main medications used are below.

Paracetamol
If you have pain caused by osteoarthritis, your GP might suggest you consider taking paracetamol for short-term pain relief. You can buy paracetamol at supermarkets or pharmacies.

However, many people find that it doesn’t work very well, and it is only normally tried if you can’t take other medicines.

When taking paracetamol, always use the dose a GP recommends and do not exceed the maximum dose stated on the pack.

Find out more about paracetamol.

Non-steroidal anti-inflammatory drugs (NSAIDs)
A GP may prescribe a non-steroidal anti-inflammatory drug (NSAID). These are painkillers that work by reducing inflammation.

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

Your doctor will discuss with you the type of NSAID you should take and the benefits and risks associated with it.

NSAID tablets may be needed if topical NSAIDs are not easing the pain. They may not be suitable for people with certain conditions, such as asthma, a stomach ulcer or angina, or if you have had a heart attack or stroke. If you’re taking low-dose aspirin, ask your GP whether you should use a NSAID.

If your GP recommends or prescribes an NSAID to be taken by mouth, they’ll usually also prescribe a medicine called a proton pump inhibitor (PPI) to take at the same time. NSAIDs can break down the lining in your stomach that protects it against stomach acid. PPIs reduce the amount of acid produced by the stomach, reducing the risk of damage to your stomach lining.

Opioids
Opioids, such as codeine, are another type of painkiller that may help relieve severe pain.

GPs will only usually prescribe opioids on a short-term basis because of side effects such as drowsiness, nausea and constipation.

You may be prescribed a laxative to take alongside it to prevent constipation.

Capsaicin cream
You may be prescribed capsaicin cream if you have osteoarthritis in your hands or knees and topical NSAIDs have not been effective in easing your pain.

Capsaicin cream works by blocking the nerves that send pain messages in the treated area. You may have to use it for a while before it has an effect. You should experience some pain relief within the first 2 weeks of using the cream, but it may take up to a month for the treatment to be fully effective.

Apply a pea-size amount of capsaicin cream to your affected joints up to 4 times a day, but not more often than every 4 hours. Do not use capsaicin cream on broken or inflamed skin and always wash your hands after applying it.

Be careful not to get any capsaicin cream on delicate areas, 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’s 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. But 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.