Guidelines for the use of nonsurgical interventions in osteoarthritis management

Abstract

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.

Keywords::

• basic therapy
• exercise
• flare
• inflammation
• information
• nonsteroidal anti-inflammatory drug
• opioid
• osteoarthritis
• paracetamol
• weight loss

Financial & competing interests disclosure

H Bliddal is not employed by the pharmaceutical industry but has received payment for lectures and his participation in review boards from several relevant companies. The research background for this was work supported by the University Hospital of the Capital Region of Denmark, the Oak Foundation, the Velux foundation and the Danish Rheumatism Association. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.