The cause of osteoarthritis (OA) - the most prevalent joint disease - remains unknown and no cure has been identified. The OA patient seeks help because of symptoms (primarily pain) and impaired function. However, the underlying mechanisms resulting in pain or structural damage that contribute to impairment of joint function are not completely understood. Currently available drug treatments are palliative at best. Although they are reported to offer some clinical benefit, few, if any, have been extensively investigated by well-validated, evidence-based studies. They often fail to control symptoms in the long term, and do little to address the underlying causes of disease progression. While OA pain is still an unmet medical need, alleviating pain alone may lead to further joint damage, because pain may have a protective role in the affected joint by causing a reduction in weight bearing. Moreover, there is a poor correlation between disease severity and symptoms. OA disease progression, regardless of the pathogenesis, involves anabolic and catabolic changes in multiple components of the joint, including cartilage, subchondral bone, synovium and the joint capsule. Thus, comprehensive treatment for OA should aim for long-term improvement in all dimensions, including palliating symptoms, alleviating pain, inhibiting tissue destruction, promoting repair and regeneration, and improving joint function. The ultimate objective is to treat the OA patient as a whole. This paper reviews the available therapeutic options for OA and discusses the prospects for developing a comprehensive treatment(s) for osteoarthritic and damaged joints.