Knee Osteoarthritis: Non-Surgical Treatment and Medications
There are many treatment options, including many non-surgical options, including medications used to treat knee osteoarthritis. Learn more about your options, including NSAIDs, corticosteroids, and other medications for knee OA
There are many treatments available for knee osteoarthritis. Your doctor will work with you to develop a treatment plan that helps reduce your symptoms, especially the pain and trouble moving.
Some non-surgical treatments for knee osteoarthritis include:
- Exercise: Although it may sound painful, exercise can help improve the range of motion in your knee. Also, if you currently exercise but the type of exercise you do—running, for example—increases your pain, you will probably need to switch to a more low-impact exercise, such as swimming. A physical therapist can help you develop an exercise plan that works for your life, as well as learn how to move in ways that don't increase your pain. In addition to exercise, you may also need to undergo other physical therapy treatments for knee OA.
- Losing weight: Being overweight can put extra pressure on your knees, so if you have extra weight, your doctor may recommend that you lose it. with knee OA can help you maintain a healthy weight.
- Heat and cold: Heat or cold (or a combination of the two) can help relieve joint pain. Heat can be applied with warm towels, hot packs, or a warm bath or shower. Cold packs, such as bags of ice or frozen vegetables wrapped in a towel, may help relieve pain or numb the area.
Complementary and alternative treatments
This includes acupuncture, which stimulates different anatomical points on the body using very fine needles. You may also want to try massage, tai chi or TENS (transcutaneous electrical nerve stimulation), a therapy that uses low-voltage electrical current for pain relief.
Whether prescription or over-the-counter (OTC)—medications can make your knee osteoarthritis (OA) more manageable. OTC medications are typically the first line of treatment to help you deal with knee osteoarthritis, while prescription medications are reserved for more severe pain.
This article walks you through common medications used to treat knee osteoarthritis. Note that everyone is different when it comes to whether a medication will work for them: Your doctor may prescribe you a medication that may not be as effective for someone else with knee OA.
No matter what medication you're taking—even if it's an over—the-counter medication-talk to your doctor about it. Some medications can have undesireable side effects or interact with other medications you're already taking.
Acetaminophen: Before recommending any other medication, your doctor may have you try acetaminophen—a common over-the-counter pain medication. It's typically considered a safe and effective medication for osteoarthritis. Tylenol is one example of an OTC acetaminophen you can take to manage knee OA symptoms.
Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs): This medication addresses both the pain and the inflammation associated with knee osteoarthritis. Advil and Aleve are examples of over-the-counter NSAIDs.
Prescription-strength NSAIDs: These are the most commonly prescribed prescription medications used to treat osteoarthritis. They help relieve pain and inflammation; however, they carry certain risks, such as stomach and kidney problems if used without proper monitoring by your doctor. The US Food and Drug Administration has also warned that patients with a history of heart disease should be cautious when taking this medication. Because of these risks, it's important to talk with your doctor about being on these medications for a long period of time.
COX-2 inhibitors: COX-2 inhibitors are the newer class of prescription-strength NSAIDs. COX-2 inhibitors help reduce pain and inflammation as effectively as traditional NSAIDs but are believed to carry fewer risks for stomach problems. Celecoxib (eg, Celebrex) is the only COX-2 inhibitor currently on the market in the US.
Corticosteroids: Corticosteroids are powerful anti-inflammatory agents that can be injected directly into the knee joint. They work by helping to temporarily reduce pain and inflammation in the joint. The effects of the corticosteroids don't last very long, and you typically can't have more than 4 injections in each knee joint per year. Also, over time, corticosteroids can become less effective as the arthritis gets worse.
Hyaluronic acid substitutes: Also known as viscosupplements, hyaluronic acid substitutes help reduce pain and swelling by lubricating joints and restoring the healthy joint fluid that typically diminishes with OA. They're typically given in a series of 3 to 5 injections, and they're approved only for knee osteoarthritis. A new single-injection formula is available for use that offers up to 6 months of pain relief.
Opioids (also called narcotics): Opioids are generally effective at treating severe pain caused by knee osteoarthritis. However, because they're incredibly potent, you'll need to take them under your doctor's careful supervision. And you'll most likely only be on them for a short period of time. A combination pill of hydrocodone and acetaminophen (eg, Vicodin) is the most commonly prescribed opioid in the US. Tramadol (eg, Ultram) is an example of a less potent pain reliever you can take for knee OA if you want to avoid taking a more powerful opioid.
Remember that while medications and injections used for knee osteoarthritis help treat the pain, swelling, and other symptoms, they aren't actually curing the arthritis. However, reducing pain can help improve your daily function—an important part of making it easier to deal with knee OA on a day-to-day basis.