Osteoarthritis, also known as OA, is one of the most common causes of pain, stiffness, and difficulty with movement, particularly among older adults. It can affect several joints, especially the knees, hips, hands, and feet.
Although there is currently no treatment that can completely reverse osteoarthritis, several strategies can reduce pain, improve mobility, and help preserve quality of life.
Treatment should be individualized. Pain severity, the joints affected, other health conditions, body weight, physical activity level, and the impact of osteoarthritis on daily activities should all be considered when choosing the most appropriate treatment.
What is the best treatment for osteoarthritis?
There is no single treatment that works the same way for everyone.
For most people, especially those with knee or hip osteoarthritis, treatment begins with non-drug measures such as education about the condition, physical exercise, and weight management when appropriate.
These strategies can be combined with pain-relieving medications and, in selected cases, injections or surgery. Combining different treatments is often more useful than relying on a single intervention.
Patient education is also an important part of treatment. Understanding the condition, learning how to manage symptoms, and staying physically active may help reduce the limitations caused by osteoarthritis. (jamanetwork.com)
Non-drug treatments for osteoarthritis
Non-drug strategies are the foundation of osteoarthritis treatment and should be considered for virtually all patients.
The main approaches include:
- regular physical exercise;
- muscle strengthening;
- balance and coordination exercises;
- physical therapy;
- weight management;
- self-management programs;
- education about the condition;
- use of canes or other assistive devices when needed;
- use of braces or orthoses in selected situations.
For people who are overweight or obese and have knee osteoarthritis, sustained weight loss can improve pain and physical function. In addition to benefits for the joints, weight loss can improve cardiovascular and metabolic health. (jamanetwork.com)
Is exercise important for people with osteoarthritis?
Yes.
Exercise is one of the main strategies for managing osteoarthritis. Studies and clinical guidelines indicate that supervised exercise, home-based exercise, and aquatic exercise can improve pain and function in people with knee osteoarthritis. (aaos.org)
Exercise can help:
- reduce pain;
- strengthen muscles;
- improve mobility;
- improve balance;
- make daily activities easier;
- increase walking ability;
- preserve independence;
- reduce sedentary behavior.
An exercise routine may combine muscle strengthening, walking, flexibility exercises, aquatic activities, and balance training.
For some people, low-impact activities such as cycling and water aerobics may be more comfortable than activities that place greater stress on the joints.
Ideally, an exercise program should be adapted to each person’s physical condition and limitations. Experiencing some pain does not necessarily mean that all physical activity should be stopped.
Muscle strengthening
Muscle strengthening deserves special attention in osteoarthritis treatment.
When muscles are stronger, people tend to have better physical function and greater ability to perform everyday movements. Exercises that target the muscles of the legs can be particularly important for people with knee or hip osteoarthritis.
In addition to traditional strengthening exercises, programs that include balance, coordination, and agility may improve walking and physical function. (aaos.org)
For older adults, this type of training can be particularly useful because it helps maintain the ability to perform everyday activities.
Can physical therapy help with osteoarthritis?
Yes.
Physical therapy can be part of the treatment, particularly when pain, muscle weakness, stiffness, or difficulty with certain movements is present.
A physical therapist can help develop an individualized exercise program, recommend activities that can be performed at home, and work on strength, mobility, balance, and physical function.
Manual therapy may also be used as a complement to exercise in some patients. However, exercise and other self-management strategies remain important components of treatment. (medicaldialogues.in)
Does losing weight help osteoarthritis?
For people who are overweight or obese, yes.
Excess body weight increases the load on weight-bearing joints, particularly the knees and hips. Sustained weight loss can improve pain and physical function in people with knee osteoarthritis. (aaos.org)
Weight management should be gradual and sustainable. Combining a healthy diet with physical activity may be more effective than relying exclusively on restrictive diets.
In addition to its effects on osteoarthritis, weight loss can provide other health benefits.
Can canes, knee braces, and orthoses help?
In some situations, yes.
The AAOS considers canes an option for improving pain and function in people with knee osteoarthritis. Braces and orthoses may also be useful for selected patients. (aaos.org)
These devices are not necessary for everyone. The appropriate type of brace or orthosis and how it should be used should be assessed individually.
When are medications needed?
When exercise, weight management, and other measures are not enough to control symptoms, medications may be used to relieve pain.
Options include:
- topical nonsteroidal anti-inflammatory drugs (NSAIDs);
- oral NSAIDs;
- acetaminophen in selected situations;
- intra-articular corticosteroid injections.
The AAOS guideline recommends topical and oral NSAIDs for people with knee osteoarthritis when there are no contraindications. Acetaminophen may also be an option in certain situations. (aaos.org)
For older adults, it is particularly important to weigh the potential benefits and risks of medications. Kidney disease, cardiovascular problems, a history of ulcers or gastrointestinal bleeding, and the use of other medications can affect treatment choices.
For this reason, medications for osteoarthritis should not be used continuously without medical guidance.
Are topical anti-inflammatory medications better than pills?
Topical NSAIDs can be a particularly useful option for some people with knee or hand osteoarthritis.
Because they are applied directly to the painful area, they may provide pain relief with less systemic exposure than oral NSAIDs.
The choice between a topical and oral medication depends on the severity of symptoms, the joints involved, other health conditions, and the medications a person is already taking.
Do corticosteroid injections work?
Intra-articular corticosteroid injections can provide short-term pain relief for some people with knee osteoarthritis. The AAOS considers them an option for symptom relief, particularly when other measures do not provide adequate pain control. (aaos.org)
However, injections should not be considered a definitive treatment for osteoarthritis.
The indication, frequency, and potential risks should be assessed by a healthcare professional.
What about hyaluronic acid injections?
Hyaluronic acid is used in some clinics to treat knee osteoarthritis, but its effectiveness has not been shown to be sufficiently consistent to support routine use.
The AAOS does not recommend the routine use of hyaluronic acid injections for symptomatic knee osteoarthritis. (aaos.org)
This does not necessarily mean that no individual patient could experience a benefit, but it indicates that the treatment should not be considered a standard option for everyone.
What about platelet-rich plasma (PRP)?
Platelet-rich plasma, or PRP, is a treatment that uses components of a patient’s own blood and has been studied as a treatment for osteoarthritis.
Study results are variable, and there are important limitations related to how PRP is prepared, the techniques used, and patient selection.
The AAOS considers the evidence supporting PRP limited and highlights the need for better research to determine its effectiveness. (cir.nii.ac.jp)
Therefore, PRP should not be presented as a cure or as a treatment proven to be superior to conventional approaches.
What about supplements for osteoarthritis?
Supplements such as glucosamine and chondroitin are very popular among people with osteoarthritis, but study results are inconsistent.
The AAOS does not recommend the routine use of glucosamine and chondroitin for knee osteoarthritis. Differences between commercially available products and the variable quality of studies also make it difficult to draw definitive conclusions about their benefits. (effectivehealthcare.ahrq.gov)
Other supplements and treatments, such as turmeric, vitamin D, and various products marketed to “regenerate cartilage,” should also not be considered substitutes for treatments with stronger evidence.
In addition, supplements can interact with medications. People who take multiple medications should talk to a healthcare professional before starting any supplement.
Can radiofrequency treatment help osteoarthritis pain?
Genicular nerve radiofrequency is a technique being studied as a treatment for chronic pain associated with knee osteoarthritis.
The goal is to use radiofrequency energy to modify the transmission of pain signals from the knee.
A Cochrane review published in 2025 was registered as a protocol to evaluate the benefits and potential harms of genicular nerve radiofrequency for people with chronic pain related to knee osteoarthritis. This means that the reference provided describes the planned review rather than presenting definitive results demonstrating that the treatment is effective. (cochrane.org)
Therefore, radiofrequency should be considered an intervention that is still being studied rather than an established treatment for everyone with osteoarthritis.
Should opioids be used to treat osteoarthritis?
Opioids, including tramadol, are generally not considered a good routine treatment for knee osteoarthritis.
The AAOS guideline indicates that opioids increase the risk of adverse events and do not provide enough benefit to justify their routine use for improving pain and function. (aaos.org)
For older adults, this is particularly concerning because of the risk of adverse effects such as dizziness, sedation, falls, and other complications associated with these medications.
When is surgery recommended?
Surgery is generally considered when osteoarthritis is causing significant symptoms and non-surgical treatments have not provided sufficient relief.
Joint replacement may be considered when there is:
- severe and persistent pain;
- major difficulty walking;
- difficulty performing daily activities;
- significant impairment in quality of life;
- advanced structural changes;
- inadequate response to conservative treatments.
For people with advanced symptoms and structural changes, total joint replacement can provide significant pain relief and improve physical function. (jamanetwork.com)
Does knee or hip replacement cure osteoarthritis?
Joint replacement surgery does not “cure” the tendency to develop osteoarthritis in other joints, but it can replace a severely damaged joint and significantly reduce pain and functional limitations.
The decision to undergo joint replacement should take into account symptom severity, clinical and imaging findings, the patient’s overall health, and their expectations regarding treatment.
Surgery is generally reserved for cases in which the impact of the disease is substantial and non-surgical options have not provided adequate symptom control.
Should surgery be the first treatment option?
In most cases, no.
Education, exercise, and weight management when appropriate are fundamental components of osteoarthritis treatment and should generally be considered before surgery. (jamanetwork.com)
However, this does not mean that a person should spend years living with severe pain before considering joint replacement.
When osteoarthritis is advanced and symptoms significantly affect quality of life, an evaluation by an orthopedic surgeon can help determine whether it is time to consider surgery.
Is osteoarthritis treatment the same for everyone?
No.
Osteoarthritis is a heterogeneous condition, and people with similar findings on X-rays may experience very different levels of pain and functional limitation.
Treatment should therefore take into account:
- pain severity;
- ability to perform daily activities;
- affected joint;
- muscle strength;
- body weight;
- other health conditions;
- medications;
- personal goals;
- response to previous treatments.
The goal should not simply be to “treat the X-ray,” but to improve symptoms and physical function.
What can people with osteoarthritis do every day?
Several simple measures can help manage symptoms:
- stay physically active;
- avoid long periods of inactivity;
- exercise regularly;
- strengthen the muscles;
- manage weight when appropriate;
- follow the physical therapy program;
- use assistive devices when recommended;
- take medications as directed;
- avoid treatments and supplements without sufficient evidence.
Consistency is often more important than exercising intensely only occasionally.
Frequently asked questions about osteoarthritis treatment
Can osteoarthritis be cured?
There is currently no cure that can completely reverse osteoarthritis. However, effective treatments are available to control pain, improve function, and preserve quality of life.
What is the best exercise for osteoarthritis?
There is no single ideal exercise for everyone. Strength training, walking, aquatic exercise, cycling, flexibility exercises, and balance training can all be part of an osteoarthritis exercise program, depending on each person’s condition. (aaos.org)
Should people with osteoarthritis avoid walking?
Not necessarily. Walking can be part of an exercise program for people with osteoarthritis, as long as it is adapted to the person’s physical capacity and symptoms.
Does losing weight help reduce osteoarthritis pain?
Yes. In people who are overweight or obese and have knee osteoarthritis, sustained weight loss can improve pain and physical function. (aaos.org)
Do glucosamine and chondroitin work?
Study results are inconsistent. The AAOS does not recommend their routine use for knee osteoarthritis. (effectivehealthcare.ahrq.gov)
Do knee injections cure osteoarthritis?
No. Injections such as corticosteroids may provide temporary pain relief in some patients, but they do not eliminate osteoarthritis. (aaos.org)
When is a joint replacement necessary?
Joint replacement may be considered when osteoarthritis causes significant pain and functional limitations, particularly when non-surgical treatments have not provided sufficient improvement. (jamanetwork.com)
Final message
Osteoarthritis treatment goes far beyond medications.
Regular physical exercise, muscle strengthening, education about the condition, self-management, and weight management when appropriate are fundamental components of treatment. Medications, injections, and assistive devices can complement these strategies in selected situations. (jamanetwork.com)
For more advanced cases, when pain and functional limitations significantly affect quality of life, joint replacement may be an effective option.
For people living with osteoarthritis, the goal should not simply be to eliminate every abnormality seen on an imaging test, but to control pain, improve function, and preserve independence and quality of life.
This content is for educational purposes only and does not replace a medical evaluation. Treatment should be individualized according to each person’s symptoms, health conditions, and medications.
