People with osteoarthritis should be referred for surgery before they are in severe pain, according to new recommendations which also urge regular exercise.
Experts at the National Institute for Health and Clinical Excellence (Nice) said there was a "mistaken belief" that osteoarthritis is an inevitable part of ageing and will only get worse.
The "core treatment" for the condition, which is the most common type of arthritis in the UK, is exercise, which can help relieve pain for some people and improve function, Nice said in new guidance for the NHS.
Those who are overweight should be encouraged to lose weight while drugs such as paracetamol and ibuprofen gel should be considered for pain relief.
The guidance said patients should be referred for consideration of joint replacement surgery - such as hips or knees - before mobility is reduced over a long period of time and patients are in severe pain.
Nice warns doctors that a patient's age, sex, smoking history or whether they are obese "should not be barriers to referral for joint surgery".
About a million people see their GP about osteoarthritis every year, and it accounts for 115,000 hospital admissions. The NHS in England and Wales performs more than 140,000 hip and knee replacement operations annually.
Today's guidance said GPs can diagnose osteoarthritis in the practice if a person is 45 or over and has activity-related joint pain with either no morning joint-related stiffness or morning stiffness that lasts no longer than 30 minutes.
Professor Mark Baker, director of the centre for clinical practice at Nice, said: "There's a common but mistaken belief that osteoarthritis is an inevitable part of ageing and that it will get worse, but that's not the case.
"The guidance highlights that the core treatment for osteoarthritis remains exercise - this not only helps relieve pain for some people but also improves function."
Nice is currently reviewing recommendations on the use of paracetamol for the condition after draft guidance it published last year said the drug should be used cautiously.
Nice warned of "extreme concern" that higher doses of paracetamol could lead to multiple adverse effects, including heart, kidney and intestinal problems, and recommended GPs only prescribe the lowest effective dose for the shortest possible time.
However, the Medicines and Healthcare products Regulatory Agency (MHRA) said there was no new evidence to support the advice and is now carrying out a wide-ranging review.
Until that work is completed, Nice has said it will continue to recommend paracetamol as an option.
Philip Conaghan, professor of musculoskeletal medicine at the University of Leeds, said: "The symptoms often caused by osteoarthritis, such as pain and limited joint movement, can be managed with muscle strengthening, exercise and weight loss if people are overweight.
"If a person is still experiencing pain that interferes with their daily life despite addressing these core treatments and use of analgesics as appropriate, then the guideline makes a new recommendation that the person be referred for consideration of joint surgery before there is prolonged limited joint movement and severe pain.
"The guideline is also clear that factors such as the person's age, smoking status and obesity should not affect referral for joint surgery."
The guidance states that glucosamine and chondroitin, as well as acupuncture should not be offered as a solution because the evidence on their clinical effectiveness is "uncertain".
People with osteoarthritis should also be regularly reviewed by doctors.
Professor Karen Middleton, chief executive of the Chartered Society of Physiotherapy (CSP), said: "These guidelines should help challenge the perception that many people often have about osteoarthritis being a normal part of ageing and that 'nothing can be done'.
"Physiotherapists provide effective treatment for the symptoms of osteoarthritis and deliver expert advice on physical activity and weight-management strategies to reduce pain and improve mobility."
Professor Alan Silman, medical director of Arthritis Research UK, said: "Joint replacement can make an enormous difference to people with severe osteoarthritis, and we're very pleased that the new guidelines recommend surgery before their pain becomes severe and restricts their everyday activities, rather than having to wait until they are incapacitated.
"Exercise and keeping moving is one of the most effective ways in which people with osteoarthritis can help themselves. It's important that people with osteoarthritis find a type of exercise they enjoy doing and keep doing it.
"Stretching, strengthening and aerobic exercises are the ideal combination to ease stiffness, improve movement in the joints and strengthen muscles."
