What non-pharmacological interventions are effective for managing osteoarthritis-related pain in primary care?

Therapeutic exercise tailored to individual needs, including local muscle strengthening and general aerobic fitness, is recommended for all people with osteoarthritis to help manage pain ².

Supervised therapeutic exercise sessions may be considered to improve outcomes ².

Patients should be advised that joint pain may increase initially when starting therapeutic exercise, but regular and consistent exercise will be beneficial in the long term for reducing pain and improving function and quality of life ².

Weight loss, if the person is overweight or obese, is advised as it can improve quality of life, reduce pain, and enhance physical function ².

Manual therapy, such as manipulation, mobilisation, or soft tissue techniques, may be considered alongside therapeutic exercise, specifically for hip or knee osteoarthritis ².

Education programmes or behaviour change approaches, including pain coping skills training, goal setting, motivational coaching, and workplace risk counselling, can be combined with other treatments as part of a structured management plan ².

Use of walking aids (e.g., sticks, frames) can support safe movement and reduce joint strain ².

Other interventions such as acupuncture, dry needling, electrotherapy (e.g., TENS, ultrasound), and devices like insoles, braces, or splints are not routinely recommended due to insufficient evidence of benefit ².