Treatment Options for Osteoarthritis
From exercise and medication to injections and low-dose radiation therapy (LDRT), and when surgery may become the right option
Osteoarthritis treatment is rarely one-size-fits-all. Most people use a combination of approaches, adjusted over time according to the affected joint, symptom severity, overall health, prior treatment, and personal goals. The aim is to reduce pain, preserve movement, and make daily life easier.
The Foundation of Care
Exercise and Physical Therapy
Regular movement and strengthening can reduce pain and stiffness and improve function. A therapist can tailor activity around balance problems, prior injuries, or other health conditions.
Weight and Joint Load
For weight-bearing joints, weight loss can reduce pain for people who are overweight. Regardless of weight, pacing, footwear, activity changes, and assistive devices can reduce joint stress.
Braces and Assistive Devices
Braces, splints, canes, walkers, shoe inserts, and household adaptations may improve stability or make daily tasks less painful when properly selected and fitted.
Self-Management
Tracking symptoms, setting realistic activity goals, improving sleep, and learning how to handle flares can help people stay involved in work, family, and daily routines.
Medicines
Topical Medicines
Topical anti-inflammatory medicines are applied to the skin over a painful joint. They can be especially useful for joints such as the knee or hand and may have fewer whole-body effects than oral medicines.
Oral Pain Medicines
Acetaminophen or nonsteroidal anti-inflammatory drugs may be considered. The safest choice depends on kidney, stomach, heart, liver, blood-pressure, and bleeding risks, as well as other medicines.
Other Prescription Options
Selected patients may be offered other medicines for chronic osteoarthritis pain. These choices require an individual discussion about likely benefit, side effects, and interactions.
Joint Injections and Related Procedures
Injections are not all the same. Some are placed inside the joint, some are placed around painful structures, and nerve procedures work by changing pain signals rather than treating the joint itself. Evidence, insurance coverage, and guideline recommendations vary by treatment and by joint. An option sometimes considered for the knee may not be recommended for the hip, hand, shoulder, or ankle.
Corticosteroid injections
A corticosteroid is an anti-inflammatory medicine injected into a joint. It may provide short-term relief, especially when inflammation or a flare is contributing to pain.
- Relief may begin within days and can last from weeks to a few months, but responses vary.
- The injection does not restore cartilage.
- Repeated injections into the same joint require a careful discussion about timing, risks, diabetes, infection, and plans for possible surgery.
Hyaluronic acid injections
Hyaluronic acid products, sometimes called viscosupplementation, are injected into the knee with the goal of improving joint-fluid properties and reducing pain.
- Some patients report relief, while others do not.
- Average benefit in clinical studies has been modest, and major guidelines do not fully agree on routine use.
- These products are generally discussed for knee osteoarthritis, not as a standard injection for every joint.
Platelet-rich plasma (PRP)
PRP is prepared from a sample of the patient’s own blood and contains a concentrated mixture of platelets. It is marketed as a biologic treatment rather than a conventional drug.
- Some studies suggest improvement in pain and function for selected people with knee osteoarthritis.
- Preparation methods and injection protocols vary, making results difficult to compare.
- It is often not covered by insurance, and it should not be described as proven cartilage regrowth.
“Stem cell,” bone marrow concentrate, and other regenerative injections
Clinics may use terms such as stem cell therapy, bone marrow aspirate concentrate (BMAC), amniotic products, exosomes, or regenerative medicine. These products are not interchangeable.
- The FDA states that regenerative medicine therapies are not approved to treat orthopedic conditions such as osteoarthritis.
- Evidence remains limited, products and processing methods vary, and claims of rebuilding cartilage should be viewed cautiously.
- Patients should ask exactly what product is being used, what evidence supports it, whether it is part of a clinical trial, and what the total cost will be.
Prolotherapy
Prolotherapy usually involves injecting an irritating solution, often concentrated dextrose, around a painful joint, tendon, or ligament. The proposed goal is to stimulate a local healing response.
Research is still limited and protocols vary. It is not a standard first-line treatment for osteoarthritis and is often paid for out of pocket.
Genicular nerve blocks and radiofrequency ablation
These procedures target small sensory nerves around the knee. A diagnostic nerve block may be used first. Radiofrequency ablation then uses energy to reduce pain signals for a period of time.
- They do not repair cartilage or change the underlying joint damage.
- Some patients experience months of pain relief.
- They are usually considered after simpler treatments have not provided enough relief or when surgery is not appropriate.
Other Procedures and Surgery
Surgery
Joint replacement can be highly effective for advanced hip or knee osteoarthritis when pain and disability remain severe despite non-surgical care. Other operations may be used for selected joints or structural problems.
Arthroscopy
Arthroscopy may help certain mechanical problems, but routine “clean-out” surgery is generally not used to treat uncomplicated knee osteoarthritis alone.
Timing the Decision
A more damaged-looking joint on imaging doesn't automatically mean it's time for surgery, and a milder image doesn't mean it can wait. The right timing depends on symptoms, function, overall health, treatment goals, surgical risk, and the patient's readiness, together with what imaging shows.
Where LDRT Fits
Some radiation oncology programs offer low-dose radiation therapy for selected patients with persistent osteoarthritis pain after conservative treatment has not provided enough relief. It is non-surgical and does not rebuild cartilage. The goal is to reduce pain and improve function. Evidence in the United States is developing, and availability, selection criteria, and insurance coverage vary.
It Is One Option, Not the Starting Point
LDRT is usually discussed after diagnosis is clear and standard non-surgical approaches have been tried or considered. A radiation oncologist determines whether low-dose radiation therapy (LDRT) is appropriate.
Sources: NIAMS osteoarthritis treatment guidance, CDC arthritis self-care guidance, ACR/Arthritis Foundation guideline summary, and FDA regenerative medicine information.
What to Do Next
Am I a Candidate?
What programs generally look for before recommending LDRT.
Is It Covered by Insurance?
What Medicare and most commercial plans typically cover.
What to Expect
What a typical LDRT appointment and course of treatment looks like.
LDRT Success Rates
What the published response and pain-relief rates actually show.
Arthritis Basics
How common forms of arthritis differ and when to seek care.
Find a Location
Browse confirmed hospitals and centers offering LDRT.
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Browse our directory of hospitals and cancer centers currently offering low-dose radiation therapy for osteoarthritis.
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