Arthritis treatment depends entirely on which type you have, but nearly every form responds to some combination of movement, medication, and lifestyle changes. There are more than 100 types of arthritis, though osteoarthritis, rheumatoid arthritis, and gout account for the vast majority of cases. The right approach ranges from daily exercise and over-the-counter pain relievers to immune-suppressing drugs and joint replacement surgery.
Exercise: The Most Effective Starting Point
For osteoarthritis, the most common form, physical activity is not just helpful but considered essential. European guidelines for hip and knee osteoarthritis treat non-pharmacological approaches, especially exercise, as core treatment before any medication is introduced. That recommendation is backed by strong data: a 2025 systematic review in The BMJ found that aerobic exercise produced large reductions in knee pain both in the short term and at follow-ups of several months. Strengthening exercises, meanwhile, produced large improvements in physical function over the same timeframe.
The key is consistency. Walking, cycling, swimming, and resistance training all help, and the benefits accumulate over weeks. Many people with arthritis avoid movement because they assume it will worsen joint damage, but moderate exercise actually reduces inflammation around the joint and strengthens the muscles that support it. If you’re starting from a sedentary baseline, a physical therapist can design a program that builds gradually without triggering flare-ups.
Over-the-Counter Pain Relief and Its Limits
NSAIDs like ibuprofen and naproxen are widely used for arthritis pain, and they work well for short-term relief. The problem is long-term use. A large study from Oxford found that high doses of ibuprofen and diclofenac increased the risk of a major cardiovascular event (heart attack, stroke, or cardiovascular death) by about one third. In practical terms, that translates to roughly 3 extra heart attacks per year for every 1,000 patients on high-dose treatment, one of which would be fatal. The risk of stomach ulcer bleeding also increased two to four times, depending on the specific drug and dose.
Acetaminophen (Tylenol) is gentler on the stomach and heart but offers weaker pain relief for arthritis and does nothing for inflammation. Topical NSAIDs, applied directly to the skin over the affected joint, deliver some of the anti-inflammatory benefit with less systemic risk. For mild to moderate osteoarthritis in hands or knees, topical options are often a reasonable first choice.
Steroid Injections
Corticosteroid injections directly into the joint can provide fast, targeted relief when a single joint is particularly swollen or painful. The effect typically lasts weeks to a few months. Current guidelines recommend spacing these injections at least three months apart per joint to avoid potential cartilage damage with repeated use. Steroid injections are best understood as a bridge: they can reduce a flare enough for you to return to exercise and physical therapy, but they don’t slow disease progression.
Platelet-Rich Plasma Injections
Platelet-rich plasma (PRP), made by concentrating platelets from your own blood and injecting them into the joint, has generated growing evidence for knee osteoarthritis. A 2025 meta-analysis of 18 randomized controlled trials involving nearly 2,000 patients found that PRP significantly improved pain and function compared to placebo at both 6 and 12 months, with improvements that crossed the threshold for clinical meaningfulness. A separate 2024 review of 35 trials reported that PRP consistently outperformed corticosteroid injections in mid-term and long-term outcomes.
Dose appears to matter. Studies show a clear dose-response effect, with better results when preparations contain more than 10 billion platelets per injection. Some earlier trials that showed no benefit used concentrations well below that threshold. The European Society of Sports Traumatology gave PRP a grade A recommendation for knee osteoarthritis in 2024, though insurance coverage remains inconsistent and costs are often out of pocket.
Rheumatoid Arthritis: Immune-Targeted Drugs
Rheumatoid arthritis (RA) is fundamentally different from osteoarthritis. It’s an autoimmune disease where the immune system attacks the joint lining, causing inflammation that can erode bone and cartilage if left unchecked. Treatment focuses on suppressing that immune response early and aggressively.
The standard first-line treatment is a class of drugs called DMARDs (disease-modifying antirheumatic drugs). Methotrexate is the most commonly prescribed. It’s taken once a week, usually as a pill, and works by dampening the overactive immune cells driving joint inflammation. Other traditional DMARDs include hydroxychloroquine, sulfasalazine, and leflunomide. These drugs don’t just mask pain; they slow or stop the underlying joint destruction.
When traditional DMARDs aren’t enough, biologic DMARDs target specific molecules in the immune system. These include TNF inhibitors (which block a key inflammatory protein), interleukin inhibitors, and drugs that suppress specific immune cell types like T-cells or B-cells. Biologics are typically given as injections or infusions every one to four weeks. A newer class called JAK inhibitors works similarly but comes in pill form. These drugs block a signaling pathway inside immune cells that multiple inflammatory molecules rely on. Head-to-head trials show JAK inhibitors perform comparably to, and in some cases slightly better than, established biologics, though their side effect profile is distinct and requires monitoring.
The goal of RA treatment is remission, or as close to it as possible. Doctors adjust medications in a stepwise fashion, checking inflammatory markers regularly and escalating treatment if disease activity remains high. Starting DMARDs within the first few months of symptoms produces significantly better long-term outcomes than waiting.
Gout Treatment
Gout is caused by uric acid crystals accumulating in a joint, most famously the big toe. Treatment has two separate phases: stopping the acute flare and preventing future attacks.
During an acute gout flare, low-dose colchicine, NSAIDs, and corticosteroids (oral, injected into the muscle, or directly into the joint) are all similarly effective. The choice depends on your other health conditions. Colchicine works best when taken within the first 12 to 24 hours of a flare.
Long-term prevention centers on lowering uric acid levels in the blood to below 6 mg/dL, the threshold at which crystals begin to dissolve. Allopurinol is the most widely used drug for this, typically started at a low dose and gradually increased every two to five weeks until the target level is reached. Some patients need alternative options like febuxostat or probenecid. Urate-lowering therapy is generally lifelong; stopping it allows uric acid to climb back up and flares to return.
Supplements: What the Evidence Shows
Glucosamine and chondroitin are among the most popular arthritis supplements, but the clinical evidence is disappointing. A 2022 analysis of eight studies involving nearly 4,000 people with knee osteoarthritis found no convincing evidence of major benefit. Earlier reviews found only small improvements in pain scores, and it was unclear whether those improvements were meaningful in daily life. One 2016 trial was actually stopped early because participants taking the supplement reported worse symptoms than those on placebo.
These supplements are generally safe, though they can cause digestive side effects and may interact with blood thinners. Because the FDA does not regulate supplements the same way it does medications, the actual contents may not match the label. If you’ve been taking glucosamine or chondroitin and feel they help, the risk of continuing is low, but the evidence doesn’t support starting them with high expectations.
Joint Replacement Surgery
When arthritis has destroyed enough cartilage that pain becomes constant and daily activities like walking or climbing stairs are severely limited, joint replacement becomes a realistic option. Hip and knee replacements are the most common, with over a million performed annually in the United States alone.
Modern joint replacements are remarkably durable. Data from national registries across multiple countries show 10-year survival rates consistently above 94%. Norway’s registry, for example, reports 95% survival for hip replacements and 94.8% for knees at the 10-year mark. Registries in Australia, New Zealand, the UK, and the Netherlands report similar numbers. “Survival” here means the original implant is still functioning without needing revision surgery.
Recovery from knee replacement typically involves several weeks of physical therapy and a gradual return to normal activity over two to three months. Most people experience significantly less pain within a few months of surgery and regain enough function to walk, drive, and handle daily tasks without assistance. Hip replacement recovery tends to be somewhat faster. Surgery is not a first resort, but for advanced arthritis that hasn’t responded to other treatments, it reliably restores quality of life.