Nonsurgical Treatment of Knee Osteoarthritis

There are many nonsurgical treatments of knee arthritis. At any age, it is best to attempt conservative treatments without surgery, whenever possible. In order to permit an active lifestyle, treatment of knee arthritis is imperative, and will often involve the following modalities:

1. Physical therapy, to improve muscle strength, which allows for better shock absorption around the knee.

2. Drink plenty of water for hydration of muscles and joints.

3. A series of synthetic joint fluid injections, Supartz, to provide better joint lubrication.

4. If there is inflammation in the joint (water on the knee, “synovitis”), corticosteroid injection.

5. Osteoarthritis brace to unload the most degenerative, painful compartment of the knee.

6.  OA pattern muscle stimulator (an electrical device applied to the muscles around the knee to improve quadriceps and hamstring strength and to reduce swelling and inflammation.

7. Gel pads in the shoes to reduce the impact/pounding of the knee joints.

8. Tylenol or anti-inflammatory medications (Cox-1, e.g., old fashioned anti-inflammatories; or Cox-2, e.g., Celebrex).

9. If legs are unequal length, a heel lift on the short side to balance the knees.

10. Elastic wraps (give support and warmth).

11.  Supplements, including glucosamine sulfate, chrondroitin sulfate, MSM, and others.

12.  Topical anti-inflammatories such as Voltaren gel or Pennsaid.

13. Use of cane on the affected side.

14. Heel wedges in the shoes (change the angle on the knee to unload the painful side).

15. Possible naturopathic physician referral.

16. Possible acupuncture.

17. Possible laboratory testing, if persistent swelling, to consider gout or rheumatoid arthritis.

18. With knee stiffness flexion contracture), consider the use of a Dysnasplint (spring-loaded device to slowly increase knee extension).

19. MRI scan if symptoms indicate torn cartilage (meniscus), e.g., painful popping, catching sensations, locking.

20. If all else fails, referral for possible hemiarthroplasty (half-knee replacement) or total knee replacement, as a last resort. Knee arthroscopy
may be recommended if a torn meniscus is found to be present and is felt to be significantly symptomatic.