Management of Osteoarthritis Pain

Osteoarthritis is a degenerative joint disorder characterised by cartilage breakdown, synovial inflammation and subchondral bone remodelling, leading to chronic pain and functional limitation. Management encompasses a stepped approach combining non-pharmacological and pharmacological interventions. First-line measures include patient education, weight optimisation and tailored exercise programmes to strengthen periarticular muscles and preserve joint mobility. Analgesic therapy typically begins with paracetamol, progressing to non-steroidal anti-inflammatory drugs or selective cyclo-oxygenase-2 inhibitors for persistent symptoms, with awareness of gastrointestinal and cardiovascular risks. Intra-articular injections of corticosteroids or hyaluronic acid can provide local relief in moderate to severe cases. Adjunctive measures such as orthoses, assistive devices and thermal therapies may further reduce symptom burden. Emerging strategies under investigation target molecular pathways of cartilage degradation and inflammation, including monoclonal antibodies and disease-modifying osteoarthritis drugs. Digital health tools for symptom tracking and tele-rehabilitation are increasingly integrated to personalise care. A multidisciplinary framework, incorporating rheumatologists, physiotherapists and primary care practitioners, is essential to optimise outcomes and delay surgical intervention.

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Management of Osteoarthritis Pain publication trend

The graph below shows the total number of articles in management of osteoarthritis pain across all publications each year (not limited to Nature Index journals).

Technical terms

Visual analogue scale (VAS): A continuous line, typically 10 cm in length, on which patients rate pain intensity from ‘no pain’ to ‘worst pain imaginable’.

Kellgren and Lawrence grade: A radiographic scoring system for osteoarthritis severity ranging from 0 (no features) to 4 (severe joint space narrowing and osteophytes).

Intra-articular injection: Administration of therapeutic agents directly into the joint cavity to achieve targeted anti-inflammatory or lubricating effects.

Contextual effect: The component of clinical response arising from nonspecific influences such as patient expectations, clinician interaction and therapeutic setting.

References

1. Effects of 3′-Sialyllactose on Symptom Improvement in Patients with Knee Osteoarthritis: A Randomized Pilot Study. Nutrients (2024).
2. Examination of overall treatment effect and the proportion attributable to contextual effect in osteoarthritis: meta-analysis of randomised controlled trials. Annals of the Rheumatic Diseases (2016).
3. Engagement and Participant Experiences With Consumer Smartwatches for Health Research: Longitudinal, Observational Feasibility Study. JMIR mHealth and uHealth (2020).