OSTEOARTHRITIS

45

OSTEOARTHRITIS DX
NICE GUIDELINES OA Dx
 (OA Diagnosis)
 45 years or over
 Activity related joint pain
 No morning related stiffness / No
morning stiffness lasting >30
minutes

 Atypical features which may

indicate alternate diagnosis
include:
 History of trauma
 prolonged morning joint-related
stiffness,
 rapid worsening of symptoms or
 the presence of a hot swollen joint

 Q) What are the important ∆∆

NICE GUIDELINES OA Dx
Q) What are the
important ∆∆?

A) Gout
Inflammatory
Arthritis
Septic Arthritis
Bony Malignancy
Impact of OA on Hollistic Wellbeing

 P.O.S.S (POSSum)

 Social – Lifestyle Expectations,

ADLs, Family Duties, Hobbies.

 Occupation – Ability to
perform job, Adjustments to
workplace

 Sleep – Quality of Sleep

 Pain – Self-help strategies,

Analgesics > Drugs, doses,
frequency, timing, Side-effects.
Non-Pharmalogical Management
 Non-pharmalogical
management: (W.E.T)

 Exercise and Manual therapy –

local muscle strengthening
and general aerobic fitness.

 Weight loss

 TENS – Healthcare professions

should consider the use of
transcutaneous electric nerve
stimulation as an adjunct to
core Tx for pain relief
Pharmalogical Management
 (2008Original
recommendations)

 (GDG*) evidence review -

reduced effectiveness of
paracetamol

 Oral analgesics: Paracetamol

 Anti-Inflammatories: 1st
Topical NSAIDs, 2nd COX-2
Inhibitors
 Adjunct: Topical Capsacin
 Pain control not adequate? >
Opioid Analgesic