Initial osteoarthritis mx in primary care?

Clinical answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 8 August 2025 Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

The initial management of osteoarthritis in primary care involves offering a tailored management plan based on the severity of symptoms, joints affected, physical function, and comorbidities .

Advise on self-care strategies for symptom relief, including therapeutic exercise, weight management, and appropriate footwear .

Recommend simple analgesia, such as paracetamol or topical NSAIDs like ibuprofen gel applied up to three times daily for knee OA, if there are no contraindications .

Consider oral NSAIDs if topical treatments are ineffective or unsuitable, using the lowest effective dose for the shortest duration, and with caution regarding potential adverse effects .

Provide information and support tailored to the individual, including sources like Versus Arthritis and NHS decision support tools, and explain that management should be guided by symptoms and physical function .

Avoid recommending chondroitin, glucosamine, topical rubefacients, acupuncture, or dry needling for symptom relief .

Educational content only. Always verify information and use clinical judgement.