In osteoarthritis and soft-tissue disorders, many patients can achieve adequate control with paracetamol alone, (regular dosing may be required). NICE guidance recommends offering paracetamol and/or a topical NSAID before considering oral NSAIDs or COX-2 inhibitors for osteoarthritis. Only prescribe a NSAID if the benefits of treatment clearly outweigh the risks and a need for an anti-inflammatory agent is identified.

Choice of agent: NICE guidance recommends when offering treatment for osteoarthritis, use either a standard NSAID or a COX-2 inhibitor (not etoricoxib) as a first choice and always co-prescribe with a proton pump inhibitor.