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Managing Osteoarthritis in a 45-Year-Old Plumber: Comprehensive Guide for Improved Quality of Life

This comprehensive guide explores the impact of osteoarthritis on a 45-year-old plumber's life, including adjustments to home and workplace, self-management strategies, core treatments, pharmacological and non-pharmacological options, and when to consider surgical referral.

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Managing Osteoarthritis in a 45-Year-Old Plumber: Comprehensive Guide for Improved Quality of Life

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  1. Osteoarthritis

  2. Mr. P • 45y • Plumber • BL knee pains • OA diagnosed on XR

  3. What next?? • Impact of OA • Occupation • ADL • Family • Hobbies • Lifestyle • Sleeping Any adjustments to home or workplace

  4. What other assessment?? • I.C.E./understanding • Support/social • Mood • Pain severity • Other MSK pains • Co-morbidities

  5. Shared management… • Agreement with patient • Education • Risks vs. benefits • Regular follow up Core Treatments Patient Self-Management

  6. Core treatments?? • Access to information • Education • Footwear • Activity and exercise • Strengthening • Aerobic • Assistance with weight loss

  7. Patient Self-Management?? • Exercise • Weight loss • Suitable footwear • Heat or cold packs pain sites • TENS for pain relief

  8. What if this is not enough?? • Adjuncts Pharmacological Non - Pharmacological

  9. Pharmacological… • Paracetamol • Topical NSAIDs – knee/hand OA • Oral NSAIDs/COX-2 inhibitors • Opioid based drugs • Topical capsaicin • Intra-articular corticosteroid injection

  10. Things not to prescribe… • Rubefacients • Intra-articular hyaluronan injections • Electro-acupuncture5 • Chondroitin / glucosamine

  11. Non-Pharmacological… • Heat or cold packs • TENS • Manipulation and stretching • Hip osteoarthritis • Bracing/joint supports/insoles • Biomechanical joint pain or instability • Assistive devices • Walking sticks • Tap turners • OT/PT

  12. What if this is not helping? Refer to surgery?

  13. When can you refer?? Offered all core treatments Impact on QOL History of mechanical locking (Arthroscopic lavage & debridement) Joint symptoms (pain/stiffness/reduced function)

  14. But don’t… • Use current scoring tools for prioritisation (QOL, WOMAC) • Be biased by patient factors • Age • Gender • Smoking • Obesity • Co-morbidities

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