Non-Surgical Care

Non-surgical care is an active treatment plan built around the cause of your symptoms and what you need to do each day. It may combine education, exercise, changes to activity, practical aids and appropriate medicines. It should include a review point, so that you know whether the plan is helping and what to do if it is not.

Start with the problem being treated

Knee pain after a sudden twist, an increasingly stiff arthritic hip and a painful shoulder each raise different questions. Avoid selecting treatment purely because it helped someone with pain in the same body part. Ask the clinician to name the working diagnosis, explain any uncertainty and describe which findings support it.

Prepare a short account of when symptoms started, what aggravates them, what eases them and whether they affect sleep or essential activities. Mention an injury, fever, new numbness or weakness, and previous operations. Bring treatment records so that repeating an unsuccessful or poorly tolerated intervention is a deliberate decision, not an oversight.

Before leaving, ask what information would change the plan. If a test is suggested, ask which clinical question it addresses and how the result will influence care. These questions help you understand the sequence of assessment without assuming that every painful joint needs the same scan.

Set useful and measurable goals

A practical goal might be preparing a meal without repeatedly sitting down, using the office stairs more comfortably or sleeping with fewer interruptions. Choose one or two priorities and describe your starting point. Ask when it is reasonable to review them and what improvement would count as worthwhile.

Keep a simple record of activity and symptoms rather than checking pain constantly. For example, note what you attempted, what limited you and whether the prescribed treatment was manageable. Bring this record to review. Include side effects and practical barriers: travel, cost, limited space, language or difficulty remembering the instructions.

The aim is a plan you understand well enough to carry out. Request plain-language written instructions and demonstrate any prescribed exercise back to the clinician. If the plan is too complicated, ask which elements have the highest priority and how to fit them into your day.

Exercise and activity adjustments

For osteoarthritis, tailored therapeutic exercise is a core treatment. It can address muscle strength and general fitness. Some initial discomfort may occur, but the programme should be adjusted to the individual rather than prescribed as a universal list. NICE recommends matching exercise to a person’s needs and considering supervised sessions. NICE guidance

An arthritis programme may also address flexibility and gradual conditioning. A clinician or physiotherapist can help choose suitable activities and build them up. Severe pain after exercise is a reason to seek advice about the programme, not a target to push through. AAOS exercise guidance

Ask how to manage the activity you care about. If walking to work aggravates symptoms, discuss the route, surfaces, duration and available breaks. If your job involves lifting, explain the real load and frequency. Avoid an instruction as vague as “take it easy”; request concrete limits and criteria for progressing.

Symptom relief and medicine safety

Medicine choice depends on the diagnosis, your health and other treatment. Anti-inflammatory medicines can help pain and inflammation, but may cause stomach bleeding, kidney problems or allergic reactions and may interact with other medicines. Combining products without checking their ingredients can be unsafe. NHS NSAID information

Bring a complete medication list, including over-the-counter products, traditional remedies and supplements. Ask what each proposed medicine is intended to do, how long to use it and what should trigger a call. If you are already taking blood thinners or have a history of medication problems, make that explicit.

This page gives no dose schedule. Follow the prescription and medicine leaflet, and ask a pharmacist or prescriber about uncertainty. Severe breathing difficulty, swelling of the tongue or throat, vomiting blood or collapse requires emergency assessment rather than a routine review. Do not attempt to manage a serious reaction by exchanging online messages.

Injections and other proposed treatments

For osteoarthritis, a corticosteroid injection may be considered when other medicine is ineffective or unsuitable, or to help participation in exercise. Relief is generally short term. NICE does not recommend hyaluronan injections or routine arthroscopic washing or debridement as osteoarthritis treatment. NICE recommendations

Ask what an offered injection contains, where it will be given, what evidence supports its use for your diagnosis and what risks apply to you. Discuss what happens if it does not help and how it fits into the overall plan. Be cautious about claims that a procedure will certainly cure the problem or rebuild an arthritic joint without sound evidence.

Corticosteroid injections can cause a short-lived flare of pain and carry a small risk of infection. Blood glucose can rise temporarily in people with diabetes. Before an injection, discuss these risks and any monitoring needed with the treating clinician. AAOS injection risks

For any proposed treatment, ask whether the expected benefit is symptom relief, better function or a change in the underlying problem. These are different outcomes. Confirm availability and cost directly; a general explanation on this website is not a statement that the practice provides every intervention discussed.

Practical support around daily life

For some people with osteoarthritis, weight-management support, walking aids or adaptations to everyday tasks can be useful alongside other treatment. Equipment needs assessment and appropriate use; it should address a specific difficulty. NHS treatment and support

Describe the task before buying an aid. Is the problem getting up from a chair, standing in a queue or opening a container? Ask a therapist what adjustment is suitable, how it should fit and how to use it safely. If a suggested aid feels unstable or causes another pain, request reassessment.

Consider who can help and what independence you want to retain. Family members can help communicate progress, but the goals should reflect your preferences. Ask for instructions in a language and format you can understand, and tell the team if you cannot afford or access a recommended part of the plan.

Reassessment and when surgery enters the conversation

At review, compare the agreed goals with your starting point. Discuss both benefit and burden: symptom change, daily function, side effects and how realistically you followed the plan. Ask whether to continue, adjust the diagnosis or treatment, or discuss another option.

For osteoarthritis, surgery may be considered when symptoms substantially affect life and suitable non-surgical management is ineffective or unsuitable. It is not a punishment for failing exercise, and it is not an inevitable next step for everyone. NICE referral guidance

When not to wait for the planned review

A suddenly very painful, swollen joint, especially with fever or feeling unwell, needs urgent assessment because joint infection is one possible cause. Do not assume it is an ordinary arthritis flare. NHS septic arthritis guidance

Seek urgent assessment for a significant new injury, rapidly worsening symptoms or new loss of movement or sensation. Emergency symptoms belong with emergency services, not the appointment request channel. For a routine concern, use your agreed follow-up route and explain what changed, when it changed and what treatment you have used.