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NICE have issued clinical guidance on the management of osteoarthritis ( CG177).
Osteoarthritis (OA) is by far the most common joint disorder. It is a major cause of pain and disability in the elderly. Pain is the most common symptom and still presents a major therapeutic challenge. OA pain is typically:
Take into account the patient's attitudes and knowledge, self-treatments, constitutional factors (e.g. obesity, muscle weakness, non-restorative sleep), co-morbid disease and its therapy, treatment availability and costs.
Options include:
NICE TA304 Arthritis of the hip (end stage) - hip replacement (total) and resurfacing arthroplasty (February 2014).
Local guidance on pain relief given below is similar to NICE guidance but places more emphasis on the type of osteoarthritis as topical preparations are only of significant benefit for small joint osteoarthritis.
1st step:
2nd step:
3rd step:
4th step:
5th step:
Notes
See also general notes on local steroid injections and section 10.5 Soft tissue and joint disorders.
Guidance from the British Society of Rheumatology for the management of musculoskeletal and rheumatic conditions with corticosteroids during the Coronavirus (COVID-19) pandemic can be found here
Intra-articular injection of long-acting steroid (e.g. triamcinolone acetonide 40mg or methylprednisolone acetate 40mg) can give rapid, effective, but temporary relief of pain (acts within 24 hours, lasts 2-6 weeks). They may be appropriate for quick control of severe pain, or to tide someone over for a special event, or to temporarily control pain whilst longer-term interventions such as exercise are instituted. There are no clear predictors of response.
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