Non-pharmacological options: Offer therapeutic exercise tailored to the patient's needs, including local muscle strengthening and general aerobic fitness, and consider supervised sessions to support joint health and function NICE CKS.
Advise patients that regular and consistent exercise may initially increase joint pain but will be beneficial in the long term, reducing pain and improving function NICE CKS.
Support weight management strategies if the patient is overweight or obese, as weight loss can improve quality of life, reduce pain, and enhance physical function NICE CKS.
Consider manual therapy, such as manipulation or mobilisation, alongside therapeutic exercise, but explain that evidence does not support manual therapy alone for OA management NICE CKS.
Use assistive devices like walking aids to support mobility and reduce joint load, especially in lower limb OA NICE NG226.
Offer pharmacological treatments alongside non-pharmacological approaches, starting with topical NSAIDs for affected joints, and consider oral NSAIDs if topical treatments are ineffective or unsuitable, with attention to potential adverse effects NICE CKS, NICE NG226.
Intra-articular corticosteroid injections may be considered if other treatments are ineffective, providing short-term relief (2–10 weeks) NICE CKS.