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Osteoarthritis

Also known as: OA · degenerative joint disease

The commonest joint disorder — cartilage loss with pain and stiffness that worsen with use and ease with rest (short-lived morning stiffness under 30 minutes), commonly affecting knees, hips, hands and spine.

Source · Reviewed 2026-08-15 · v1.0— AI-assisted draft — verify against the cited guideline before clinical use.

⚕️ Education only — not medical advice. Verify against the latest official guideline and your local protocol; confirm every drug dose against the cited source before clinical use.

Who gets it

Older adults; risk with obesity, prior joint injury, occupational/repetitive load and genetic factors.

Red flags — escalate / refer

A hot swollen joint (exclude septic arthritis/gout), rapidly progressive or night pain, or true joint locking → reconsider and investigate.

Work-up / diagnosis

1Mostly clinical (typical pain pattern, bony swelling, crepitus, reduced range).
2X-rays show joint-space narrowing, osteophytes and subchondral change — but radiographic change correlates poorly with symptoms; tests mainly exclude other causes.

Management — overview

Core non-drug care first — education, exercise (strengthening and aerobic), weight loss, and walking aids/physiotherapy.
Analgesia stepwise — a topical NSAID for knee/hand, then an oral NSAID at the lowest effective dose (± gastroprotection), with paracetamol as an adjunct.
Intra-articular corticosteroid for flares; joint replacement for severe, refractory disease affecting quality of life.

In-depthFull dosing & advanced protocol

Drug dosing

Topical then oral NSAID (± PPI)

Pain relief

Adult dose: Lowest effective dose for the shortest time
Route: Topical / oral

Caution: NSAID caution in GI/renal/cardiovascular risk — add gastroprotection when needed.

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

Intra-articular corticosteroid

Flare of a single joint

Adult dose: Per protocol
Route: Intra-articular

WHOWHO Model List of Essential Medicines (electronic EML) (2025 (24th)) ↗

Exercise and weight loss work best

Exercise and weight loss are the most effective interventions.
X-ray changes do not match symptoms — treat the patient, not the film.
Use NSAIDs cautiously; consider surgery for refractory disease.

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

References

Guidelines change. If something here is out of date, tell us — we keep these current.

🚩 Report outdated / suggest update

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👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Topical then oral NSAID (± PPI)

Intra-articular corticosteroid

📈 Exercise and weight loss work best

📚 References

More protocols

👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Topical then oral NSAID (± PPI)

Intra-articular corticosteroid

📈 Exercise and weight loss work best

📚 References

More protocols

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Exercise and weight loss work best

References

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Exercise and weight loss work best

References