General Management of OA

Question 1

What self management strategies can be implemented?

Answer 1

Exercise
Weight loss
Suitable footwear in LL OA
Hot or cold packs over site of pain
Use of TENS

Question 2

What education and advice should be given?

Answer 2

Understanding of OA
Understanding of appropriate management
Benefits of shock absorbing footwear in LL OA
Emphasis on healthy diet and active lifestyle
Pacing of exercises

Question 3

What exercises should be prescribed?

Answer 3

Accessory movements
Strengthening around the joint
ROM exercises

Question 4

What aerobic fitness exercises should be advise?

Answer 4

ESSENTIAL

swimming, hydrotherapy, walking (low impact)

Question 5

What advice can be given for weightloss?

Answer 5

NHS weight loss website
Weight watchers/slimming world
Refer to dietian (or specialist If weight loss medication required)

Question 6

What are the level 2 treatment options for OA?

Answer 6

Paracetamol and topical NSAIDS (better for knee and hand)

Question 7

What are the level 3 options for OA?

Answer 7

Mild Opioids or oral NSAIDs
Intraarticular corticosteroid injections 
Manipulation and stretching
Bracing 
Surgery
Referral to OT for assistive ADL devices

Question 8

What additional recommendations can be made for OA?

Answer 8

• Aquatic exercises
• Tai chi – helps improve muscular control & posture
• Acupuncture – for pain relief
• Walking aids to relieve weight from OA joint – eg. Walking stick
• Medially directed taping of patella in OA knee