Knee Osteoarthritis.
Relieve pain and restore movement—without surgery.
Knee osteoarthritis (OA) is one of the most common causes of chronic knee pain and stiffness as we age. It results from gradual wear of the joint cartilage, leading to inflammation, swelling, and reduced mobility. While surgery—like knee replacement—can help in advanced cases, many people manage OA symptoms effectively without it.
This blog explores when nonsurgical treatments are appropriate, who can benefit, and what evidence-based options are available.
When to Consider Nonsurgical Treatment
Nonsurgical management is ideal in the early to moderate stages of knee OA or for patients who wish to delay surgery.
You should consider these options if:
You experience mild to moderate knee pain and stiffness that affects daily activity.
X-rays show cartilage loss but not total joint destruction.
You prefer to avoid or delay surgery for personal or medical reasons.
You’ve had partial relief from medications or therapy, but want additional improvement.
You’re post-surgery and need to protect your joints from further degeneration.
Who Should Consider These Options
Nonsurgical interventions benefit most people, but they’re especially valuable for:
Adults over 40 with early signs of joint wear or mild cartilage thinning.
Active individuals wanting to maintain mobility and independence.
Patients with medical conditions (like diabetes, obesity, or heart disease) that raise surgical risk.
People seeking an integrative approach, combining physical therapy, weight management, and regenerative techniques.
Nonsurgical Treatment Options for Knee Osteoarthritis
A comprehensive plan usually includes several of the following evidence-based interventions:
1. Lifestyle and Self-Care
Exercise therapy: Low-impact activities such as walking, cycling, and swimming maintain strength and flexibility. Motion is lotion, and it’s actually the number one way to help decrease pain and discomfort from OA! It seems counterintuitive, but the body makes more joint fluid the more active you are.
Weight management: Losing even 10% of body weight can significantly reduce knee strain.
Heat and cold therapy: Heat relaxes muscles; cold reduces inflammation and swelling. Discuss with your clinician when and how to best use these for your therapy.
2. Physical Therapy and Bracing
Targeted strengthening: Focuses on quadriceps, hamstrings, and hip stabilizers to improve joint alignment. Working with a trusted physiotherapist or athletic therapist/trainer can be a good idea here.
Manual therapy and stretching: Reduce stiffness and improve range of motion. Again, athletic therapists/trainers, physiotherapists, and massage therapists can be great resources.
Knee braces or orthotics: Unloader braces redistribute pressure from the affected joint area. Many insurances cover the cost of these expensive braces, so be sure to discuss this with your doctor. (Custom fittings can be completed where I work at Acacia Health after receiving a prescription from me.)
3. Medications and Injections
Topical anti-inflammatories (like diclofenac gel) for localized symptom relief. This is something I can prescribe in higher doses for adequate relief in some cases.
Oral NSAIDs for short-term pain control in moderate cases. Be sure to talk to your doctor about safe dosing strategies.
Corticosteroid injections for flare-ups of inflammation. I talk more about this in this post here.
Hyaluronic acid (viscosupplementation) to improve lubrication and shock absorption. I talk more about this in this post here.
4. Regenerative and Integrative Therapies
Platelet-rich plasma (PRP): Uses your own platelets to stimulate tissue repair. I talk more about this in this post here.
Prolotherapy: Involves small injections that may trigger healing and improve stability. I talk more about this in this post here.
Stem cell-based treatments: Emerging research supports their potential to reduce pain and slow degeneration.
The Role of Supplements
While no supplement reverses OA, some may support joint health when combined with lifestyle changes:
Curcumin (turmeric extract) as a potent natural anti-inflammatory agent.
Omega-3 fatty acids to reduce inflammation.
Hydrolyzed collagen powder for cartilage support and collagen regeneration.
Magnesium bisglyciante for supporting sore muscles that may be overcompensating if you have altered your movement patterns due to pain.
When to Re-Evaluate or Consider Surgery
Despite best efforts, some patients progress to advanced osteoarthritis where surgery may become necessary. You might revisit surgical options if:
Pain remains uncontrolled despite consistent nonsurgical care.
You experience joint instability or deformity (like bow-leg alignment).
Mobility and quality of life significantly decline.
Your doctor can help assess imaging results and functional scores to determine the right time to transition to surgical consideration.
Key Takeaway
Nonsurgical management of knee osteoarthritis can significantly reduce pain, preserve joint function, and delay or even avoid surgery. A combination of lifestyle changes, physical rehab, targeted injections, and regenerative therapies offers the best outcome. Partnering with your healthcare provider to personalize your plan ensures your treatment matches both your clinical condition and lifestyle goals.
