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How old is he?
At what time the pain is worst?
Thanks for the details
His age and severity of pain demands further investigations
He should have an examination and X-ray of affected joint
Also he should have ESR/CRP and RA factor
This could be a seronegative arthritis and may require steroids and disease modifying agent
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I am available to assist till you are satisfied
These are tests to look for inflammation and also to check for joint disease
He can go to his GP but if pain is very severe can go to A&E
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If you can go to the GP in a day or so then don,t go to A&E but if there is a delay you can go for a pain relief