What are the recommended first-line management strategies for Osgood-Schlatter disease in a primary care setting?

First-line management strategies for Osgood-Schlatter disease in primary care focus on conservative measures aimed at symptom relief and functional improvement. These include activity modification to reduce repetitive strain on the tibial tuberosity, such as avoiding high-impact sports and activities that exacerbate knee pain, while encouraging low-impact exercises to maintain general fitness and muscle strength.

Analgesia with simple pain relievers like paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) can be used to manage pain and inflammation during flare-ups.

Physiotherapy is recommended to improve flexibility and strengthen the quadriceps and hamstring muscles, which can help reduce traction forces on the tibial tuberosity and alleviate symptoms.

Use of supportive measures such as knee pads or patellar straps may provide symptomatic relief by reducing stress on the affected area.

Education and reassurance are important, emphasizing the self-limiting nature of the condition, which typically resolves with skeletal maturity.

Referral to specialist services is generally reserved for cases with persistent symptoms despite conservative management or diagnostic uncertainty.

This integrated approach aligns with the principles outlined in UK clinical guidelines for musculoskeletal conditions in children and adolescents and is supported by recent literature emphasizing conservative management as the mainstay of treatment (Rathleff et al., 2019) ¹ (Rathleff et al., 2019).