What are my treatment options besides surgery knee arthritis?

 

By Jennifer Wood, MD, FAAOS

Board-Certified Orthopedic Surgeon | Hip & Knee Replacement | OrthoConnecticut

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Not every patient with knee arthritis requires surgery. Many people achieve meaningful pain relief and improved function with non-surgical treatment, especially when symptoms are mild to moderate or arthritis is in its earlier stages.

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My goal is to help you feel better using the least invasive option that fits your symptoms, goals, and imaging findings.

 

Physical Therapy

High-quality evidence shows that physical therapy improves pain and function in hip and knee osteoarthritis compared with no care or home exercises alone. Strengthening the muscles around the joint reduces stress on cartilage and improves mobility.

 

Medications (Oral and Topical)

Medications can help manage pain and inflammation while you pursue physical therapy and lifestyle modifications. Recommendations are individualized based on symptoms, medical history, and tolerance.

Oral medications

• Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen are commonly recommended in clinical guidelines for symptomatic relief in knee osteoarthritis and inflammatory flare-ups.

• Acetaminophen may provide pain relief when NSAIDs are not appropriate, although studies suggest its overall effect is modest.

Topical medications

• Topical NSAIDs (such as diclofenac gel) provide localized anti-inflammatory relief with lower systemic exposure than oral NSAIDs and are recommended in many clinical guidelines for knee osteoarthritis.

• Topical analgesics (such as menthol or capsaicin) may reduce pain signals at the skin level and can be helpful for some patients, though individual response varies.

 

Injections

Approved injections may provide relief when conservative care isn’t enough:

• Corticosteroid injections can provide short-term pain relief in patients with knee osteoarthritis, particularly when inflammation and swelling are present. Clinical studies show symptom improvement typically lasting several weeks, with variable response between patients.

• Viscosupplementation (hyaluronic acid), often called “gel injections,” may reduce pain in some patients with knee osteoarthritis. Research shows mixed results, but certain patients experience meaningful pain relief that can last for several months.

Injections do not reverse the underlying disease, and their benefits vary by individual.

 

Activity Modification

There is strong evidence that tailored exercise programs and reduced impact activity improve pain and function in osteoarthritis.

Low-impact activities such as walking, swimming, and cycling are often better tolerated than running or jumping.

 

Anti-Inflammatory Diet Choices

While no diet “cures” arthritis, substantial research shows that dietary patterns associated with lower systemic inflammation correlate with lower pain scores and improved function in patients with musculoskeletal pain.

Key components with evidence-aligned rationale include:

• Fruits and vegetables: High in antioxidants and polyphenols, these foods are linked with lower systemic inflammatory markers.

• Omega-3 rich foods (fish, flaxseed, walnuts): Omega-3 fatty acids have well-established anti-inflammatory effects.

• Olive oil and nuts: Linked with reduced inflammatory biomarkers in large dietary pattern studies.

Reducing highly processed foods and excess added sugars, which are associated with higher inflammatory markers, may also be beneficial.

 

 

When Non-Surgical Care Is No Longer Enough

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Non-surgical options can provide durable relief for many patients, but as arthritis progresses or pain and functional limitations intensify, joint replacement surgery becomes a more reliable option for long-term pain relief and improved function.

 

A Personalized Plan

There is no one-size-fits-all treatment pathway. I take time to:

• Review your symptoms, goals, and imaging together

• Recommend treatments with the strongest evidence for your situation

• Help you decide if and when surgery is the best next step for you

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If you’re unsure which option is right for you, an in-office evaluation can help clarify the best path forward.

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