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The Beyond Pain Foundation

Conditions we support

Conditions guide

Osteoarthritis

Osteoarthritis makes joints painful and stiff. It is the most common type of arthritis in the UK. It isn't just "wear and tear", and it doesn't always get worse. This guide explains the joints it affects, the treatments that work best, what to expect from surgery, and your rights at work.

Adults in the UK likely to have it
About 10 million
People with knee osteoarthritis
5.4 million
People with hip osteoarthritis
3.2 million
Working days lost to joint and muscle conditions in 2022
23.4 million

This guide is general information, not medical advice. Medicines and treatments must be prescribed or recommended for you by a doctor or pharmacist. We do not give doses here.

What osteoarthritis is

In a healthy joint, smooth cartilage covers the ends of the bones so they move easily. In osteoarthritis, the joint is under constant low-level strain and the body can't fully repair it. The cartilage thins and roughens, and the bone underneath can thicken and grow small bony spurs. The joint lining may become inflamed. This causes pain, stiffness and swelling.

The exact cause isn't known, but several things make it more likely:

  • Being over 45
  • Being a woman
  • Being overweight
  • A past joint injury or operation
  • Repetitive or physically demanding work
  • A family history
  • Another joint condition, such as gout or rheumatoid arthritis
  • Joints that formed in an unusual shape

Osteoarthritis is long-term and there is no cure. But it doesn't always get worse, and symptoms can sometimes improve over time. Exercise and the right treatment make a real difference.

Joints it affects

Osteoarthritis can affect almost any joint. These are the most common.

Knee

The joint most often affected, and often both knees. Pain when walking, climbing stairs or getting up from a chair. The knee may creak, lock or give way.

Hip

Pain in the groin, buttock or outer thigh, sometimes felt in the knee. It can make it hard to put on socks and shoes or get in and out of a car.

Hand and thumb

Pain and stiffness in the finger joints and at the base of the thumb. Bony lumps (nodes) can form on the finger joints. Gripping, opening jars and typing can be hard.

Spine

Stiffness and pain in the neck or lower back. Bony spurs can sometimes press on nerves and cause pain, pins and needles or numbness in the arms or legs.

Big toe and foot

Pain and stiffness at the base of the big toe, which can make walking and finding comfortable shoes difficult.

After an injury

Sometimes called secondary osteoarthritis. It can develop years after a broken bone, ligament damage or another joint condition. It may start at a younger age.

Symptoms and how it changes over time

The main symptoms are pain and stiffness. Other signs include swelling, a grating or crackling feeling when you move, the joint feeling weak or unstable, and not being able to move it as far as before. Symptoms often vary from day to day.

  1. Early

    Aching with use

    Pain after activity or at the end of the day. Stiffness in the morning that eases within about 30 minutes.

  2. Days to weeks

    Flares

    Periods when pain and swelling get worse, often after doing too much on a good day, then settle again.

  3. Months to years

    More constant pain

    For some people, pain becomes more frequent, starts to affect sleep, and makes walking, stairs or gripping harder.

  4. Varies

    Severe

    A small number of people have pain that badly affects daily life even with good treatment. This is when surgery may be considered.

Everyone is different. Many people stay in the early stage, and symptoms can improve. Morning stiffness that lasts longer than 30 minutes may point to an inflammatory type of arthritis, so tell your GP.

When to get urgent help

Go to A&E or call 999 if

  • you have severe joint pain after a fall or injury
  • you can't walk or put weight on a joint
  • a joint looks out of place
  • you have tingling or no feeling around a joint after an injury
  • you suddenly lose control of your bladder or bowels, or have numbness around your bottom, with back pain

Get an urgent GP appointment or call NHS 111 if

  • a joint is suddenly hot, red and swollen
  • you have joint pain and feel unwell, with a high temperature or shivering
  • a replaced joint becomes hot, red, swollen or more painful

See your GP if

  • joint pain stops you doing normal things or affects your sleep
  • pain or swelling is getting worse or keeps coming back
  • it hasn't improved after 2 weeks of looking after it at home
  • stiffness lasts more than 30 minutes after you wake

A suddenly hot, swollen joint can be a joint infection (septic arthritis), which needs treating straight away.

Diagnosis and referral

Your GP can usually diagnose osteoarthritis from your symptoms and an examination. NICE says a diagnosis can be made without tests if you are 45 or over, your joint pain is linked to activity, and any morning stiffness lasts 30 minutes or less.

X-rays and blood tests aren't usually needed. They may be used if your symptoms are unusual, to rule out other conditions. X-ray changes don't always match how much pain you have.

You may be referred to:

  • Physiotherapy for a tailored exercise plan. In many areas you can refer yourself to NHS musculoskeletal (MSK) services without seeing your GP.
  • Occupational therapy for advice on daily tasks, splints and aids.
  • Podiatry for foot pain, insoles and footwear.
  • An orthopaedic surgeon if your symptoms badly affect your life and other treatments haven't helped enough.

Treatments and medicines

NICE says the core treatments for everyone are information, therapeutic exercise and, if you are overweight, weight loss. Medicines are there to help you stay active, not to replace exercise.

Therapeutic exercise

NHS physiotherapy, often by self-referral

Exercise to strengthen the muscles around the joint and keep it moving. NICE recommends it for everyone with osteoarthritis, whatever their age. It may hurt a little at first, but it is safe and the benefit builds over weeks.

Anti-inflammatory gels and creams

From a pharmacy, or on prescription

Topical NSAIDs such as ibuprofen or diclofenac gel. NICE recommends them first for knee osteoarthritis, and they may help other joints near the skin, such as the hands.

Anti-inflammatory tablets

Ibuprofen from a pharmacy; others such as naproxen on prescription

Oral NSAIDs can be used if gels aren't enough. NICE says to use the lowest effective dose for the shortest time. Your GP should also offer a stomach-protecting medicine. They aren't suitable for everyone, including some people with heart, kidney or stomach problems.

Capsaicin cream

Prescription

Made from chilli peppers. It can help hand and knee pain. It may sting at first and can take a few weeks to work.

Steroid injections

From your GP, physio or a specialist

An injection into the joint can ease a bad flare. NICE says to consider them only for short-term relief, usually lasting 2 to 10 weeks, alongside exercise.

Walking aids, splints and footwear

Pharmacy, mobility shops, or through the NHS

A walking stick, supportive shoes, insoles or a thumb splint can take strain off a joint. NICE suggests considering walking aids for hip and knee osteoarthritis.

What NICE doesn't recommend for osteoarthritis

NICE advises doctors not to routinely offer paracetamol or weak opioids such as codeine, except for occasional, short-term use when other medicines aren't suitable or haven't worked. It says not to offer strong opioids. It also doesn't recommend glucosamine, hyaluronic acid injections, acupuncture, or electrotherapy such as TENS. Glucosamine and chondroitin are no longer prescribed on the NHS. If you rely on codeine-based painkillers, talk to your GP or pharmacist before stopping.

Some people still find a TENS machine or heat helpful for comfort. They are low risk, but the evidence that they help osteoarthritis is weak.

Surgery and recovery

Most people with osteoarthritis never need surgery. NICE says joint replacement should be considered when symptoms have a big effect on your quality of life and other treatments haven't helped enough. You shouldn't be ruled out just because of your age, weight, smoking or other health conditions, although these can affect risks and timing.

  1. Hip replacement

    Home in 1 to 3 days. Usually back to work and driving after about 6 weeks

    You'll use crutches or a frame at first. Following your physio exercises is key to getting strength back. Full recovery can take several months.

  2. Knee replacement

    Home in 1 to 4 days. Back to work after about 6 to 12 weeks

    Most people can walk without aids by around 6 weeks. You'll usually wait at least 6 weeks to drive after a total knee replacement, or 3 weeks after a partial one. Full recovery can take several months or longer. Partial replacements tend to recover faster.

  3. Osteotomy

    Recovery over several months

    The bone is cut and realigned to take weight off the damaged part of the joint. It is mainly used for the knee in younger, active people, and may delay the need for a replacement.

  4. Joint fusion

    Varies by joint

    The bones of a joint are joined so it no longer moves. It can relieve pain in smaller joints such as the ankle, big toe, wrist or fingers when replacement isn't suitable.

The NHS says a joint replacement can last up to 20 years. NICE doesn't recommend keyhole washouts of the joint (arthroscopic lavage and debridement) for osteoarthritis.

Self-help and living well

During a flare

  • Rest the joint for a short time, but keep gently moving
  • Try heat, such as a warm pack, or cold wrapped in a towel
  • Use your anti-inflammatory gel as advised
  • Cut back activity, then build up again slowly
  • Use a stick or splint to take the strain

Day to day

  • Keep active. Walking, swimming and cycling are gentle on joints
  • Do strengthening exercises at least twice a week
  • If you are overweight, losing weight takes pressure off hips and knees. NICE says losing 10% is likely to help more than 5%
  • Pace yourself. Don't overdo it on good days
  • Wear supportive, cushioned shoes
  • Look after your sleep and mood. Talk to your GP if pain is getting you down

Arthritis UK has free information and exercise guides on its website. NHS talking therapies can help with low mood or anxiety linked to pain, and in England you can refer yourself.

Getting the best treatment

Before you see your GP

Keep a simple diary for 2 to 4 weeks. Note which joints hurt, how bad the pain is out of 10, how long you are stiff in the morning, what makes it better or worse, and what you can't do. Bring a list of the medicines and creams you have tried and whether they helped.

Questions to ask

  • Can I be referred to physiotherapy, or can I refer myself here?
  • Would an occupational therapist or podiatrist help me?
  • Is an anti-inflammatory gel or tablet safe for me?
  • Would a steroid injection help me through a bad flare?
  • Are there local exercise or weight management programmes I can join?
  • At what point should I be referred to a surgeon?
  • Could my morning stiffness or swelling be a different type of arthritis?

If treatment isn't helping, go back. You can ask to see a different GP, and you can ask for a second opinion from a specialist. If you are waiting for surgery, ask for physio while you wait and tell the hospital if things get worse.

Osteoarthritis and work

Osteoarthritis can count as a disability under the Equality Act 2010 (the Disability Discrimination Act in Northern Ireland). This applies if it has a substantial, more than minor, effect on your daily life and has lasted, or is likely to last, at least 12 months. Conditions that come and go can count. The law looks at how you would be without treatment or aids.

If it does, and your employer knows or should know about it, they must make reasonable adjustments. These might include:

  • A supportive, adjustable office chair
  • A sit-stand desk so you can change position
  • An ergonomic keyboard and mouse for hand pain
  • Voice recognition software
  • A perching stool for jobs on your feet
  • Anti-fatigue mats
  • A parking space near the entrance
  • A workspace on the ground floor
  • Lighter duties, or help with lifting
  • Flexible hours and working from home
  • Time off for appointments and surgery
  • A phased return after a joint replacement

Access to Work is a government grant that can pay for equipment, travel to work and support. For advice on your rights, contact Acas or Citizens Advice.

People with joint and muscle conditions are 20% less likely to be in work than people without them. (Arthritis UK, 2025)

Benefits

If you can't work for a while, for example after surgery, you may get Statutory Sick Pay from your employer. Depending on how osteoarthritis affects you, you may also be able to get Personal Independence Payment (PIP), or Adult Disability Payment in Scotland, Universal Credit or Employment and Support Allowance. Turn2us and Citizens Advice can help you check.

How The Beyond Pain Foundation can help

If NHS waits are too long, or the help you need isn't available to you on the NHS, we may be able to fund:

  • A course of private physiotherapy or hydrotherapy
  • A private consultation with a specialist
  • Physio to help you get strong before or after joint surgery
  • Walking aids, splints, insoles or other daily living aids
  • Workplace or home equipment, such as an ergonomic chair, sit-stand desk, ergonomic keyboard or grab rails

We don't pay for everyday living costs. We fund treatment from registered or qualified practitioners. Prices vary, so always get a written quote to include with your application.

Apply for funding Check the requirements

Support and sources

Arthritis UK

Charity, formerly Versus Arthritis

Free helpline 0800 5200 520, Monday to Friday, 9am to 6pm. Also information, exercise videos and online communities.

arthritis-uk.org

Access to Work

Government grant

Help paying for equipment, adaptations and support at work.

gov.uk/access-to-work
Sources for this guide

Last reviewed: October 2026.