The natural history of joint arthritis is for the symptoms to come and go. Some days are better than others, and some days the symptoms are worse. Overall, however, the ebbs and flows continue to decline so that the good days are not as good as before, and the bad days are worse. Nonetheless, sometimes you are not ready for surgery or your doctor is not recommending it yet. In this case, there are some other ways to alleviate pain and improve mobility without surgery.
Pain relievers are usually the first choice of therapy for osteoarthritis of the hip and knee. Simple pain relievers, such as acetaminophen (Tylenol), are available without a prescription and can be effective in reducing pain. Non-steroidal, anti-inflammatory medications include other over-the-counter medications such as aspirin, ibuprofen (Motrin or Advil), or naproxen (Aleve) to help reduce pain and swelling in the joint. More potent types of pain relievers are prescription-strength, non-steroidal, anti-inflammatory drugs (NSAIDs) that can be prescribed by your doctor.
Cortisone injections can provide you with pain relief and reduce inflammation. They can be very useful if there is significant swelling, but are not very helpful if the arthritis affects the movement of your joint. How long the injection works before it wears off is variable, and there is a limit to how many your doctor can give you per year.
Viscosupplementation is a treatment in which hyaluronic acid (HA) is injected into the joint. It can help joints to work properly by acting like a lubricant. There are several different types that your doctor will give in various treatment regimes. Due to anatomy around the hip joint, injections into the hip are more complicated and therefore less frequently prescribed. Examples of such medications include Synvisc, Orthovisc, Supartz, Hyalgan, etc.
Biologic injections, including platelet-rich plasma (PRP) injections may reduce inflammation and pain. These injections have the potential to relieve symptoms, but research is ongoing. For more information, see the Biologics page.
Many people with osteoarthritis are overweight. Simple weight loss can reduce stress on your weight-bearing joints, such as the hip or knee. Based upon the physics of the hip and knee joints, you put three to five times your body weight across these joints throughout the day – especially during stair climbing and getting in and out of a chair.
Every ten pounds of extra weight that you carry can result in fifty pounds of weight-bearing pressure across your hips and knees. Losing weight can result in reduced pain and increased function, particularly in walking.
An exercise routine can help increase your range of motion and flexibility as well as help strengthen the muscles in your legs. Exercise is often effective in reducing pain and improving function. Unfortunately, in the setting of advanced arthritis (bone-on-bone), exercise can sometimes increase pain in your hip and knee joints. Your physician or a physical therapist can help develop an individualized exercise program that meets your needs and lifestyle.
Braces may be especially helpful in knee arthritis if the arthritis is centered on one side or the other. A brace can assist with stability and function. Braces are not for everyone and they can be difficult to fit for certain people.
Physical therapy to strengthen the muscles around your joint may help absorb some of the shock imparted to the joint. Physical therapy can help to reduce the pain, swelling, and stiffness of osteoarthritis, and it can help improve joint function. It can also make it easier for you to walk, bend, kneel, squat, and sit.
Examples of alternative therapies include the use of acupuncture and magnetic pulse therapy. Acupuncture uses fine needles to stimulate specific body areas to relieve pain or temporarily numb an area. It is used in many parts of the world, and evidence suggests that it can help ease the pain of arthritis. Magnetic pulse therapy is painless and works by applying a pulsed signal to the knee, which is placed in an electromagnetic field. Data on this is somewhat inconclusive.