Physiotherapy - Osteoarthritis Therapy Session 3

Does pain relief help?

No drugs are proven to stop osteoarthritis worsening. The aim is to help you deal with the symptoms.

Some people find that pain relief is more helpful than others. We suggest you use the smallest dose for the shortest period of time possible. An injection of corticosteroid may help and this can last several months, but there is no evidence for hyaluronic acid injections.

What can I take?

●    Utilise your GP and pharmacist for specialist advice
●    Add ibuprofen creams/gels if you can tolerate before trying tablet form as the tablets can cause stomach upset
●    If on long term ibuprofen, speak to GP about PPI such as omeprazole
●    GP’s can prescribe stronger pain relief if needed

Paracetamol or weak opioids are not offered routinely, unless:

●    Used infrequently for short-term pain relief
●    All other treatments are ineffective or unsuitable

NSAIDS

●    Ibuprofen, naproxen or diclophenac
●    Some NSAIDS are available as creams/gels, which you can apply directly to the affected joint
●    As well as helping to reduce pain, they can also help to reduce swelling in your joints
●    Not suitable with conditions such as asthma or a peptic ulcer

Injections

●    A treatment where medicine is injected directly into the knee
●    Injection is generally a Corticosteroid, which reduces swelling and pain
●    Too many injections can damage your joints
●    Minimum of 3 months between treatments
●    Usually given to allow relief of pain to engage with physio/ exercise rather than repeated injections

Due to inconsistent evidence, the following treatment options are not recommended:

●    Acupuncture or dry needling
●    Electrotherapy treatments
●    Routine use of insoles, braces, tape, splints, or supports

Heat and Ice

●    Acupuncture or dry needling
●    Electrotherapy treatments
●    Routine use of insoles, braces, tape, splints, or supports

Walking Aid

●    Assistive devices such as a walking stick or crutch may be beneficial to help off load the affected knee
●    Hold stick on the opposite side to the affected knee

Surgery

●    Surgery for osteoarthritis is only needed in a small number of cases if conservative measures have not been successful
●    In a knee replacement 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