If your knees have been giving you grief, you are far from alone. Knee arthritis is one of the most common causes of daily pain among older adults. The good news is that surgery is not the only path forward, and for many people, it need not be on the table at all.
Researchers and doctors have tested many approaches. Some work well. Some barely work. And a few things that sound promising just do not have the evidence to back them up. Here is a clear look at what the evidence actually shows.
What Works Best
At the top of the list is exercise and physiotherapy. This has the strongest evidence of anything reviewed. Strengthening the muscles around your knee reduces pain and improves how well your knee functions, more reliably than any medication. The key is to keep moving while avoiding or adjusting activities that make your pain noticeably worse.
Weight loss is one of the most powerful tools if it applies to you. Even modest weight loss significantly reduces the load on your joints and eases pain. This is especially true on stairs, where the forces on your knees are much greater than on flat ground.
NSAIDs, the anti-inflammatory pain relievers you can find over the counter or get by prescription, are among the most effective medications for arthritic pain. The catch is that long-term use comes with side effects, so they are better suited for flare-ups than daily use.
Corticosteroid injections can give you meaningful short-term relief during a bad flare-up. The benefit typically fades over a few weeks to a few months, so they are not a permanent fix, but they can help you get through a rough patch.
Worth Knowing About
Braces and orthotics offer moderate help, particularly if your arthritis affects one specific part of your knee rather than the whole joint.
Topical treatments, creams, or gels with anti-inflammatories, anesthetics, or CBD, can ease localized pain with fewer side effects than pills. They are generally less potent than oral medications, but they are a gentler option.
Diet changes work best as a supporting player, not a lead role. They can help reduce inflammation and support weight loss, both of which can ease knee pain.
Acetaminophen (Tylenol) is easier on your kidneys than NSAIDs. But it is less effective for most people with knee arthritis, and it can harm your liver if you take too much of it over time.
Hyaluronic acid injections have mixed results. Some people see a benefit. But the overall evidence shows modest and inconsistent effects.
A Word on Supplements and Other Remedies
You may have heard that certain supplements help with arthritis. The honest answer is: it depends on the supplement. The evidence varies greatly from one to the next. Lumping them all together as simply “mixed” does not tell the whole story; some have solid evidence, and some do not.
The same goes for other popular remedies. Magnets and copper bracelets have weak evidence. Red light therapy, while well-researched for other health purposes, has not been shown to help with arthritis specifically.
The bottom line? You have real options here, and the ones at the top of the list do not require a prescription or a hospital. A conversation with your doctor about exercise, weight, and the right medications for your situation is a solid place to start.