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supervised exercise can strengthen periarticular muscles and reduce joint loading Topical NSAIDs (e.g., topical diclofenac) as a preferred first-line pharmacological option for localised joint pain, particularly in older adults where systemic NSAID use carries greater risk Paracetamol is not routinely recommended by NICE for osteoarthritis-type pain but may be considered for short-term use if other options are unsuitable or not tolerated [15] [16] Cold or warm compresses for symptomatic relief If oral NSAIDs are considered necessary, they should be used at the lowest effective dose for the shortest possible duration, on medical advice, and with gastroprotection (a proton pump inhibitor) as recommended by NICE

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