Osteoarthritis (OA) is the most prevalent form of arthritis, characterized by the breakdown of cartilage that cushions the ends of the bones in the knee joint. This deterioration leads to pain, stiffness, and reduced mobility as the protective space between the bones narrows. While no cure exists, numerous effective non-surgical strategies can significantly manage symptoms and improve function. These approaches focus on reducing mechanical stress, controlling inflammation, and strengthening supportive structures to delay or avoid the need for surgery.
Modifying Daily Movement and Habits
Fundamental to managing knee discomfort is reducing the force placed on the affected joint through careful lifestyle adjustments. Weight management is the most impactful intervention, as mechanical stress increases substantially with body weight. Losing just one pound of body weight can remove approximately four pounds of pressure from the knees with every step.
Experts often recommend that individuals with a higher body mass index aim to lose at least 10% of their current weight to achieve meaningful pain relief and functional improvement. This reduction in load eases discomfort and contributes to slowing the rate of cartilage loss over time.
Incorporating regular, low-impact exercise is also beneficial for maintaining joint function. Activities like walking, cycling, and water aerobics or swimming are excellent choices because they promote muscle strength without high-impact jarring. Strengthening the muscles around the knee, particularly the quadriceps, provides better stability and shock absorption. Daily habits should also be adjusted by employing proper body mechanics, such as avoiding prolonged standing to minimize strain during movement.
Oral and Topical Pain Relief
Pharmacological treatments offer important options for managing pain and inflammation related to knee joint irritation. Over-the-counter and prescription Nonsteroidal Anti-inflammatory Drugs (NSAIDs), such as ibuprofen and naproxen, work by blocking enzymes that contribute to pain and swelling. While effective for symptom control, oral NSAIDs carry risks of stomach irritation, gastrointestinal bleeding, and potential cardiovascular concerns, especially with prolonged use.
Acetaminophen, a common non-opioid pain reliever, is often recommended for those with mild-to-moderate pain, though its overall effectiveness for knee OA symptoms is sometimes debated. Adhering strictly to recommended dosages is important, as excessive intake can lead to liver damage.
For patients who cannot tolerate oral medications or prefer localized treatment, topical pain relievers offer a safer alternative with fewer systemic side effects. Topical NSAIDs, such as diclofenac gel, are applied directly to the skin over the knee and can provide comparable pain relief.
Another topical option is capsaicin cream, derived from chili peppers, which temporarily desensitizes nerve endings responsible for pain signals. This cream may require several weeks of consistent application before a noticeable benefit is achieved, and it can initially cause a mild burning sensation.
Targeted Joint Injections
When oral and topical medications fail to provide sufficient relief, healthcare providers may administer targeted injections directly into the knee joint. Corticosteroid injections, often called cortisone shots, are a powerful anti-inflammatory treatment that rapidly reduces swelling and pain. The medication suppresses the inflammatory cascade by inhibiting the production of pro-inflammatory substances within the joint space.
Corticosteroids offer short-term relief, with the peak effect seen within one to four weeks, though the benefit may last anywhere from one to eight weeks. Because frequent use may accelerate cartilage loss, these injections are usually limited to a few times per year.
A separate type of injection, known as viscosupplementation, involves injecting a gel-like substance containing hyaluronic acid into the joint. Hyaluronic acid is a natural component of healthy joint fluid that provides lubrication and shock absorption.
The injected material is thought to restore the joint fluid’s lubricating properties and may stimulate the body’s own production of hyaluronic acid. Viscosupplementation has a slower onset of action than corticosteroids, often taking four to six weeks to become effective, but relief can last for up to six months or longer for some patients. Emerging treatments, such as Platelet-Rich Plasma (PRP) therapy, are under investigation, but their use is not yet standardized.
Physical Therapy and Assistive Devices
Professional guidance through physical therapy (PT) is a structured approach to improving knee function and stability. A physical therapist designs an individualized program that focuses on strengthening the muscles supporting the knee, particularly the quadriceps and hamstrings. Strengthening these muscle groups helps stabilize the joint and absorb impact during movement, directly reducing stress on the damaged cartilage.
PT also incorporates range-of-motion exercises to combat stiffness and maintain the knee’s flexibility. This structured approach is tailored to address specific biomechanical issues contributing to the pain.
External supports can also be utilized to reduce joint loading during daily activities. Assistive devices, such as a cane used in the hand opposite the affected knee, can significantly reduce the force transmitted through the joint while walking.
Specialized knee braces, known as unloader braces, are designed for patients with damage primarily on one side of the knee. These braces work by applying a corrective force to shift pressure away from the damaged area to a healthier part of the joint, improving stability and mobility. Simple thermal treatments, using heat to relax stiff muscles or cold packs to reduce acute inflammation after activity, can provide temporary relief.