There is no cure for osteoarthritis, but the symptoms can be eased with a number of different treatments. These include non-drug treatments such as physiotherapy and weight loss, medicine such as painkillers, and surgery.

Lifestyle changes and supportive treatments

• a healthy diet
• a weight loss program, if you are overweight
• gadgets that make daily tasks easier
• balancing rest and activity

Physiotherapy

Physiotherapists and other therapists such as exercise physiologists, occupational therapists and psychologists, sometimes working together in team-based rehabilitation centres, can be utilised if locally available. Options they can suggest include land-based exercise, weight management, strength training, water-based exercise, self-management and an education program designed to suit your needs.

Simple pain relief

While paracetamol can be tried, non-steroidal anti-inflammatory medicines (NSAIDs) are now considered first line. If there is concern around potential side effects, such as in the elderly or in patients with reflux, then topical NSAIDs can be tried. There are other medicines available including a cream to rub on the joint (capsaicin), antidepressants and stronger painkillers. Discuss your pain management and potential side effects with your doctor. It can be very helpful to learn to change the way you think about, and react, to pain.

Transcutaneous electrical nerve stimulation (TENS) uses a machine that may help ease the pain caused by your osteoarthritis. It works by numbing the nerve endings in your spinal cord which control pain, so you can no longer feel it. Treatment with TENS is usually arranged by a physiotherapist. Small electrical pads (electrodes) are applied to the skin over your affected joint. These deliver small pulses of electricity from the TENS machine. Your physiotherapist can advise on the strength of the pulses and how long your treatment lasts.

Applying hot or cold packs to the joints can relieve the pain and symptoms of osteoarthritis in some people. A hot-water bottle filled with either hot or cold water and applied to the affected area can be very effective in reducing pain. Special hot and cold packs that can either be cooled in the freezer or heated in a microwave are also available, and work in a similar way. Care should be taken regarding avoiding burning the skin by having heat on too long or too hot.

Surgery

If you need surgery for osteoarthritis, your doctor will refer you to an orthopaedic surgeon. There are several different types of surgery for osteoarthritis. You may have surgery to replace your whole joint, the weight-bearing surface (resurfacing), or to fuse it into position (arthrodesis).

Joint replacement therapy, also known as an 'arthroplasty', is most commonly carried out to replace hip and knee joints.

If you have osteoarthritis in your knees but you are not suitable for joint replacement surgery (arthroplasty), you may be able to have an operation called an 'osteotomy'. This involves your surgeon adding or removing a small section of bone either above or below your knee joint to help straighten the joint.