24th February 2025

You are reviewing an 81-year-old man in clinic who has a background of ischaemic heart disease, severe aortic stenosis and age-related macular degeneration.

You are reviewing an 81-year-old man in clinic who has a background of ischaemic heart disease, severe aortic stenosis and age-related macular degeneration. He is having an issue with his OA, which is ‘playing up,’ and paracetamol and diclofenac gel are not helping like they usually do. He describes aches and pains in most of his joints, which are bearable, but he is particularly troubled by pain in the right knee, which is causing him to limp. You are satisfied, based on the history and examination, that this is a progression of his OA. In this specific case, what would be the most optimal next step in regards to analgesia?

Select the SINGLE most appropriate option from the list below. Select ONE option only.