- General Information
- See Your Pharmacist or Medical Professional
- Treatment Tips
- Treatment Options
- More Information
Osteoarthritis is the most common form of arthritis, with the average age of onset at 45 years. Almost half of those aged over 60 years, and almost everyone over 80, will develop osteoarthritis.
Osteoarthritis develops gradually from the breakdown of parts of your joints. In a healthy joint, a firm rubbery material called cartilage covers the end of each bone. This allows your joints to move smoothly and easily. In osteoarthritis the cartilage becomes damaged and starts to wear away. This makes your joints painful and stiff.
Weight-bearing joints such as your knees, hips, feet and spine are most commonly affected by osteoarthritis, but it also affects hands.
Osteoarthritis is more common in women (especially after menopause) than in men. It is more likely to develop in people who are overweight for long periods, since this puts more stress on the weight-bearing joints.
Osteoarthritis was previously thought to be a result of normal wear and tear. However, it is now known that other factors are involved. These include damage to a joint earlier in life, repetitive joint use, sports such as weight lifting, being overweight (which can cause inflammation that damages joints), or a family history of osteoarthritis.
Many people are not seriously affected by osteoarthritis, but it can lead to severe pain and significant disability for some. For example, it may be difficult to climb stairs or get in and out of a car with a severely affected knee joint.
Osteoarthritis may come and go, with periods when there is very little or no pain. Some people have particular times when their pain is worse, such as in damp weather.
- pain that usually gets worse when you move, and feels better if your joint is rested. This is one of the first symptoms, but as the disease gets worse, the pain may occur at rest
- stiffness when your joint is not moved for long periods, such as overnight; this usually lasts less than thirty minutes
- swelling when your joint is irritated and produces extra fluid
- a popping or creaking noise (‘crepitus’) may be heard if your knees are affected
- bony growths (‘nodes’) and can be seen on your hands
See Your Pharmacist or Medical Professional
It is best to see your doctor if you think you have osteoarthritis; this will help you manage it as well as possible and minimise long-term effects.
Also see a healthcare professional if:
- your pain is severe or interferes with movement
- you have had a recent accident, such as a fall
- your joint is red and swollen or there is a burning pain
- you feel generally unwell, as well as having joint pain
- the pain began very suddenly
- the pain gets worse or continues after 2 or 3 days, despite taking pain medicine
- try to keep to a healthy bodyweight - obesity is the most important risk factor for osteoarthritis that you can influence
- a tailored exercise program is recommended for everyone with osteoarthritis; exercise can reduce pain and improve function in the joints
- a physiotherapist can help design an exercise programme for you
- heat or ice packs (with a towel wrapped around them to avoid burns or frostbite) may help knee or hip osteoarthritis; they should not be applied for longer than 20 minutes each time
- a walking stick (used in opposite hand to affected knee or hip) can help reduce stress on your hips or knees and reduce pain when walking
- short-term taping of the knee may help in arthritis of the knee joint when getting started with exercise, as may the use of a knee brace
- special aids to help with everyday life, such as opening jars, turning on taps, putting on stockings and picking up objects are available from some pharmacies and Independent Living Centres Australia
Osteoarthritis cannot be cured, but there are medicines and treatments that can help you manage pain and other symptoms.
In the long term, hip or knee joint replacement surgery may be necessary when you have severe pain or your mobility is very restricted.
Oral pain relief medicines (analgesics)
e.g. paracetamol, packets of 24 or fewer (Panadol range)
e.g. paracetamol, larger pack sizes (Panadol Osteo)
- paracetamol may be helpful for mild to moderate osteoarthritis, but is not recommended as first-line treatment any more. NSAID tablets (see below) have been shown to be more effective, but are not suitable for everyone.
- paracetamol is a safe option for most people but it is important not to take more than the recommended dose (4 g/day)
- paracetamol is an ingredient in many cold and flu remedies, so be careful to take these doses into consideration in your calculations
- the maximum daily dose for an adult is 4 g (4000 mg), with no more than 1 g every 4 hours
- some people find taking paracetamol regularly works better than waiting until the pain is bad and taking occasional doses
e.g. ibuprofen, packets of 24 or fewer (Advil Tablets, Advil Liquid Caps, Nurofen range)
e.g. ibuprofen, larger pack sizes (Nurofen, Rafen)
e.g. diclofenac (Voltaren Rapid 25)
NSAIDs can provide good pain relief in osteoarthritis. They have been shown to be equal to and often better than paracetamol for relief of osteoarthritis pain, but NSAIDs are not suitable for everyone. Health professionals only recommend NSAIDs if you are at low risk of side effects. Check with your doctor or pharmacist before taking NSAIDs if you:
- have a history of stomach problems, such as ulcers or indigestion
- have asthma; some people with asthma find their condition is made worse by these medicines
- have kidney problems or a heart condition
- take other medicines
- have an allergy to aspirin or NSAIDs
- are pregnant or breastfeeding
- are elderly; you may be at more risk of side effects
- are dehydrated
Sometimes NSAIDs can cause side effects. It is important to take these products with a glass of water and food to minimise heartburn. If you develop indigestion, or unusual or increased bleeding or bruising, stop taking them and talk to your pharmacist.
Aspirin is not usually recommended for osteoarthritis because the dose required often leads to unacceptable side effects.
[PRESCRIPTION ONLY FROM 1 FEBRUARY 2018]
e.g. paracetamol + codeine, packets of 24 or fewer (Codalgin, Comfarol Forte, Mersyndol Day Strength, Panadeine, Panadeine Forte, Panadeine Extra, Prodeine Forte)
- these products contain two or more ingredients that relieve pain in different ways
- try single-ingredient products first; if these do not give adequate pain relief then try combination products
- see warnings above relating to the individual ingredients, particularly those for ibuprofen
- codeine may cause drowsiness and constipation; avoid alcohol and do not drive or operate machinery if you feel drowsy
- always follow the directions on the packet and do not take more than the recommended dose
e.g. ibuprofen (Nurofen Gel), diclofenac (Voltaren Emulgel, Dencorub Anti-inflammatory Gel), piroxicam (Feldene Gel)
- Topical treatments means treatments rubbed into the skin
- NSAID gels rubbed gently into your joints may be helpful for some people
- gel medication can be absorbed into your bloodstream so it is important to check if NSAIDs are suitable for you (see warnings above under Oral NSAIDs).
- treatment beyond 2 weeks is not recommended unless advised by a medical professional
- do not apply to open wounds, lips or near eyes, and wash hands after use
Other topical preparations
e.g. Deep Heat range, Metsal range, Finalgon, Ice Gel, Percutane Pain Relief Cream, Tiger Balm, Rubesal, Dencorub range, Difflam Gel
- rubbing these products onto your skin can help stimulate blood flow and create warmth, which can relieve pain and stiffness
- do not apply heat rubs to open wounds, eyes, mouth or nose
- heat rubs may irritate the skin; stop using them if this happens
- massage heat rubs in for better effect, except with Finalgon
- Finalgon is much stronger; if extreme stinging occurs, remove excess product with cooking oil or margarine, not water. Test the product on the skin first to identify any reactions
e.g. Zostrix Cream
- it may take up to 4 weeks for pain relief to be noticed
- burning or tingling may occur briefly when this product is applied to your skin
e.g. glucosamine, chondroitin, fish oil
- some people find taking glucosamine or chondroitin supplements helpful, however, the evidence for their benefit is inconsistent; ask your pharmacist for more information
- it may take up to 4 weeks for effects to be noticed
- if you have diabetes, ask your doctor before starting glucosamine; it may affect your blood glucose levels
- glucosamine should be avoided by people with shellfish allergies
- fish oil has not yet been thoroughly evaluated in osteoarthritis
- people taking warfarin should speak to their pharmacist or doctor before using these products
For more information see the link at Related Health Information below.
Availability of medicines
- GENERAL SALE available through pharmacies and possibly other retail outlets.
- PHARMACY ONLY available for sale through pharmacies only.
- PHARMACIST ONLY may only be sold by a pharmacist.
- PRESCRIPTION ONLY available only with a prescription from your doctor or other health professional.
2. Therapeutic Guidelines. Osteoarthritis. Updated March 2017. In: eTG Complete. eTG Nov 2017 edition.