Musculoskeletal

Medicines for Osteoarthritis

The most common form of arthritis, causing joint pain and stiffness as cartilage wears — managed mainly with exercise, weight management and education, with medicines as adjuncts.

Education and reference only. This explains which medicines are used and why, in plain language — it deliberately contains no doses and is not a substitute for advice from your doctor or pharmacist. Always discuss your own treatment with a qualified clinician, and check the BNF and the product labelling for prescribing detail.

Written by Meds Global Health Clinical Team · Clinically reviewed by Dr Muhammad Suffyan, MB BS, Founder & Clinical Director · Last reviewed · How we review

Quick answer

What is Osteoarthritis?

Osteoarthritis is the most common joint condition, in which the smooth cartilage that cushions a joint gradually breaks down and the underlying bone changes, leading to pain, stiffness and sometimes swelling and reduced movement. It most often affects the knees, hips, hands and spine.

  • How it is treated: The core treatments for osteoarthritis are not medicines at all: tailored exercise to strengthen the muscles around the joint and maintain movement, weight management where appropriate to reduce load on weight-bearing joints, and clear information so people can manage the condition confidently.
  • Self-care: Staying active with regular, joint-friendly exercise (such as walking, cycling or swimming) and muscle-strengthening, losing weight if overweight to ease load on the joints, using supportive footwear and aids where helpful, and pacing activities all reduce pain and maintain function.
  • When to seek help: See your GP if joint pain or stiffness is limiting your daily activities, sleep or mobility, or is not controlled by self-care, so that exercise, weight support and treatment options can be discussed.

What it is

Osteoarthritis is the most common joint condition, in which the smooth cartilage that cushions a joint gradually breaks down and the underlying bone changes, leading to pain, stiffness and sometimes swelling and reduced movement. It most often affects the knees, hips, hands and spine. Although it is sometimes called "wear and tear", that label is misleading: it is an active process the joint goes through, and the amount of joint change seen on a scan does not always match how much pain a person has. Importantly, osteoarthritis is different from rheumatoid arthritis — it is not primarily an inflammatory or autoimmune disease driven by the immune system, and it is not treated with the same disease-modifying drugs. Symptoms typically come and go, often worse after activity, and many people manage well with the right support.

How it is treated

The core treatments for osteoarthritis are not medicines at all: tailored exercise to strengthen the muscles around the joint and maintain movement, weight management where appropriate to reduce load on weight-bearing joints, and clear information so people can manage the condition confidently. Medicines are adjuncts that support activity rather than replace these foundations. For knee or hand osteoarthritis, a topical anti-inflammatory (NSAID) applied to the joint is the recommended first drug option, because it can ease pain with less risk than tablets. Paracetamol may help some people but its benefit is limited and it is no longer relied upon as a mainstay. Oral NSAIDs can be used in short courses for flares, at the lowest effective amount, usually with stomach protection and with care in people who have heart, kidney or stomach problems. Opioids are not recommended for routine osteoarthritis pain — the evidence for benefit is weak and the risks of harm and dependence are real — so they are used only briefly and in limited situations. Where a joint is severely affected and quality of life is poor despite these measures, joint replacement surgery can be very effective.

For this condition, these medicines

Medicine classes used for Osteoarthritis

Each links to a full, dose-free guide — what it is, how it works, who can and cannot use it, side effects, interactions and FAQs.

Topical NSAIDs Pain & inflammation The recommended first drug option for knee or hand osteoarthritis; eases pain with less risk than tablets. Paracetamol Pain An adjunct with limited benefit; may help some people but is not relied on as a mainstay. NSAIDs Pain & inflammation Oral anti-inflammatories used in short courses, with stomach protection and caution over heart and kidney risk. Opioid analgesics Pain Only short-term and limited use; weak evidence of benefit and real risk of harm, so not for routine pain.

Symptom checker

Symptoms that can point to Osteoarthritis

Osteoarthritis can be one cause of these symptoms. Each guide explains the other possible causes and the red-flag warning signs that mean you should get urgent help:

Joint painPain, stiffness or swelling in one or more joints, ranging from everyday wear-and-tear art…Back painBack pain is very common, usually comes from the muscles, joints or discs of the spine, an…Leg painAching, cramping or sharp pain in one or both legs, from a range of muscle, joint, nerve o…Lower back painPain across the lower part of the back that is extremely common and usually due to muscle …Knee painKnee pain is discomfort in or around the knee joint, often from wear, injury or inflammati…Shoulder painShoulder pain is discomfort in or around the shoulder joint, often from the soft tissues, …Neck painNeck pain is discomfort or stiffness in the neck, usually from muscle or joint strain, and…Hip painPain felt in the hip joint, groin, outer thigh or buttock — most often from wear-and-tear …Foot painPain in any part of the foot — heel, arch, toes or the ball of the foot — most often from …Hand and finger painPain, aching or stiffness in the hands, fingers or thumb — most often from arthritis, a tr…Ankle painPain, stiffness or swelling in or around the ankle joint that most often comes from a spra…

By active ingredient

Specific medicines used for Osteoarthritis

Dose-free guides to individual active ingredients used in osteoarthritis — what each is, how it works, how to take it, and its advantages and disadvantages:

NaproxenA common anti-inflammatory painkiller (NSAID) for musculoskeletal pain, gout attacks and s…IbuprofenA widely used anti-inflammatory painkiller for pain, inflammation and fever — effective, b…DiclofenacA strong anti-inflammatory painkiller (NSAID) for pain and inflammation, with a comparativ…CelecoxibA COX-2 selective anti-inflammatory painkiller for arthritis, gentler on the stomach than …EtoricoxibA once-daily COX-2 selective NSAID that eases joint pain with less stomach upset than olde…NabumetoneAn NSAID used mainly for the pain and inflammation of osteoarthritis and rheumatoid arthri…EtodolacA non-steroidal anti-inflammatory (NSAID) used to ease the pain and stiffness of arthritis…GlucosamineA joint supplement taken for osteoarthritis, though the evidence for it is limited and unc…ChondroitinA joint supplement taken for osteoarthritis, often with glucosamine, with limited and unce…CapsaicinA chilli-derived cream or patch applied to the skin to relieve nerve pain and the pain of …IndomethacinA strong anti-inflammatory painkiller used for gout, arthritis and other inflammatory pain…SulindacAn anti-inflammatory painkiller (NSAID) used to relieve pain and inflammation, including i…FlurbiprofenAn anti-inflammatory painkiller used for pain and inflammation, also available as a sore-t…OxaprozinA long-acting anti-inflammatory painkiller used mainly for arthritis, taken once a day.…FenoprofenAn anti-inflammatory painkiller used for pain and arthritis.…DiflunisalAn anti-inflammatory painkiller, related to aspirin, used for pain and inflammation such a…SalsalateA salicylate anti-inflammatory painkiller used to ease pain and inflammation in conditions…TriamcinoloneA steroid medicine that reduces inflammation, often given as an injection into a joint or …Tiaprofenic acidAn anti-inflammatory painkiller used for pain and swelling in joint conditions, with a kno…ParacetamolThe everyday first-choice painkiller for mild-to-moderate pain and fever — effective, well…

Beyond medication

Lifestyle and self-care

Staying active with regular, joint-friendly exercise (such as walking, cycling or swimming) and muscle-strengthening, losing weight if overweight to ease load on the joints, using supportive footwear and aids where helpful, and pacing activities all reduce pain and maintain function.

When to get help

When to see a doctor

See your GP if joint pain or stiffness is limiting your daily activities, sleep or mobility, or is not controlled by self-care, so that exercise, weight support and treatment options can be discussed. Seek prompt review for a hot, swollen, very painful joint, especially with fever, as this can suggest a different problem such as infection.

999Emergency — call 999 or go to A&E
111Urgent advice — call NHS 111 or use 111 online
GPNon-urgent — see your GP or pharmacist

Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.

Answers

Osteoarthritis: frequently asked questions

What medicines are used for osteoarthritis?

A topical NSAID applied to the joint is the recommended first drug option for knee or hand osteoarthritis. Paracetamol may help some people but its benefit is limited. Oral NSAIDs can be used in short courses with stomach protection, while opioids are not recommended for routine osteoarthritis pain. Medicines support the core treatments of exercise, weight management and education rather than replace them.

Is osteoarthritis the same as rheumatoid arthritis?

No. Osteoarthritis comes from changes to the joint and its cartilage and is not primarily an inflammatory or autoimmune disease. Rheumatoid arthritis is driven by the immune system attacking the joints and is treated with different, disease-modifying medicines. The two are managed in different ways, so an accurate diagnosis matters.

Will exercise make my osteoarthritis worse?

No — the opposite is usually true. Regular, suitable exercise strengthens the muscles supporting the joint, maintains movement and reduces pain over time, and it is one of the core treatments. It is normal to feel some discomfort at first; a physiotherapist or your clinician can help you find activities that work for you.

When is a joint replacement considered?

Joint replacement is considered when osteoarthritis severely affects your quality of life — pain, mobility and daily activities — despite exercise, weight management and appropriate medicines. It can be very effective for badly affected hips and knees. Your clinician can discuss whether and when referral is right for you.

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Sources

Where this is drawn from

  • NICE NG226: Osteoarthritis in over 16s: diagnosis and management.
  • NICE CKS: Osteoarthritis.

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