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Initial pharmacologic therapy of osteoarthritis

Kenneth C Kalunian, MD
Section Editor
Peter Tugwell, MD
Deputy Editor
Monica Ramirez Curtis, MD, MPH


Osteoarthritis (OA) is a common cause of joint pain and disability. The treatment of OA is directed towards reduction of symptoms and the prevention of disability. There are no pharmacologic therapies that have been proven to prevent the progression of joint damage due to OA. (See "Clinical manifestations and diagnosis of osteoarthritis".)

The management of OA includes a combination of nonpharmacologic approaches, such as exercise and patient education; pharmacologic therapies, including oral, topical, and intraarticular medications; and surgical interventions, including total joint arthroplasty. The goal of finding disease-modifying agents for OA is being addressed through ongoing research.

The initial pharmacologic therapy of OA will be reviewed here. The risk factors, pathogenesis, clinical manifestations, and diagnosis of OA; the treatment of patients who are resistant to initial pharmacologic therapy; and the nonpharmacologic, surgical, and investigational pharmacologic therapies of OA are presented separately. (See "Risk factors for and possible causes of osteoarthritis" and "Pathogenesis of osteoarthritis" and "Treatment of osteoarthritis resistant to initial pharmacologic therapy" and "Nonpharmacologic therapy of osteoarthritis" and "Overview of surgical therapy of knee and hip osteoarthritis" and "Investigational approaches to the management of osteoarthritis" and "Clinical manifestations and diagnosis of osteoarthritis".)


The goals of therapy for patients with osteoarthritis (OA) are to control pain and swelling, minimize disability, improve the quality of life, and educate the patient about their role in disease management. Pain and other symptoms of OA can be confused with soft tissue processes such as bursitis at periarticular sites; in addition, pain in a particular area may be referred from OA at other site or may be due to a nonarticular process. Thus, an important first step in management is to be confident that pain in a particular joint is most likely due to OA at that site. (See "Clinical manifestations and diagnosis of osteoarthritis".)

Management should be individualized based upon the patient's expectations, their level of function and activity, the joints involved, the severity of disease, occupational and avocational needs and interests, and the nature of any coexisting medical problems. Subjective complaints and objective findings may guide the clinician in designing appropriate therapeutic goals together with the patient. The degree to which the treatment targets have been achieved should be periodically reassessed; such assessment can facilitate collaborative decision-making with the patient regarding whether and what adjustments may be needed in the treatment program.


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Literature review current through: Sep 2016. | This topic last updated: May 19, 2016.
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