Discuss with the patient the new realities

You can see your patient is struggling with his new realities. OA is a chronic disease and chronic pain management is something that you can educatie your patients on. 

You have to explain the medical / biological part of OA to your patient, along with his rheumatologist, and probably his pain specialist (if you have made a prior referral to a pain clinic). If your patient is struggling with mental health issues such as depression and/or anxiety, like this male patient, then probable you should also make a referral to a psychologist and/or a psychiatrist. 

Pain management in OA needs a multidisciplinary approach to have the best outcome for the patient. 

Your patient needs to understand at least the basics, in simple and without complex medical terms explanations so he will be able to learn how to self-manage his condition in terms of use of medication, lifestyle adjustments, daily activities etc.