The guidance presented in this OA guidebook is all evidence-based. The evidence flowers shown here gives a visual summary of evidence-based recommendations for managing Osteoarthritis and joint pain with multi layer flower petals. The central (pink coloured) petals with 3 stars are core and represent the first line of recommended interventions for everyone with osteoarthritis and joint pain. Getting good education and advice about osteoarthritis and joint pain are the very first elements of high quality care for people living with osteoarthritis. Strengthening exercises, topical NSAIDs (creams) and weight loss (as appropriate) follow on as core interventions.

Further out with 2 stars (light blue coloured petals) are local heat and cold applications (as appropriate), joint injections and referral for joint replacement are additional interventions that may be considered.

In the outer layer (dark blue coloured petals) are other options that are commonly used but there is no good evidence to suggest these may be effective for managing Osteoarthritis and joint pain. In summary, routine/continuous use of electrotherapy equipment such as TENs, support braces, paracetamol and other medications such as capsaicin and opioids are not recommended.