Osteoarthritis

Osteoarthritis is a chronic joint condition in which the protective cartilage that cushions the ends of bones gradually wears down, most commonly affecting the knees, hips, and hands, and becoming more common with age.

• Joint pain that worsens with activity and improves with rest
• Stiffness, especially after waking or periods of inactivity, usually easing within about 30 minutes
• Reduced range of motion in the affected joint
• Swelling or a grating sensation with joint movement in more advanced disease

• Wear and tear of joint cartilage over time, most often affecting weight-bearing joints.
• Risk is increased by older age, obesity, previous joint injury, repetitive joint stress from certain occupations, and family history.

• Mainly a clinical diagnosis based on the pattern of joint pain, stiffness, and examination findings.
• X-ray of the affected joint, where available, can show characteristic changes such as joint space narrowing, though imaging is not always required to start treatment.

First-line treatment includes paracetamol for pain relief, alongside weight management and regular low-impact exercise to strengthen supporting muscles and maintain joint mobility.

An NSAID such as ibuprofen may be added for flares of pain, used at the lowest effective dose for the shortest necessary time due to stomach and kidney side effects, particularly in older adults.

Physiotherapy and use of supportive aids (such as a walking stick) can help maintain function.

Patients with severe pain, marked disability, or joint deformity that does not respond to these measures are referred for specialist assessment, which may include consideration of joint injection or surgery.

• Maintain a healthy body weight to reduce joint load.
• Engage in regular low-impact exercise, such as walking or swimming.
• Use proper technique and protective measures for repetitive joint-loading activities or occupations.
• Seek early assessment for joint injuries to reduce long-term joint damage.