9 Best Treatments for Knee Arthritis in 2023
If you are looking for knee pain treatment, this is the guide for you. This article is based on relevant peer-reviewed studies, academic research institutions and medical associations.
Chronic knee pain is long-term pain, swelling, or sensitivity in one or both knees. The cause of your knee pain can determine the symptoms you experience. Many conditions can cause or contribute to chronic knee pain, and many treatments exist. Each person’s experience with chronic knee pain will be different.
Chronic knee pain is long-term pain, swelling, or sensitivity in one or both knees. The cause of your knee pain can determine the symptoms you experience. Many conditions can cause or contribute to chronic knee pain, and many treatments exist. Each person’s experience with chronic knee pain will be different.
What causes chronic knee pain?
Temporary knee pain is different from chronic knee pain. Many people experience temporary knee pain as a result of an injury or accident.Chronic knee pain rarely goes away without treatment, and it isn’t always attributable to one incident. It’s most often the result of several causes or conditions.
Step 1 in dealing with a chronic knee pain is to know the cause or 'diagnosis', a term used by medical doctors. Treatment is step 2. This may appear logical but many people jump into various kind of treatments without even knowing the cause of the knee pain. Thus, wasting their hard-earned money in none effective treatments.
Physical conditions or diseases can cause knee pain. These include:
Physical conditions or diseases can cause knee pain. These include:
- osteoarthritis: pain, inflammation, and joint destruction caused by degeneration and deterioration of the joint
- tendinitis: pain in the front of the knee that is made worse when climbing, taking stairs, or walking up an incline
- bursitis: inflammation caused by repeated overuse or injury of the knee
- chondromalacia patella: damaged cartilage under the knee cap
- gout: arthritis caused by the buildup of uric acid
- Baker’s cyst: a buildup of synovial fluid (fluid that lubricates the joint) behind the knee
- rheumatoid arthritis (RA): a chronic autoimmune inflammatory disorder that causes painful swelling and can eventually cause joint deformity and bone erosion
- dislocation: dislocation of the kneecap most often the result of trauma
- meniscus tear: a rupture in one or more of the cartilage in the knee
- torn ligament: tear in one of the four ligaments in the knee — the most commonly injured ligament is the anterior cruciate ligament (ACL)
- bone tumors: osteosarcoma (second most prevalent bone cancer), most commonly occurs in the knee
As you can see from the above, there are many causes of knee pain. That's why you need to understand the importance of 'diagnosis' or finding the cause of the knee pain. Knee pain due to gout or rheumatoid arthritis has to be treated differently from knee osteoarthritis. A mis-diagnosis will lead to a mis-treatment.
Of late, there are also dozens of supplements and ways that claim to treat joint pain, but which ones actually work? Here’s a look at the best options and what the existing research says about them.
1. Glucosamine
Glucosamine is a natural component of cartilage, a substance that prevents bones from rubbing against each other and causing pain and inflammation. It might also help prevent the cartilage breakdown that can happen with arthritis.
Many supplements aimed at treating joint pain contain glucosamine, which is one of the most well-studied supplements for osteoarthritis. But despite this research, there are still some questions about how well it works.
There are two types of glucosamine found in supplements: glucosamine hydrochloride and glucosamine sulfate.
One meta-analysis found that products containing glucosamine hydrochloride don’t do much to improve joint pain caused by osteoarthritis. Another study shows that glucosamine sulfate does improve these symptoms, so it may be a better option than glucosamine hydrochloride.
When taken over a long period of time, glucosamine sulfate may also help to slow down the progression of osteoarthritis. Studies suggest that it slows down narrowing of the joint space, a marker of the condition getting worse, when taken for up to three years.
1. Glucosamine
Glucosamine is a natural component of cartilage, a substance that prevents bones from rubbing against each other and causing pain and inflammation. It might also help prevent the cartilage breakdown that can happen with arthritis.
Many supplements aimed at treating joint pain contain glucosamine, which is one of the most well-studied supplements for osteoarthritis. But despite this research, there are still some questions about how well it works.
There are two types of glucosamine found in supplements: glucosamine hydrochloride and glucosamine sulfate.
One meta-analysis found that products containing glucosamine hydrochloride don’t do much to improve joint pain caused by osteoarthritis. Another study shows that glucosamine sulfate does improve these symptoms, so it may be a better option than glucosamine hydrochloride.
When taken over a long period of time, glucosamine sulfate may also help to slow down the progression of osteoarthritis. Studies suggest that it slows down narrowing of the joint space, a marker of the condition getting worse, when taken for up to three years.
Try it: Glucosamine sulfate is typically taken once daily in a dose of 1,500 milligrams (mg). If this upsets your stomach, try spreading it out over three doses of 500 mg each. You can find glucosamine sulfate supplements on Amazon.
2. Chondroitin
Like glucosamine, chondroitin is a building block of cartilage. It may also help prevent cartilage breakdown from osteoarthritis.
Many clinical studies have found that chondroitin can reduce joint pain and stiffness in people with osteoarthritis. About 53 percent of people who take chondroitin have a 20 percent or greater improvement in knee pain.
Chondroitin sulfate may also slow down the progression of osteoarthritis when taken long-term. Studies show that it slows down narrowing of the joint space when taken for up to 2 years.
Joint supplements often combine chondroitin with glucosamine. But it’s still unclear if taking a combination supplement is any better than taking one or the other on their own.
Try it: Chondroitin is typically taken in a dose of 400 to 800 mg two or three times per day. You can find chondroitin supplements on Amazon.
3. Methylsulfonylmethane (MSM)
Methylsulfonylmethane (MSM) is another common ingredient in supplements said to help with joint pain. One of the most popular uses of MSM is to decrease joint or muscle pain. It has been shown to benefit those with joint degeneration, a common cause of pain in the knees, back, hands and hips.
In one randomised controlled study, MSM improved pain and functioning compared to a placebo in people with osteoarthritis.
A study in 100 people over the age of 50 found that treatment with a supplement containing 1,200 mg of MSM for 12 weeks decreased pain, stiffness and swelling in the joints, compared to a placebo (Int J Biomed Sci. 2015).
The group receiving the supplement also reported improved overall quality of life and less difficulty walking and getting out of bed (Int J Biomed Sci. 2015).
Another study in 32 people with lower back pain found that taking a glucosamine supplement containing MSM significantly reduced lumbar stiffness and pain upon movement, plus greatly increased quality of life (Curr Ther Res Clin Exp. 2005).
Try it: Typical MSM doses range from 1,500 to 6,000 grams per day, sometimes divided into two doses.
2. Chondroitin
Like glucosamine, chondroitin is a building block of cartilage. It may also help prevent cartilage breakdown from osteoarthritis.
Many clinical studies have found that chondroitin can reduce joint pain and stiffness in people with osteoarthritis. About 53 percent of people who take chondroitin have a 20 percent or greater improvement in knee pain.
Chondroitin sulfate may also slow down the progression of osteoarthritis when taken long-term. Studies show that it slows down narrowing of the joint space when taken for up to 2 years.
Joint supplements often combine chondroitin with glucosamine. But it’s still unclear if taking a combination supplement is any better than taking one or the other on their own.
Try it: Chondroitin is typically taken in a dose of 400 to 800 mg two or three times per day. You can find chondroitin supplements on Amazon.
3. Methylsulfonylmethane (MSM)
Methylsulfonylmethane (MSM) is another common ingredient in supplements said to help with joint pain. One of the most popular uses of MSM is to decrease joint or muscle pain. It has been shown to benefit those with joint degeneration, a common cause of pain in the knees, back, hands and hips.
In one randomised controlled study, MSM improved pain and functioning compared to a placebo in people with osteoarthritis.
A study in 100 people over the age of 50 found that treatment with a supplement containing 1,200 mg of MSM for 12 weeks decreased pain, stiffness and swelling in the joints, compared to a placebo (Int J Biomed Sci. 2015).
The group receiving the supplement also reported improved overall quality of life and less difficulty walking and getting out of bed (Int J Biomed Sci. 2015).
Another study in 32 people with lower back pain found that taking a glucosamine supplement containing MSM significantly reduced lumbar stiffness and pain upon movement, plus greatly increased quality of life (Curr Ther Res Clin Exp. 2005).
Try it: Typical MSM doses range from 1,500 to 6,000 grams per day, sometimes divided into two doses.
You can find MSM supplements on Amazon.
4. Fish Oil and Omega-3s
The two types of omega-3 fatty acids found in fish oil are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
For the omega-3 fatty acids in fish oil to work against arthritis, it’s necessary to consume a fairly large quantity of it each day. Fish oil — or cod liver oil — enclosed in capsules makes this fairly easy.
Fish Oil vs Cod Liver Oil
On the other hand, because cod liver oil contains very high amounts of vitamin A and vitamin D, taking too much can be toxic. For the purpose of treating arthritis, fish oil is the safer choice.
EPA and DHA can reduce inflammation, which causes swelling and pain. Research has indicated that both acids might suppress the body’s immune system. However, a 2016 study suggests that DHA might enhance immune function instead. DHA is more effective at reducing inflammation than EPA, but both have a role.
All of these effects makes fish oil potentially beneficial for people with arthritis.
EPA and DHA come with other health benefits: They can help prevent heart attacks by making it harder for blood to clot. They help lower blood triglyceride levels and blood pressure. As well, EPA taken with statin medication is more effective in reducing the inflammation of arteriosclerosis than medication alone.
For the omega-3 fatty acids in fish oil to work against arthritis, it’s necessary to consume a fairly large quantity of it each day. Fish oil — or cod liver oil — enclosed in capsules makes this fairly easy.
On the other hand, because cod liver oil contains very high amounts of vitamin A and vitamin D, taking too much can be toxic. For the purpose of treating arthritis, fish oil is the safer choice as compared to cod liver oil.
Shop for fish oil supplement.
It’s also available as a supplement.
Curcumin, present in turmeric, has long played a role in Chinese and Ayurvedic medicine, due to its anti-inflammatory properties.
In 2019, some researchers found that curcumin capsules had a similar effect on the symptoms of knee osteoarthritis as diclofenac, an NSAID.
In the study, 139 people with OA of the knee took either a 50-milligram tablet of diclofenac twice a day for 28 days or a 500-milligram curcumin capsule three times a day.
Both groups said their pain levels improved, but those who took curcumin had fewer negative effects. The research suggested that people who can’t take NSAIDs may be able to use curcumin instead.
Sources of resveratrol include:
They took this combination alongside a 15-gram dose of the NSAID meloxicam every day for 90 days.
People who took resveratrol found that their pain levels dropped significantly, compared with those who took the placebo.
More research is needed to confirm that resveratrol can benefit people with OA.
However, if you’re already taking another NSAID and it doesn’t reduce your pain as much as you’d like, the research suggests resveratrol may be a useful add-on.
4. Fish Oil and Omega-3s
The two types of omega-3 fatty acids found in fish oil are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
For the omega-3 fatty acids in fish oil to work against arthritis, it’s necessary to consume a fairly large quantity of it each day. Fish oil — or cod liver oil — enclosed in capsules makes this fairly easy.
Fish Oil vs Cod Liver Oil
On the other hand, because cod liver oil contains very high amounts of vitamin A and vitamin D, taking too much can be toxic. For the purpose of treating arthritis, fish oil is the safer choice.
EPA and DHA
EPA and DHA can reduce inflammation, which causes swelling and pain. Research has indicated that both acids might suppress the body’s immune system. However, a 2016 study suggests that DHA might enhance immune function instead. DHA is more effective at reducing inflammation than EPA, but both have a role.
All of these effects makes fish oil potentially beneficial for people with arthritis.
In one study, people said their pain levels decreased after taking fish oil supplements.
Those who reported the improvement had taken a low dose rather than a high dose. They saw the improvement after 2 years. After 1 year, there was no significant improvement.
Commenting on this study, other scientists expressed further concerns. They noted that consuming more than 3 grams of fish oil a day could be hazardous.
Potential hazards include increased mercury consumption and bruising and bleeding.
Those who reported the improvement had taken a low dose rather than a high dose. They saw the improvement after 2 years. After 1 year, there was no significant improvement.
Commenting on this study, other scientists expressed further concerns. They noted that consuming more than 3 grams of fish oil a day could be hazardous.
Potential hazards include increased mercury consumption and bruising and bleeding.
EPA and DHA come with other health benefits: They can help prevent heart attacks by making it harder for blood to clot. They help lower blood triglyceride levels and blood pressure. As well, EPA taken with statin medication is more effective in reducing the inflammation of arteriosclerosis than medication alone.
For the omega-3 fatty acids in fish oil to work against arthritis, it’s necessary to consume a fairly large quantity of it each day. Fish oil — or cod liver oil — enclosed in capsules makes this fairly easy.
On the other hand, because cod liver oil contains very high amounts of vitamin A and vitamin D, taking too much can be toxic. For the purpose of treating arthritis, fish oil is the safer choice as compared to cod liver oil.
Shop for fish oil supplement.
5. Curcumin
Curcumin is an antioxidant that may offer a variety of anti-inflammatory benefits. It’s present in turmeric, a mild spice that can add color and flavor to sweet and savory dishes, as well as teas.It’s also available as a supplement.
Curcumin, present in turmeric, has long played a role in Chinese and Ayurvedic medicine, due to its anti-inflammatory properties.
This new meta-analysis on curcumin was published in 2021 by researchers at the University of Miami (1). After reviewing 10 different studies on curcumin and knee arthritis with almost thirteen hundred patients, the researchers concluded that:
“Although limitations exist within the 10 RCTs reviewed, this small set of studies show a reduction in pain and improvement in function similar to that of NSAIDs but with a reduced incidence of adverse events. Turmeric appears to be a safe adjunct to NSAID therapy allowing for additional analgesic benefit as well as a reduced dosage requirement for NSAIDs. “
Meaning that Curcumin was shown to be as good as NSAIDs like Motrin, Alleve, or Celebrex with far fewer side effects!
In 2019, some researchers found that curcumin capsules had a similar effect on the symptoms of knee osteoarthritis as diclofenac, an NSAID.
In the study, 139 people with OA of the knee took either a 50-milligram tablet of diclofenac twice a day for 28 days or a 500-milligram curcumin capsule three times a day.
Both groups said their pain levels improved, but those who took curcumin had fewer negative effects. The research suggested that people who can’t take NSAIDs may be able to use curcumin instead.
You can find curcumin supplements on Amazon.
www.onedaymd.com
6. Resveratrol
Resveratrol is another nutrient that has antioxidant and anti-inflammatory properties.Sources of resveratrol include:
- grapes
- tomatoes
- red wine
- peanuts
- soy
- some teas
They took this combination alongside a 15-gram dose of the NSAID meloxicam every day for 90 days.
People who took resveratrol found that their pain levels dropped significantly, compared with those who took the placebo.
More research is needed to confirm that resveratrol can benefit people with OA.
However, if you’re already taking another NSAID and it doesn’t reduce your pain as much as you’d like, the research suggests resveratrol may be a useful add-on.
You can find resveratrol supplements on Amazon.
7. Hip and Knee Exercises for Knee Pain
This research is a meta-analysis of 13 studies on exercises to help patello-femoral (knee cap) pain. The authors broke the studies into hip+knee, hip-only, and knee-only exercises. They found that hip+knee and hip-only exercises worked about as well as each other to get rid of PF (patello-femoral) pain, but that knee-only exercises were inferior.
8. Platelet Rich Plasma (PRP) for Knee Pain
Platelet-rich plasma (PRP) is a novel treatment for managing pain related to osteoarthritis (OA) of the knee. Some PRP preparations have approval from the US Food and Drug Administration (FDA), but approval does not yet cover the use of PRP in OA of the knee. Nevertheless, some clinics may offer it “off-label”.
There are currently more than 80 studies on stem cell treatment for knee osteoarthritis alone, under the U.S. Clinical Trial Registry.
Regenexx, the largest provider of stem cell therapy for orthopaedic conditions in the United States alone, have treated 30,000 patients with stem cell therapy for various joint conditions including knee pain. According to Regenexx, common regenerative medicine treatments used in common orthopedic problems have better research evidence than orthopedic surgery.
PRP vs Hyaluronic Acid vs Steroid Injections
There are 20 PRP studies that show superiority over hyaluronic acid (source) and 5 PRP studies that show superiority over steroid injections (source).
9. Stem Cell Therapy for Knee Osteoarthritis: Evidence and Reviews
Some doctors and media channels argue that there is very little evidence to support the use of stem cells to treat knee conditions. However, there are more than 250 publications related to the use of stem cells in treating knee orthopaedic conditions alone.
There are currently more than 80 studies on stem cell treatment for knee osteoarthritis alone, under the U.S. Clinical Trial Registry.
Regenexx, the largest provider of stem cell therapy for orthopaedic conditions in the United States alone, have treated 30,000 patients with stem cell therapy for various joint conditions including knee pain. According to Regenexx, common regenerative medicine treatments used in common orthopedic problems have better research evidence than orthopedic surgery.
www.onedaymd.com
Several other comparative studies have demonstrated good evidence in the treatment of osteoarthritis. However, there are several approaches and cell lines used. More well-designed and randomised controlled trials are needed to evaluate the best approach and universal consensus. As studies continue, the methods, forms and combinations of stem cell preparations are improving, and outcomes are expected to improve as well.
Several other comparative studies have demonstrated good evidence in the treatment of osteoarthritis. However, there are several approaches and cell lines used. More well-designed and randomised controlled trials are needed to evaluate the best approach and universal consensus. As studies continue, the methods, forms and combinations of stem cell preparations are improving, and outcomes are expected to improve as well.
New Research on Meniscectomy and Steroid Shots
A study on meniscectomy (Arthroscopy 2021) looked at 11,652 patients with and 37,261 without a history of a knee steroid injection within 1 year of arthroscopic meniscectomy. The patients who received knee steroid injections within 1 month prior to this surgery developed post-operative infections at twice the rate of those who did not receive an injection. However, those patients who had an injection more than a month after surgery didn’t have any increased rate of infection.
The key takeaway for this is that you should avoid steroid injection within 1 month prior to removal of your knee meniscus.
Summary and Key Takeaway
It’s important to speak with your doctor if you’re already taking non-steroidal anti-inflammatory drugs (NSAIDs) that suppress the immune system, blood thinners, or blood pressure drugs.Check with your doctor before taking any other alternative or complementary remedies. They should be able to advise you about any potential drug interactions.
Related:
Comments