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Osteoarthritis

Osteoarthritis treatment

The treatments that help most are often the simplest. Here is what the NHS offers for osteoarthritis and what the evidence says.

Written by Neil Hyde Last checked 2 minute read

On this page
  1. Exercise: the most important treatment
  2. Managing your weight
  3. Pain relief
  4. Injections
  5. Surgery
  6. Treatments NICE advises against

Exercise: the most important treatment

NICE says therapeutic exercise should be offered to everyone with osteoarthritis. This means exercise that is designed to help your joints, such as:

  • strengthening exercises for the muscles around the joint
  • general activity, like walking, cycling or swimming
  • stretches to keep the joint moving

Strong muscles take pressure off the joint. It can take a few weeks to feel the benefit, so keep going. A physiotherapist can plan exercises for you. In many areas you can refer yourself to NHS physiotherapy.

Managing your weight

If you are overweight, losing even a small amount of weight can ease pain in your knees and hips, because they carry less load. Your GP can refer you to a weight management service.

Pain relief

  • Anti-inflammatory gels or creams (topical NSAIDs, such as ibuprofen gel) are usually tried first for osteoarthritis of the knee, and can help other joints near the skin, like the hands.
  • Anti-inflammatory tablets (oral NSAIDs) may be offered at the lowest dose for the shortest time, usually with a medicine to protect your stomach. They are not safe for everyone, so talk to your GP or pharmacist.
  • Paracetamol and weak opioids such as codeine are not usually recommended for long-term use in osteoarthritis. They may help for short periods now and then.
  • NICE advises doctors not to offer strong opioids for osteoarthritis.

Injections

A steroid injection into the joint may help for a short time during a painful flare, when other treatments have not worked well enough. The effect usually wears off after a few weeks.

Surgery

A joint replacement, most often of the hip or knee, may be offered if your symptoms still have a big effect on your life after trying other treatments. Your age, weight and other health conditions do not rule you out on their own.

Treatments NICE advises against

  • glucosamine supplements
  • acupuncture and dry needling
  • keyhole surgery to wash out or tidy the knee joint (unless the knee is locking)

Next, read about living well with osteoarthritis.

Common questions

Is it safe to exercise if my joints hurt?

Yes, for most people. Some aching during or after exercise is normal and is not a sign of damage. Start gently and build up slowly. A physiotherapist can help you find exercises that suit you.

Do glucosamine supplements help?

NICE advises against glucosamine for osteoarthritis because there is not enough evidence that it works.

Sources we used

We check this page at least once a year, and sooner when the rules change. Read how we check our facts, or tell us if something looks wrong.