Non-surgical treatment of osteoarthritis
Non-surgical treatment is usually the first approach to osteoarthritis. The goal is to reduce pain, maintain mobility, improve strength and confidence, and help the patient stay active for as long as possible.
Purpose of non-surgical care
Non-surgical treatment is usually preventive and symptomatic rather than curative. It may slow progression, reduce flare-ups, improve function, and delay or sometimes avoid the need for surgery. It does not usually reverse established arthritis or restore a worn joint surface back to normal.
Main treatment categories
- Lifestyle adjustment and rehabilitation: activity modification, exercise, strengthening, stretching, weight management when appropriate, walking aids, braces, footwear changes, and physiotherapy.
- Medications: pain relievers, anti-inflammatory medication when safe, topical treatments, and other medications selected according to the patient's medical history and risk profile.
- Injections: selected injections may reduce pain, improve function, calm inflammation, or help the patient participate more effectively in rehabilitation.
How treatment is chosen
The best plan depends on the joint involved, the severity of arthritis, the pattern of symptoms, the patient's general health, medication risks, activity goals, imaging findings, and how much the arthritis interferes with activities of daily living.
In the early stages of arthritis, treatment usually begins with lifestyle adjustment, exercise, strengthening, weight management when appropriate, and medication when safe. If symptoms remain limiting, injection therapy may be discussed.
For early knee arthritis, I currently consider platelet-rich plasma, or PRP, to be the best injection option when an injection is appropriate. Recent comparative research generally supports PRP over corticosteroid or hyaluronic acid for medium-term pain and function improvement, although results vary and PRP does not reverse established arthritis.
When non-surgical treatment is not enough
If pain, stiffness, deformity, walking limitation, sleep disruption, or loss of function remain unacceptable despite a reasonable non-surgical program, surgical treatment may become the more appropriate option.