History and examination are sufficient to diagnose osteoarthritis (OA) in most cases. Joint pain and stiffness (lasting no longer than 30 minutes in the morning), which is worse with weight bearing or usage, in a patient aged 45 or over, is indicative of OA. Muscle strengthening and aerobic exercise remain core treatments and exercise should be tailored to the individual. Pharmacological therapy should be used ‘at the lowest effective dose for the shortest possible time’ in combination with non-pharmacological therapy. Referral for joint replacement should be based on severity of symptoms and failure of conservative treatment, and should not be influenced by factors such as age, gender or comorbidities.