Knee osteoarthritis (OA) can affect your every move: walking, climbing stairs, even sitting or lying down. Surgery can help bring relief, but doctors almost always advise trying other treatment options first. These include:
Medications you take by mouth. Over-the-counter options include Tylenol (acetaminophen) as well as nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil or Motrin (ibuprofen) or Aleve (naproxen sodium). Stronger NSAIDs are available by prescription.
The pain of arthritis makes it tough for many people to get a good night’s sleep. Worse yet, tossing and turning at night can actually increase the perception of pain.
“There’s a reciprocal relationship between pain and poor sleep. The poorer people sleep, the more pain they tend to be in,” says Kevin Fontaine, PhD, assistant professor of rheumatology at Johns Hopkins University. “If people with arthritis can improve the quality of their sleep, they can usually reduce their day-to-day pain.”
Creams or ointments you rub onto the skin. Different forms are sold over-the-counter. Stronger versions are available with a prescription.
Medications injected into the joint. Corticosteroid injections fight inflammation and can offer fast pain relief that may last up to several months. Injections of hyaluronic acid boost the natural joint fluid that keeps knees moving smoothly.
Exercise and physical therapy. Exercise strengthens the muscles that support your knee. Physical therapy also helps. A physical therapist can design the program for you and see if you need supportive braces, splints, or canes. If you're overweight, exercise can help you lose weight and take some of the pressure off your knees.
Weight loss. Every pound you gain puts an extra 3 pounds of pressure on your knees. If you eventually need knee replacement surgery, your chances of success are much greater if you first lose extra weight.
Nutritional supplements. Some people take glucosamine and chondroitin for OA. Studies on how well they work have had mixed results. Another substance, called SAMe, has been shown to work as well as non-prescription pain relievers and may have fewer side effects. It works more slowly, though. Before you start taking any supplements, even if they're natural, tell your doctor so they can check on side effects.
These treatment options may provide enough relief to keep you moving comfortably. If they don't relieve your pain well enough, they become less effective, or you can't tolerate them, your doctor may suggest surgery. The two types of surgery most often recommended for knee OA are arthroscopic surgery and knee replacement surgery.