Joint pain: Management

Man holding knee

Managing joint pain

Joint pain can impinge on all areas of a person’s life, particularly in older individuals.

Together with education, a range of pharmacological and non-pharmacological techniques is available to help manage pain and flare-ups1,2 and help keep patients moving.

Guideline recommendations for treating joint pain

Stepwise management of osteoarthritis

Guidelines recommend a stepped approach to management2,3–5

Management of osteoarthritis may require a combination of non-pharmacological and pharmacological modalities.2,5

Guidelines* recommend a stepwise strategy for the pharmacological management of osteoarthritis.2,3-5

*From the National Institute for Health and Care Excellence (NICE), European League Against Rheumatism (EULAR) and American College of Rheumatology (ACR).

More than one pain treatment might be needed

Image of lady holding her knee

Additional support might be needed to cover pain flares

Chronic joint pain is often accompanied by acute inflammatory flares.6

During this flare-up pain, patients may require additional short-term pain relief.6

  • Patient education and lifestyle changes

    Patient education around disease progression and management issues is helpful to encourage proactive self-management.2,4,7–10

    Lifestyle changes for patients with osteoarthritis may include:9

    • Weight management
    • Tackling depression and sleep disturbances
    • Vocational rehabilitation
    • Adaptations to the home and working environments

    Patient support groups specifically for patients with osteoarthritis can provide practical and emotional advice and support, enabling patients to cope with their condition, feel more positive and live life more fully on a daily basis.11,12

  • Exercise

    Exercise is a key part of maintaining healthy joints and should be a core recommendation as part of the holistic management of osteoarthritis.13 It builds stamina, strengthens muscles that support the joint, and helps to reduce fatigue.14 It can also help patients to maintain a healthy weight, which reduces the burden on weight-bearing joints.14

    However, the type and amount of exercise must be tailored to each individual patient's capabilities and needs; putting excess strain on a joint or doing too much exercise can worsen symptoms.14 Contact sports are not advisable, but swimming, cycling and low-resistance strengthening exercises are may be appropriate.14

    Suitable exercises

  • Physical therapy

    Physical therapy is used in osteoarthritis management approaches and includes strengthening and aerobic exercises, supports and orthotics and heat/cold therapy.4,5,7–10

  • Pharmacological treatment

    First-line pharmacological treatment is with oral paracetamol and/or topical non-steroidal anti-inflammatory drugs (NSAIDs)

    Following a stepwise approach to intervention for osteoarthritis, oral paracetamol and/or topical NSAIDs such as diclofenac should be used as first-line pharmacological treatment options.3–5,16

    Long-term use of paracetamol may be required, and topical NSAIDs are appropriate for further pain relief or for treatment of pain flares.3,4,17 However, the risk–benefit ratio should be considered when using paracetamol for osteoarthritis.18

    Oral NSAIDs can be considered as the next step in therapy, but should be restricted to short-term use.2,4,5,7

    Opioids should be reserved for refractory or severe osteoarthritis only.2,4,5,7

    There is mixed evidence and guidance on whether topical capsaicin and nutraceuticals such as glucosamine and chondroitin may also offer some benefits as adjunctive treatments.2,4,5,7,8,10,19,20 Recent guidelines from the Royal Australian College of General Practitioners do not recommend these nutraceuticals for the management of knee and/or hip osteoarthritis.15

  • Surgery

    Surgical interventions for severe joint pain and osteoarthritis include partial or total joint replacements.2,4,5,7,8

How can Nora and Wendy be helped?

Nora

Nora

Nora wakes with joint pain and stiffness each morning.

She wants sustained relief from her pain so she can return to the activities she enjoys, like walking and spending time with her grandchildren. However, she is concerned about treatment side effects.

Nora needs to regain her mobility by easing joint pain.

Voltaren Emulgel 1.16% relieves pain, reduces inflammation and speeds up healing.

Topical diclofenac has a low systemic absorption, meaning a lower risk of systemic side effects.21

Find out more

Max

Max

Max has experienced intermittent knee pain for 5 years. The pain disrupts his sleep and limits his previously active lifestyle and social life making him feel anxious and depressed.

His doctor recommended weight loss and exercise as a remedy. But chronic pain creates a lack of motivation and he feels his pain prevents him from exercising.

Voltaren Emulgel 1.16% relieves pain, reduces inflammation and speeds up healing.

Find out more

Understanding joint pain

Causes icon

Causes

Find out about the causes of joint pain.

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Signs and symptoms icon

Signs and symptoms

Explore an overview of how to recognise joint pain and know when to refer patients.

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Overview of sprains and strains

Overview of sprains and strains

Find out about how common sprains and strains are, and meet two patients with these problems.

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Voltaren Emulgel 1.16%

Voltaren Emulgel 1.16% for joint pain

Relief from joint pain

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Conditions

Conditions

Our overviews of common pain conditions explore the causes, signs, symptoms and impact of each condition, and summarise the latest evidence-based management recommendations.

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Patient care

Patient care resources

Access educational resources to share with your patients, to help them have a better understanding of their pain condition.

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