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Guidelines for the use of nonsurgical interventions in osteoarthritis management

Osteoarthritis (OA) is a major cause of disability in the population and interventions are necessary to optimize function in patients with this disease. The recommended OA therapy consists of a basic set of interventions to maintain function as far as possible, including information, weight loss (in the case of obesity) and exercises. To ensure compliance with such programs and to relieve pain, a stepwise increasing analgesia may be added, beginning with paracetamol and supplemented by second-line analgesics, including opioids for more significant pain situations. The role of nonsteroidal anti-inflammatory drugs, is suggested to be that of treating flares of disease activity characterized by inflammation; they should not be used routinely. Alternative medications are widely used by patients and may have some role in pain relief, although the potency of such compounds is generally somewhat low.