Osteoarthritis is treated with a combination of lifestyle changes, physical therapy, medications, and, when those stop working, surgery. There is no cure, but the right mix of treatments can significantly reduce pain and keep you moving. Most people start with the least invasive options and add or switch approaches as the condition progresses.
Exercise and Physical Therapy
Regular exercise is one of the most effective treatments for osteoarthritis, and it’s typically the first thing recommended. That can feel counterintuitive when your joints hurt, but strengthening the muscles around an arthritic joint takes pressure off the damaged cartilage and reduces pain over time. A large network meta-analysis published in The BMJ, covering thousands of patients with knee osteoarthritis, found that aerobic exercise consistently had the highest probability of being the best treatment across pain, function, and walking performance outcomes.
Different types of exercise offer different benefits. Aerobic exercise (walking, cycling, swimming) improves walking ability in both the short and medium term. Balance and coordination training, sometimes called neuromotor exercise, produces large improvements in gait within a few weeks. Flexibility work and mind-body practices like tai chi and yoga also improve mobility, though the evidence is slightly less certain. A mixed routine that combines several of these tends to produce lasting gains over months.
You don’t need to figure this out alone. A physical therapist can design a program matched to your joint, your fitness level, and how severe your arthritis is. They can also teach you how to protect your joints during daily tasks, a skill set called joint protection that reduces strain without limiting your activity.
Weight Loss
For people carrying extra weight, losing it is one of the most powerful things you can do for an arthritic knee or hip. Every pound of body weight translates to roughly three to four pounds of force on the knee during walking, so even modest weight loss makes a real mechanical difference. Research suggests that losing at least 5% of your body weight within about 20 weeks produces moderate pain relief. To reach a point where the improvement in pain and physical function is clearly noticeable in daily life, the threshold is closer to 7.7% of your starting weight. For someone who weighs 200 pounds, that means about 15 pounds.
Over-the-Counter Pain Relief
Acetaminophen is often the starting point for mild pain because it carries fewer side effects than anti-inflammatory drugs. It won’t reduce swelling, but it can take the edge off everyday aching.
Non-steroidal anti-inflammatory drugs, or NSAIDs, are more effective for osteoarthritis pain because they target both pain and inflammation. Oral versions like ibuprofen and naproxen work well but come with real risks when used regularly, including stomach ulcers, cardiovascular problems, and kidney stress. Topical NSAIDs (gels or creams applied directly to the skin over the joint) deliver comparable pain relief for accessible joints like the knee or hand while dramatically reducing the amount of drug circulating through your body. That makes them a safer first choice for people over 65 or anyone with heart, kidney, or stomach concerns. The trade-off is that topical versions work best on joints close to the surface and are less effective for deeper joints like the hip.
Prescription Medications
When over-the-counter options aren’t enough, doctors sometimes prescribe stronger NSAIDs or add a medication that works on pain processing in the brain rather than inflammation in the joint. Duloxetine, originally developed for depression, works by boosting the brain’s natural pain-dampening signals in the spinal cord. In osteoarthritis, it’s used as an add-on therapy, typically starting at a low dose for one week before increasing. It’s particularly useful when pain has become chronic and the nervous system has become oversensitized, meaning you feel more pain than the physical damage alone would explain.
Injections
Corticosteroid injections deliver a potent anti-inflammatory directly into the joint. They can provide substantial relief, but it’s temporary, lasting anywhere from a few weeks to a few months. Most doctors recommend waiting at least three months between injections and limiting them to no more than three per year, because repeated steroid exposure can accelerate cartilage breakdown over time. Steroid shots are most useful for flare-ups or when you need short-term relief to participate in physical therapy.
Hyaluronic acid injections (sometimes called viscosupplementation) aim to restore the lubricating fluid inside the joint. The evidence here is genuinely mixed. Some trials show meaningful short-term pain relief; others show no benefit beyond placebo. This disagreement has led to conflicting recommendations from major medical organizations. The American Academy of Orthopaedic Surgeons does not recommend routine use. The American College of Rheumatology recommends against them for both knee and hip. UK guidelines say not to offer them at all. However, the Osteoarthritis Research Society International considers them conditionally appropriate for the knee, and the US Department of Veterans Affairs supports their use in selected patients. In practice, some people do experience relief, but insurance coverage varies and you may need to pay out of pocket.
Braces and Assistive Devices
Unloader knee braces are rigid devices designed to shift weight away from the damaged side of the knee. They work by applying corrective forces through a three-point pressure system, keeping the leg in better alignment while redistributing the load. In a randomized clinical trial, patients wearing an unloader brace saw their pain during motion drop by about 52 points on a 100-point scale after six weeks, compared to roughly 20 points for those without a brace. That’s a meaningful, noticeable difference. Pain reduction began as early as day 10.
Simpler tools also help. A cane held in the hand opposite your affected leg reduces joint stress while walking. Shoe insoles can correct foot alignment that contributes to uneven knee loading. Jar openers, raised toilet seats, and ergonomic kitchen tools reduce strain on arthritic hands and hips during daily activities.
PRP and Stem Cell Treatments
Platelet-rich plasma (PRP) and stem cell injections are widely marketed for osteoarthritis, but the evidence doesn’t yet support their routine use. The American Association of Hip and Knee Surgeons issued a 2025 position statement concluding that biologic therapies, including PRP, bone marrow concentrate, and mesenchymal stem cells, cannot be recommended for routine treatment of advanced hip or knee osteoarthritis. The data so far hasn’t shown significant improvements over existing non-biologic therapies.
It’s also worth knowing that PRP injections into a joint are considered off-label by the FDA, meaning they weren’t specifically approved for that purpose. These treatments are rarely covered by insurance and can cost hundreds to thousands of dollars per injection. Some people report improvement, but without stronger evidence, it’s difficult to separate a real biological effect from a placebo response.
Joint Replacement Surgery
When conservative treatments no longer control your pain or your joint function has deteriorated to the point where daily life is significantly affected, joint replacement becomes an option. Total knee and hip replacements are among the most common and successful elective surgeries performed today, with the vast majority of patients reporting substantially less pain afterward.
Recovery takes longer than many people expect. Based on physical therapy billing data, the median recovery period after total knee replacement is about 126 days, or roughly four months. But that number hides a wide range: while 54% of patients wrapped up their postoperative rehabilitation within six months, 46% took longer. Full functional recovery, meaning you feel like yourself again rather than just completing formal therapy, often extends beyond that. Most people return to light daily activities within a few weeks, driving within four to six weeks, and more demanding activities over three to six months.
Partial joint replacements are an option for some people whose damage is limited to one section of the joint. These typically involve a shorter recovery, but not everyone is a candidate. Your surgeon will recommend the approach based on the pattern and severity of your cartilage loss, your age, your activity level, and the alignment of your joint.