Arthritis treatment combines several approaches: exercise, weight management, medication, injections, and in advanced cases, surgery. There is no cure for any form of arthritis, so treatment focuses on reducing pain, slowing joint damage, and keeping you as mobile as possible. The right combination depends on which type of arthritis you have and how far it has progressed.
Exercise and Physical Activity
Exercise is considered a core treatment for arthritis, not just a nice add-on. European guidelines for hip and knee osteoarthritis recommend that every patient be offered a structured exercise program that includes strength training, aerobic activity, flexibility work, or a combination of all three. The program should be tailored to your current physical function and progress over time as your capacity improves.
Different types of exercise serve different purposes. Range-of-motion exercises like stretching your arms overhead or rolling your shoulders help reduce stiffness by moving joints through their full arc of motion. These can be done daily. Aerobic exercise, such as walking, cycling, swimming, or water aerobics, improves heart and lung health, helps manage weight, and increases energy without putting excessive stress on joints. Strength training builds the muscles around affected joints, which helps stabilize them and absorb shock.
How you exercise matters less than whether you do it consistently. Land-based classes, aquatic therapy, one-on-one sessions with a physical therapist, group programs, and even digital or app-guided routines all show benefit. Pick the format that fits your schedule and preferences, because that’s the one you’ll actually stick with.
Weight Management
Carrying extra weight increases the mechanical load on weight-bearing joints like knees and hips, and excess body fat also produces inflammatory chemicals that can worsen joint damage throughout the body. Clinical guidelines recommend that people with hip or knee osteoarthritis who are overweight or obese receive active support to lose weight and maintain that loss. Even modest reductions in body weight can meaningfully decrease pain and improve function.
Topical and Oral Pain Relief
For osteoarthritis, anti-inflammatory gels and creams applied directly to the skin over an affected joint offer surprisingly effective relief. A network meta-analysis published in Osteoarthritis and Cartilage found that topical anti-inflammatory medications improved function just as well as their oral counterparts for knee osteoarthritis. The real advantage, though, is safety: topical versions carried roughly half the risk of gastrointestinal side effects compared to oral anti-inflammatories and were also safer than acetaminophen for gut-related problems. If your arthritis is limited to one or two accessible joints, like a knee or hand, a topical option can deliver the same benefit with far fewer systemic side effects.
Oral anti-inflammatory medications remain useful when multiple joints are involved or when topical application isn’t practical. They work well for pain and swelling but carry risks to the stomach, kidneys, and cardiovascular system with long-term use, so they’re generally used at the lowest effective dose for the shortest time needed.
Cortisone Injections
Cortisone shots deliver a powerful anti-inflammatory directly into a joint, and they can provide significant short-term relief from pain and swelling. They’re often used when oral or topical medications aren’t enough, or when a single joint is flaring badly.
There is no formal upper limit on the number of injections you can receive, but most doctors set a practical cap of three to four shots per year in the same joint. The reason for caution: cortisone has a negative effect on the cells responsible for maintaining smooth cartilage surfaces, and repeated injections can actually accelerate cartilage loss over time. So while they’re a useful tool for managing flare-ups, cortisone shots aren’t a long-term strategy on their own.
Disease-Modifying Drugs for Inflammatory Arthritis
Osteoarthritis is primarily a wear-and-tear condition, but rheumatoid arthritis, psoriatic arthritis, and other inflammatory forms involve an immune system that attacks joint tissue. These types require a fundamentally different class of medication: disease-modifying drugs, commonly called DMARDs, which don’t just mask pain but actually slow or stop joint destruction by calming the immune response.
Traditional DMARDs work broadly across the immune system. Methotrexate is the most commonly prescribed and is typically the first medication tried for rheumatoid arthritis. Other options in this category include hydroxychloroquine, sulfasalazine, and leflunomide. These drugs take weeks to reach full effect, so your doctor may prescribe a short-term anti-inflammatory alongside them to bridge the gap.
When traditional DMARDs don’t provide enough control, biologic drugs offer a more targeted approach. Instead of dampening the whole immune system, biologics are engineered proteins that block specific immune signals driving inflammation. Some target a protein called tumor necrosis factor (TNF), which is a major driver of joint inflammation. Others block interleukins, which are chemical messengers that amplify the immune response. Still others work by shutting down specific types of immune cells, like T-cells or B-cells, that are attacking joint tissue.
Treating Psoriatic Arthritis
Psoriatic arthritis affects both joints and skin, which means treatment needs to address inflammation in two different tissue types simultaneously. This condition is driven by an overactive loop in the immune system: certain immune cells overproduce inflammatory signals that act on skin cells and joint linings, which in turn stimulate more immune activity, creating a self-reinforcing cycle of inflammation.
Biologics that target specific interleukins have proven particularly effective here. Drugs that block the IL-17 pathway reduce both joint swelling and skin plaques, as do those targeting IL-23, which sits upstream in the inflammatory cascade and helps drive the production of IL-17. A network meta-analysis of randomized controlled trials confirmed that IL-17 inhibitors, IL-23 inhibitors, and IL-12/23 inhibitors are all effective for psoriatic arthritis. In 2025, the FDA approved guselkumab, an IL-23 inhibitor, for active psoriatic arthritis, expanding the available options.
Several biosimilars (lower-cost, near-identical versions of established biologics) have also recently been approved as fully interchangeable with their brand-name counterparts. This is making biologic treatment more accessible for people who previously couldn’t afford it.
Assistive Devices and Workplace Adjustments
Simple tools can make a real difference in daily function. Walking aids like canes reduce the load on hip and knee joints. Supportive footwear and orthotic insoles can change how forces travel through your lower body. Jar openers, built-up pen grips, long-handled reachers, and lever-style door handles reduce strain on hand joints. Ergonomic adjustments at work, such as a raised desk, supportive chair, or modified keyboard, can help you stay productive without aggravating symptoms. If arthritis is affecting your ability to do your job, guidelines recommend seeking advice on modifiable workplace factors early, before the problem becomes severe.
Anti-Inflammatory Diet
No diet cures arthritis, but certain eating patterns can measurably reduce inflammation. The strongest evidence points to omega-3 fatty acids, found in fatty fish like salmon, mackerel, and sardines, as well as in walnuts and flaxseed. People with the highest omega-3 intake have lower blood levels of C-reactive protein (CRP) and interleukin-6, two key markers of systemic inflammation.
Fiber-rich foods, including beans, whole grains, fruits, and vegetables, also help lower CRP levels. Beans in particular are packed with both fiber and plant compounds that reduce inflammation. The broader pattern that emerges is a Mediterranean-style diet: heavy on fish, vegetables, whole grains, nuts, and olive oil, with limited processed food, added sugar, and red meat. This won’t replace medication for inflammatory arthritis, but it supports every other treatment you’re doing.
Joint Replacement Surgery
When arthritis has progressed to the point where daily activities are severely limited and non-surgical treatments no longer provide adequate relief, joint replacement becomes an option. This is typically reserved for advanced, end-stage joint disease. The decision is based on two factors: your overall health and fitness for surgery, and how much the arthritis is actually affecting your quality of life in terms of disabling pain and declining function.
Modern hip and knee replacements last 20 years or more for most people. Recovery involves several weeks of restricted activity followed by months of physical therapy to rebuild strength and range of motion. Most people return to walking, light exercise, and everyday tasks within a few months, though full recovery can take up to a year. Joint replacement consistently ranks among the most successful elective surgeries in terms of patient satisfaction and pain relief.