Knee arthritis is a progressive condition involving the gradual breakdown of the protective cartilage that cushions the ends of the bones, leading to pain, stiffness, and reduced mobility. While advanced cases may necessitate surgery, many effective non-surgical treatments exist to manage symptoms and improve daily function. Treatment is a personalized strategy focused on reducing mechanical stress, controlling inflammation, and strengthening supportive structures. The goal is to manage discomfort and restore the ability to participate in activities without resorting to an operation.
Lifestyle and Movement Modifications
The foundation of non-surgical management involves modifying lifestyle and movement, which directly controls the stress placed on the joint. Managing body weight is particularly impactful, as every pound of body weight exerts approximately four to six pounds of pressure on the knee during walking. Even a modest weight reduction significantly decreases the total force placed on the joint.
Movement patterns should focus on low-impact activities that maintain muscle strength without causing joint trauma. Exercises like swimming, water aerobics, and cycling minimize impact while strengthening the leg muscles. Strengthening the quadriceps and hamstrings creates a muscular support system that stabilizes the knee and absorbs shock. A physical therapist can design a personalized regimen focused on improving flexibility and range of motion safely.
When activities cause mechanical strain, assistive devices can immediately reduce the load on the joint. Using a cane in the hand opposite the affected knee shifts body weight away from the painful joint, lessening compressive force. Specialized devices, such as an unloader knee brace, physically shift pressure away from the damaged compartment of the knee. This mechanical off-loading can decrease pain and improve walking ability, sometimes delaying the need for more invasive treatments.
Pharmacological Relief Options
Medications provide a direct approach to managing the pain and inflammation associated with knee arthritis. For initial pain relief, over-the-counter options include Acetaminophen, which elevates the pain threshold. This medication does not address inflammation and must be used carefully, as exceeding the recommended daily dose can lead to liver toxicity.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen and naproxen, address both pain and inflammation by blocking pain-signaling chemicals. Oral NSAIDs can irritate the stomach lining or affect kidney and cardiovascular function, making long-term use a concern. These systemic side effects can be minimized by using topical NSAID creams or gels, which deliver the medication directly to the localized joint area.
For more persistent symptoms, a physician may prescribe stronger oral NSAIDs or other pain-modifying agents. These prescription options require close medical supervision to monitor for potential side effects and ensure proper dosage. The strategy is to use the lowest effective dose for the shortest duration possible, often combined with other non-drug therapies, to achieve sustained relief.
Targeted Joint Interventions
When oral medications and lifestyle changes do not provide sufficient relief, interventions performed directly into the joint can offer targeted therapeutic benefits.
Corticosteroid Injections
Corticosteroid injections deliver anti-inflammatory medication directly into the knee joint. This provides rapid, short-term relief, often within a few days, by reducing inflammation around the joint structures. Because repeated use can potentially damage cartilage tissue, these injections are typically limited in frequency, usually to three or four times per year.
Viscosupplementation
Viscosupplementation involves injecting hyaluronic acid, a gel-like substance, into the joint. In an arthritic knee, the natural lubricating fluid loses thickness, and the injected hyaluronic acid acts as a replacement for this joint fluid. This procedure aims to restore lubrication and shock-absorbing properties. Relief is often delayed, sometimes taking several weeks, but the pain reduction can last for about six months and can be repeated if effective.
Emerging Therapies
Emerging therapies, such as Platelet-Rich Plasma (PRP) and stem cell injections, are being explored for their potential to stimulate healing and reduce inflammation. PRP involves injecting a concentrated solution of the patient’s own platelets, which contain growth factors, into the joint. While these regenerative treatments show promise, they are often considered experimental and may not be covered by health insurance, making them non-standard options that require discussion with a specialist.