most common form of arthritis

leading cause of pain and disability around the world

\~50% of people >60yo

Factors;

• genetic factors

• age

• joint damage by injury

• joint damaage by chronic obesity

• knee, hip, spine, hand

Treatment

• no treatemnt that can reverse joint damage

• early management can slow disease progress

• symptom control

• glucosamine

  • 1500mg / day provides pain relief perhaps

First tier:

• Knowledge/education

• exercise

• weight loss (if overweight)

Second tier - safe pharmacological agents:

• Paracetamol

• Topical NSAIDs

• Capsaicin cream

  • 0.025% - chilli pepper extract

  • use four times/day

Third tier

• oral NSAIDs

  • evidence superior to paracetamol for pain relief

• Opioids

• intra-articular corticosteroid injection

Surgery

• joint arthroplasty