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The Top 3 Nondrug Treatments for Knee Pain

A study finds knee braces, hydrotherapy and exercise can help relieve pain caused by common osteoarthritis


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AARP (Getty Images 2)

More than 70 percent of adults 50 and older say they experience pain in their joints from arthritis. And for many older adults, that pain occurs in the knees.

But a new study finds that a few simple tools can help tame these aches. When researchers combed through existing studies on nondrug treatments that provide the most relief for knee osteoarthritis, knee braces, water therapy (or water exercise) and traditional exercise came out on top.

For the study, published June 18 in PLOS One, researchers analyzed 139 randomized control trials spanning 9,644 people with knee osteoarthritis and evaluated 12 nondrug treatments, including laser therapies, ultrasound, water exercise, knee braces, traditional exercise and taping.

Knee braces were the most effective at lowering pain, improving function and easing stiffness, the researchers found. Hydrotherapy, or water exercise, relieved pain, while traditional workouts improved pain and physical function.

Finding ways to manage symptoms from a menu of options

David A. Wang, M.D., a sports medicine physician at the Hospital for Special Surgery in New York, says he isn’t surprised that knee braces, hydrotherapy and exercise were the top performers in the meta-analysis. They all put less pressure on the knee, which can ease pain and improve function, he explains. But just because these therapies ranked high in the research doesn’t mean they will work for everyone.

“There’s no one-size-fits-all for arthritis,” Wang says.

It’s important to note that there’s no cure for knee osteoarthritis other than a total knee replacement. For those looking to avoid or delay surgery, all you can do otherwise is manage symptoms, Wang says.

Many people manage their symptoms by treating their knee pain with medications, such as over-the-counter anti-inflammatories. But the study’s authors note that anti-inflammatory drugs are linked to gastrointestinal and cardiovascular issues in older adults.

Topical treatments and corticosteroid injections can also help, says Tom Kernozek, a professor and chair of physical therapy at the University of Wisconsin–La Crosse. And working with a physical therapist can improve your knee strength and lead you to tools, such as braces or shoe inserts, that may bring relief.

Another pivotal intervention: weight loss. A study published in Arthritis & Rheumatology found that for older adults with knee osteoarthritis, losing 1 pound of weight removed 4 pounds of pressure from the knees. 

“Weight loss is a very important part of osteoarthrosis management,” Wang says. Along with exercise, it gives the “most bang for our buck.” Of course, it can take time to shed pounds, just as it can take time to get stronger from exercise, he adds.

Bracing up

Wang points out that the authors of the PLOS One study don’t define the best type of knee brace, and there are many on the market.

Kernozek says you’ll want to choose a brace “that specifically addresses the area of the knee that is experiencing pain.”

An unloader brace, for example, can redistribute the load to ease pain from arthritis, but it works well only if you have pain on either side of the knee. A patellofemoral brace is ideal for arthritis pain behind the kneecap. Knee sleeves can offer some relief or provide extra support.

Your best bet: Talk to an orthopedic or sports medicine doctor who can help you pick the best brace for your situation and get the right fit, Wang says. Over-the-counter options aren’t always as effective.

What doesn’t work for arthritis pain

If you’re experiencing knee pain, your doctor can help you choose the best course of treatment, based on your level of pain and overall fitness, Wang says.

What you shouldn’t do is stop moving completely. Not staying active is one of the worst things you can do for arthritis, Wang points out. Exercise helps keep the joints lubricated, according to the Arthritis Foundation, and it can reduce inflammation and increase blood flow. It can also improve your range of motion and helps deliver key nutrients to the joints.

“You do not want to lose your mobility,” says Steve Messier, a professor of biomechanics at Wake Forest University. “Things can go downhill pretty rapidly once mobility is lost.”

Low-impact exercise, weight loss and physical therapy are a great place to start when it comes to tackling common knee pain, Kernozek adds.

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