Osteoarthritis is the most common cause of disability in elderly people in the developed world, and pain and restricted activity are the most common symptoms.1 Disabling chronic knee pain alone is thought to affect a quarter of all elderly people in the United Kingdom.2 Traditional approaches to treatment such as joint replacement are successful for people who have advanced or severe disease, but they are not useful for most patients, who present with milder symptoms or at earlier stages of disease progression. Targets for preventing osteoarthritis of the hip and knee are similar to those for many chronic diseases—for example, controlling weight, increasing physical activity, improving education and psychological health, and avoiding injury. However, optimal management of symptoms and of restricted activity in people who already have hip and knee pain is a priority for general practitioners, as this can reduce the prevalence of disability among elderly people in the community. A trial in this week's BMJ assesses one of the ways this may be achieved, by teaching patients to manage their arthritis in …