How Osteoarthritis Is Treated

Treatment for osteoarthritis (OA) is usually multi-faceted and depends on the joint (or joints) affected and other individual factors. Options include (but aren't limited to) home remedies and lifestyle modifications such as hot or cold therapy and exercise; over-the-counter (OTC) pain medications or prescription drugs; and surgical joint replacement.

These treatments can work together to relieve the underlying inflammation and the symptoms of osteoarthritis—joint pain, stiffness, and swelling. In addition, goals of osteoarthritis treatment include preserving or improving joint function, minimizing disability, and improving quality of life.

Senior Couple Strolling
Ronnie Kaufman / Corbis / Getty Images

Home Remedies and Lifestyle

Several lifestyle strategies can help reduce the pain and other symptoms of osteoarthritis. Some of these measures may also help to slow the progression of cartilage loss.

Your healthcare provider's recommendations will depend on the stage and extent of your disease, and can include:

  • Gentle exercise: Walking, biking, and swimming and other forms of water exercise are safe and effective physical activities for people who have arthritis.
  • Weight loss: Excess pounds put added strain on weight-bearing joints. According to the Centers for Disease Control and Prevention, a modest reduction in weight can be highly beneficial if you are overweight. For example, every pound lost adds up to a four-pound reduction in weight load on the knees.
  • Hot/cold therapies: Also known as thermal modalities, these are simple strategies that involve applying heat (with a heating pad, for example) or cold (such as with an ice pack) to the affected joints.
  • Supportive devices: Knee braces, specialized footwear, insoles, and splints can help give support and stability to affected joints.
  • Kinesiotaping: This involves using a special type of tape (available over the counter) that adheres to the skin and can be positioned to support joints.
  • Walking aids: Walking aids like canes, walkers, and motorized scooters can provide balance support for some people who have osteoarthritis.

Over-the-Counter (OTC) Therapies

Over-the-counter drugs can help reduce mild to moderate pain and inflammation of osteoarthritis. If you aren't sure which OTC medications to try, ask your healthcare provider or pharmacist for recommendations.

Oral NSAIDs

Nonsteroidal anti-inflammatory drugs (NSAIDs) relieve pain, as well as inflammation.

They include:

  • Aspirin (only appropriate for adults; aspirin is unsafe for children due to a risk of a serious disease called Reye's syndrome)
  • Ibuprofen (Advil and others)
  • Ketoprofen
  • Naproxen (Aleve and others)

NSAIDs can be hard on the stomach and can irritate the digestive tract, especially when used long-term.

Acetaminophen

Acetaminophen is the active ingredient in Tylenol. It works by blocking impulses that send pain signals to the brain. While it can ease the discomfort of osteoarthritis, it does not reduce inflammation.

Acetaminophen has few side effects when taken as directed. Too much can cause liver damage, though, so don't take more than your healthcare provider advises and don't use it if you have liver disease.

Topical Pain Relievers

Medicated creams, balms, ointments, and patches can be applied directly to affected joints. These treatments are most suitable for small areas of osteoarthritis—a few knuckles of the hand rather than the entire back and hips, for example.

Topical pain relief products are available by prescription as well as over-the-counter, and contain a variety of different active ingredients.

The American College of Rheumatology (ACR) suggests that people with osteoarthritis who are 75 or older use topical NSAIDs rather than oral NSAIDs.

Examples of Topical Medications for Arthritis
Medication Active Ingredient  Rx?  OTC?
Voltaren Diclofenac 1% gel  
Flector Diclofenac epolamine 1.3% patch
Pennsaid 1.5% liquid or 2% liquid

Bengay
Lidocaine   
Aspercreme Lidocaine
Aspercreme Pain Relieving Creme Lidocaine plus trolamine salicylate  
Aspercreme Warming Patch Lidocaine plus capsaicin
Tiger Balm Camphor and menthol (counterirritants)
Icy Hot Original Lidocaine plus menthol or salicylate
Salonpas Pain Relieving Hot Patch Capsaicin

Prescriptions

Your healthcare provider might recommend a prescription medication to help relieve your osteoarthritis pain.

Prescription NSAIDs

These are stronger medications than those that are available over the counter:

Opioid Pain Relievers

Weak opioids and narcotic analgesics may be prescribed for osteoarthritis pain in some situations (such as inability to tolerate NSAIDs). Ultram (tramadol) is an example.

Opioid medications reduce pain, but not inflammation. Because of the risk of dependency, these medications can only be used with extreme caution.

Being Researched

Researchers are working on developing disease-modifying osteoarthritis drugs (DMOADs), which are intended to slow disease progression.

Surgeries and Specialist-Driven Procedures

When the joint is severely damaged and repairable, sometimes an interventional procedure can be beneficial.

Procedures can include:

Total joint replacement is also an option but is usually considered only after all other treatments have failed.

Complementary/Alternative Medicine (CAM)

A number of alternative treatments have been found to be effective adjuncts to conventional therapies for managing symptoms of osteoarthritis, including:

  • Acupuncture
  • Cognitive behavioral therapy
  • Tai chi
  • Yoga (for knee arthritis)

Recommendations for Specific Joints

An expert panel convened by the American College of Rheumatology and the Arthritis Foundation issued detailed recommendations for treating osteoarthritis of the hand, knee, and hip in 2019, based on these levels of recommendation:

  • Strongly recommended based on high-quality evidence that greatly favors benefits over risks associated
  • Conditionally recommended based on a lack of sufficient, high-quality evidence or evidence that was less distinct when weighing benefits versus risks
  • Strongly recommended against
  • Conditionally recommend against

Although the ACR/AF guidelines focus on the hand, knee, and hip, some of them may pertain to other joints, such as the spine and shoulder.

That said, it is important to always follow the advice of your healthcare provider, as they will base their guidance on the general recommendations with special consideration to your individual symptoms and disease severity.

Hand Hip Knee
Strongly recommended Exercise
Self-efficacy/self-management programs
Hand orthosis (for the first carpometacarpal joint, or CPC joint)
Exercise
Weight loss
Self-efficacy/self-management programs
Tai chi
Cane
Exercise
Weight loss
Self-efficacy/self-management programs
Tai chi
Cane
Tibiofemoral knee brace
Conditionally recommended Cognitive behavioral therapy (CBT) Kinesiotaping of CPC joint
Hand orthosis (of joints other than CPC)
Acupuncture Hot/cold therapy Paraffin
Balance training Yoga
CBT 
Patellofemoral knee brace
Kinesiotaping Acupuncture Hot/cold therapy Radiofrequency ablation
Balance training CBT
Acupuncture Hot/cold therapy
Strongly recommended against Bisphosphonates Glucosamine  Hydroxychloroquine Methotrexate
TNF inhibitors
Il-1 receptor antagonists
Transcutaneous electrical nerve stimulation (TENS)  Bisphosphonates Glucosamine Hydroxychloroquine Methotrexate
TNF inhibitors
Il-1 receptor antagonists
PRP
Stem cell injection Chondroitin
TENS Bisphosphonates Glucosamine Hydroxychloroquine Methotrexate
TNF inhibitors
Il-1 receptor antagonists
PRP
Stem cell injection Chondroitin
Intra-articular hyaluronic acid
Conditionally recommended against Iontophoresis for CPC
Chondroitin
Intra-articular hyaluronic acid Topical capsaicin Colchicine
Non-tramadol opioids
Fish oil
Vitamin D
Modified shoes Wedged insoles Massage therapy Manual therapy with/without exercise
Pulse vibration therapy 
Intra-articular hyaluronic acid Prolotherapy Colchicine
Non-tramadol opioids
Fish oil
Vitamin D
Wedged insoles Massage therapy Manual therapy with/without exercise
Protherapy Colchicine
Non-tramadol opioids
Fish oil
Vitamin D
Adapted from 2019 American College of Rheeumatology/Arthritis Foundation Guideline for Management of Osteoarthritis of the Hand, Hip, and Knee

Other Joints

Although the feet and spine, as well as other joints, were not included in the ACR's treatment recommendations, many of the guidelines apply to any affected joint.

  • Osteoarthritis of the spine occurs when there is deterioration in the discs between the vertebrae. Most people with degenerative disc problems do not require surgery and experience symptom improvement with conservative treatments. If conservative measures fail, however, surgical options may include lumbar laminectomy, discectomy, or spinal fusion.
  • Foot osteoarthritis symptoms can be relieved with orthotics or foot supports. Weight loss can literally take a load off of feet and other weight-bearing joints. If conservative options aren't effective, surgery may be considered. Arthroscopy, arthrodesis (fusion), or arthroplasty (joint replacement) may be considered, depending on the joint involved in the foot or ankle. The goal of foot surgery is to relieve pain and improve joint function.

Frequently Asked Questions

  • What are the stages of osteoarthritis?

    Osteoarthritis (OA) often is classified according to what is called the Kellgren and Lawrence grading system, which is based on X-rays:

    • Grade 0 (none): No evidence of OA
    • Grade 1 (doubtful): Unclear evidence of narrowing of the space between joints; possible osteophytic lipping
    • Grade 2 (minimal): Definite osteophytes (bone spurs); possible joint space narrowing
    • Grade 3 (moderate): Moderate multiple osteophytes; definite joint space
    • Grade 4 (severe): Large osteophytes; severe narrowing of joint space; severe sclerosis; obvious deformity of bone ends
  • What activities should I avoid if I have osteoarthritis?

    Regular physical activity is vital to overall health, and exercises that strengthen muscles around arthritic joints can help prevent further damage. Depending on the severity of your OA, you may be advised to stop doing activities that could further damage your joints. For example, if you developed knee OA due to years of running, you may be advised to switch to biking.

  • How can I prevent my osteoarthritis from getting worse?

    In order to keep damaged joints from degenerating further, the Arthritis Foundation advises people with OA to:

    • Lose weight, if excess pounds are putting excess stress on joint
    • Gently stretch every day to help maintain the full range of motion of affected joints
    • Warm-up before exercise and cool down after
    • Manage stress
    • Maintain a healthy lifestyle—don't smoke, only drink alcohol in moderation, eat a healthy diet, and get adequate rest
    • Control blood sugar levels (for those who have diabetes)
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11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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