What Is The Best Treatment For Osteoarthritis In Knees? | Ranking 15 Treatments

Yes, there are at least 15 ways to relieve pain from knee OA. But, what is the best treatment for osteoarthritis in knees?

The truth is that there isn’t a single best way to treat knee osteoarthritis. But, some treatments will definitely help more than others.

So, we reviewed guidelines from several medical associations and ranked 15 treatments for knee osteoarthritis, from best to worst.

Here’s a sneak peek of this science-backed ranking. Tap on the bullet to jump straight to that section:

• The most strongly recommended treatments for knee OA
• Other recommended treatments for knee OA
• Treatments that only help in specific circumstances
• Treatments that may or may not work
• Treatments that definitely don’t work
• Why physical therapy isn’t on this list?

Strongly recommended treatments for knee osteoarthritis pain

These treatments are strongly recommended because there’s tons of evidence showing their success in treating knee osteoarthritis. Plus, they’re fairly easy to do:

1) Learn how to manage it

Patient education is high on the list of most (if not all) medical societies.

The main point here is that the medical professionals handling your case should teach you how to self-manage the knee osteoarthritis symptoms you will experience now and in the future.

Because this condition is irreversible, you may have to do some lifestyle changes to delay its progression. (1, 2, 3)

This is also why it’s key to learn how to self-manage osteoarthritis. To that end, your physio and/or occupational therapist will teach you how to (1, 2, 4):

• Perform everyday tasks without straining your knee
• What to do if and when the knee pain gets worse
• Give you any other recommendation you may need

This can help: Our complete guide on knee osteoarthritis

2) Do home treatments

Home treatments for knee osteoarthritis are extremely beneficial. They are the cornerstone of self-managing your condition.

These treatments may vary from person to person, but they often include (1, 2, 3, 4):

• Doing home exercises to keep your range of motion
• Using cold packs to reduce swelling
• Or hot packs to relieve symptoms
• Having a bedtime routine to promote quality sleep
• Applying capsaicin cream or a topical NSAID a few times per day

Learn more: 11 effective home treatments for knee osteoarthritis

3) Do regular exercise

Exercise is one of the best arthritis treatments out there. It will strengthen your muscles, reduce pain on your knee joints, and protect them from further damage.

Tai-chi and yoga are very helpful. But, in reality, you will benefit from almost any fitness discipline. If you’re not sure, consult with your physio or doctor first. (1, 2, 3, 4)

Keep in mind that you may feel mild pain at first but this should improve after a few days. This is expected, particularly if you haven’t exercised in a while. (1)

4) Take nonsteroidal anti-inflammatory drugs (NSAIDs)

As the name suggests, these over-the-counter medications help reduce inflammation and pain. A popular NSAID is ibuprofen.

If you don’t have any contraindications to these pain relievers, taking them can help you manage severe pain. They can cause stomach upset for some people, though.

If you can’t take NSAIDs for health reasons, your doctor may prescribe acetaminophen. (3, 4)

Further reading: The 11 medications available for treating knee OA.

Other effective treatments for osteoarthritis knee pain

These treatments also have tons of evidence showing their success in treating knee osteoarthritis. But they may not be as easy to do, at least compared to the ones above:

5) Wear a knee brace

Most medical associations recommend wearing supportive devices for knee osteoarthritis.

This is because studies have shown that knee braces can provide pain relief, boost your confidence in your affected joint, and improve your life in general.

These benefits are evident regardless of the severity of your knee osteoarthritis.

There’s a wide variety to choose from as well. For example, some braces can double as heat packs. Others have special anti-inflammatory fabrics.

But, this wide variety can also be a challenge in terms of picking out the best ones for your needs.

This will help: Our streamlined list of the best knee braces for osteoarthritis

6) Lose weight

Overweight or obese patients (BMI>25) with knee osteoarthritis will benefit from losing weight. Studies show that a weight loss of 10% body weight can be enough to provide good results. (1, 3)

But, losing weight is in itself a challenge for a lot of people.

A study says that 50% of your ability to change weight depends on your genetics, while the other 50% depends on environmental factors.

This means that even if you follow someone else’s diet and exercise routine, you may not get the same results in the same amount of time.

The safest way to go around this is to work with a nutritionist who will construct a weight loss strategy that won’t damage your health.

Treatments that help knee osteoarthritis in more specific cases

7) Walking with an assistive device

Assistive devices can ease pain while walking. Medical associations recommend them for people with pain and/or stability problems. (1, 3, 4)

They include canes, crutches, walkers, and similar devices.

Some people like using a cane and find relief with it. Others, prefer wearing a knee brace that keeps their knee stable. So, it’s often a matter of personal preference. (3, 4)

Whatever you choose, it’s essential that you feel comfortable with it.

8) Take certain dietary supplements

Some nutritional supplements may help relieve the symptoms of osteoarthritis, particularly in the first stages of degeneration. The most popular are (1, 4):

• Glucosamine – the building blocks of cartilage.
• Chondroitin – present in soft tissue.
• Turmeric – a natural anti-inflammatory.
• Ginger – also a natural anti-inflammatory.
• Vitamin D – crucial for bone, cartilage, and muscle development.

In general, taking supplements following the manufacturer’s instructions won’t harm your health. (1, 2, 3, 4)

But, make sure you’re not allergic to the ingredients. Glucosamine supplements, for example, often come from shellfish that many people are sensitive to. (3)

Learn more: The 9 best supplements for knee osteoarthritis

9) Receive intra-articular injections

Injections for knee osteoarthritis are a popular option for managing symptoms. The most common are:

Intra-articular corticosteroids

Steroid injections can be effective at relieving pain in the short term and up to 3 months.

But these injections may also speed up the cartilage loss in the long term. So, they’re only recommended for specific cases, like a sudden flare of symptoms or if the pain is very limiting and oral/topic medication doesn’t work. (1, 4)

Hyaluronic acid injections

The main compound in this acid is naturally present in our joints. Injecting it may help some people with knee osteoarthritis. However, this is only done if the treatments above have failed. (1, 4)

It may be a safer option than constantly injecting corticosteroids. (3)

Platelet-rich plasma

Here, the doctor takes platelets from your blood and injects them into the joint. Platelets stimulate tissue regeneration, so, in theory, PRP injections should help regenerate your cartilage. (4)

In practice, the results are very similar to those of hyaluronic acid. It’s worth trying if the options above failed and you have the money for it, as they can be expensive. (1, 4)

10) Undergo knee surgery

Your doctor may recommend surgery if your symptoms persist despite doing other treatment methods. Here are the most common surgical procedures available (1, 5):

Knee arthroscopy

In this minimally invasive procedure, the surgeon removes damaged cartilage, bone spurs, and/or repairs other damaged tissues (e.g. worn out menisci). (5)

This can preserve your joint for longer, but you still might need a knee replacement in the future. (5)

Knee osteotomy

This is an option for younger patients and/or people with osteoarthritis on one side of the knee. The procedure relieves pressure on the affected area to prevent more cartilage loss. (5)

Partial or total knee replacement surgery

Knee joint replacement surgery can mean a total or partial knee replacement, depending on the level of joint damage. (5)

Here, the surgeon substitutes the damaged area with an artificial joint.

Learn more: When is surgery necessary for knee osteoarthritis?

Treatments with limited evidence but still might relieve pain from knee OA

11) Acupuncture

It can reduce pain in some people but not everyone benefits from it. If you want to give it a try, make sure to do so with a certified acupuncture practitioner. (1)

12) Transcutaneous electrical nerve stimulation (TENS)

TENS is a portable device that provides a low-voltage electric current to the injured area. This can reduce pain temporarily in some people. (1, 4)

People with chronic pain may find it useful as a self-management strategy. Make sure to discuss with your physio how to use it properly.

13) Cognitive-behavioral therapy

This is a psychological intervention. Here, you learn how certain thoughts affect your mood and symptoms. It can be useful for people that also struggle with chronic pain, depression, anxiety, and/or insomnia. (4)

14) Massage

Although it may not have a direct impact on your knee osteoarthritis, it can help you manage stress and improve your well-being.

Treatments that won’t help knee arthritis pain

15) Wear lateral wedges insoles

Most medical associations conclude insoles are not an effective treatment for osteoarthritis. But, wearing them likely won’t do any harm. (1, 3)

Why isn’t physical therapy on this list?

Because the truth is that you should do most of your treatments under the supervision of a physical therapist.

See, we – physios – are healthcare professionals specialized in assessing and treating pain and movement-related problems.

To do so, we adapt to your needs via different treatment methods. Most of them are already mentioned above. This individualized treatment plan maximizes your chances of overcoming your knee osteoarthritis symptoms.

Know more: Everything about physical therapy for knee OA.

FAQs:

Resources

1. American Academy of Orthopaedic Surgeons Management of Osteoarthritis of the Knee (Non-Arthroplasty) Evidence-Based Clinical Practice Guideline (3rd Edition). https://www.aaos.org/oak3cpg Published August 31, 2021.
2. Bannuru, R R et al. “OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis.” Osteoarthritis and cartilage vol. 27,11 (2019): 1578-1589. DOI: 10.1016/j.joca.2019.06.011
3. Kolasinski, Sharon L et al. “2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee.” Arthritis care & research vol. 72, 2 (2020): 149-162. DOI: 10.1002/acr.24131
4. The Royal Australian College of General Practitioners. Guideline for the management of knee and hip osteoarthritis. 2nd edn. East Melbourne, Vic: RACGP, 2018. Retrieved on December 2021 from: https://www.racgp.org.au/download/Documents/Guidelines/Musculoskeletal/guideline-for-the-management-of-knee-and-hip-oa-2nd-edition.pdf
5. de l’Escalopier, Nicolas et al. “Surgical treatments for osteoarthritis.” Annals of physical and rehabilitation medicine vol. 59, 3 (2016): 227-233. DOI: 10.1016/j.rehab.2016.04.003