Osteoarthritis
Changes to cartilage, bone and surrounding tissue that produce joint pain and stiffness.
Last revised
Key takeaways
- First-line treatment: therapeutic exercise, strengthening and aerobic
- Clinical diagnosis possible: over 45, activity-related pain, morning stiffness under 30 minutes
- Most useful single change: Do strengthening and aerobic exercise; it is the core treatment.
- Commonest mistake: Resting the joint, which worsens function over time.
- See a doctor if any of the signs under "When to get help" below apply to you.
Why it matters
Calling it wear and tear discourages the treatment that works best, which is loading the joint rather than resting it.
The numbers, in one place
| Measure | Figure |
|---|---|
| First-line treatment | therapeutic exercise, strengthening and aerobic |
| Clinical diagnosis possible | over 45, activity-related pain, morning stiffness under 30 minutes |
| Preferred analgesia for knees and hands | topical NSAIDs before oral |
| Weight loss | meaningfully improves knee and hip symptoms |
| X-ray change and pain | correlate poorly |
What helps
- Do strengthening and aerobic exercise; it is the core treatment
- Expect some discomfort when starting; it does not indicate damage
- Lose excess weight if knees or hips are affected
- Use topical NSAIDs for accessible joints before oral ones
What to avoid
- Resting the joint, which worsens function over time
- Assuming an X-ray is needed to make the diagnosis
- Long-term oral NSAIDs without review
Where to go next
- A Q and A on Osteoarthritis
- The Short Guide to Osteoarthritis
- Osteoporosis: What Published Guidance Supports
- What the Guidance Really Says About Inflammatory Arthritis
When to get help
See a GP if a joint is hot, red and swollen, particularly with fever — a joint infection is an emergency. Seek assessment for morning stiffness lasting more than thirty minutes, swelling in multiple joints, or symptoms starting before 45, which suggest inflammatory arthritis. Sudden inability to weight-bear after injury needs urgent assessment.
Where this comes from
- NICE — Osteoarthritis in over 16s
- Versus Arthritis — exercise and osteoarthritis
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.