In the management of osteoarthritis, there are several tools available (5.1). There are a wide number of options, including non-pharmacological, pharmacological, and surgical options, which may be selected and tried for the individual patient. The management plan has to be individualized, taking into account factors such as: severity of pain and disability; constitutional factors (e.g. obesity, muscle weakness); psychosocial factors; co-morbidity; concurrent drug therapy; and patient beliefs. With respect to choice of additional interventions, the evidence for efficacy is clearly important, although other factors that will guide decision-making include: the safety profile; the availability and practicality of the intervention; its mode of delivery; the cost of treatment; previous experience of the patient; and physician and patient preference.

As with any chronic disease, patient education is paramount, particularly as evidence suggests that patients with high degrees of self-efficacy have better outcomes in terms of pain and disability. Ideally, education should take a cognitive approach, as enhanced problem-solving strategies and behaviours are the goal, rather than simple knowledge. A variety of approaches have been used, but essentially the fundamental principles are:

While these principles are easy to elucidate, putting them into practice is a considerable challenge within most health and social care services. Doctors and allied health-care professionals clearly have a role in this, but patients may receive a lot of their information and, indeed, possible misinformation from a number of sources (5.2, 5.3). There are a wide variety of sources that provide information on osteoarthritis (e.g. patient literature, interactive programmes, websites, and books). Many patients receive much of their education from non-professionals, such as friends and family. Education, therefore, may need to take place at a societal, as well as personal level. This is again a major public health challenge.