Management of moderate to severe knee osteoarthritis
Management of moderate to severe knee osteoarthritis
OA: osteoarthritis; NSAID: nonsteroidal antiinflammatory drug; TENS: transcutaneous electrical nerve stimulation. * Patients with moderate to severe knee OA have persistent pain, which significantly impairs functionality, activity participation, and quality of life. ¶ If the patient has OA limited to the knees and hands, a trial of topical NSAIDs is reasonable before advancing to oral NSAIDs (if not otherwise contraindicated). Δ Assess the need for a proton pump inhibitor if increased risk for gastrointestinal side effects. ◊ Intraarticular glucocorticoid injections are not routinely recommended because the pain relief is mild to moderate and is short-lived. Refer to UpToDate content on management of knee OA. § Refer to UpToDate content on management of knee OA for adjunctive measures.
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