Joint pain: Management

Man holding knee

Managing joint pain

Joint pain can impinge on all areas of a person’s life, particularly in older individuals.

Together with education, a range of pharmacological and non-pharmacological techniques is available to help manage pain and flare-ups1,2 and help keep patients moving.

Guideline recommendations for treating joint pain

Stepwise management of osteoarthritis

Guidelines recommend a stepped approach to management2,4–6

Management of joint pain may require a combination of non-pharmacological and pharmacological modalities.2,6

More than one pain treatment might be needed

  • Patient education and lifestyle changes

    Patient education around disease progression and management issues is helpful to encourage proactive self-management.2,5,8–11

    Lifestyle changes for patients with joint pain may include:10

    • Weight management
    • Tackling depression and sleep disturbances
    • Vocational rehabilitation
    • Adaptations to the home and working environments
  • Exercise

    Exercise is a key part of maintaining healthy joints and should be a core recommendation as part of the holistic management of joint pain.14 It builds stamina, strengthens muscles that support the joint, and helps to reduce fatigue.15 It can also help patients to maintain a healthy weight, which reduces the burden on weight-bearing joints.15

    However, the type and amount of exercise must be tailored to each individual patient's capabilities and needs; putting excess strain on a joint or doing too much exercise can worsen symptoms.15 Contact sports are not advisable, but swimming, cycling and low-resistance strengthening exercises may be appropriate.15

    SUITABLE EXERCISES

  • Physical therapy

    Physical therapy is used in joint pain management approaches and includes strengthening and aerobic exercises, supports and orthotics and heat/cold therapy.5,6,8–11

  • Pharmacological treatment

    Pharmacological treatment with oral paracetamol and/or topical non-steroidal anti-inflammatory drugs (NSAIDs)

    Following a stepwise approach to intervention for joint pain, oral paracetamol and/or topical NSAIDs such as diclofenac could be used as first-line pharmacological treatment options.4–6,17

    Long-term use of paracetamol may be required, and topical NSAIDs are appropriate for further pain relief or for treatment of pain flares.4,5,18 However, the risk–benefit ratio should be considered when using paracetamol for joint pain.19

    Oral NSAIDs can be considered as the next step in therapy for joint pain, but should be restricted to short-term use.2,5,6,8

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