The most effective things you can do for your joints are also the simplest: move regularly, maintain a healthy weight, and strengthen the muscles around your joints. These three strategies have the strongest evidence behind them and are strongly recommended by the American College of Rheumatology for managing joint pain in the hands, knees, and hips. Beyond those basics, a range of supplements, medications, and therapies can help, though they vary widely in how well they work.
Why Joints Need Movement to Stay Healthy
Understanding a little about how your joints work explains why certain strategies help more than others. The cartilage that cushions your joints has no blood supply. It gets its nutrients entirely from synovial fluid, the slippery liquid inside the joint capsule. That fluid acts as a lubricant, a nutrient delivery system, and an immune regulator all at once.
Here’s the key part: cartilage absorbs nutrients through a pumping action driven by movement. When you put weight on a joint, pressure pushes fluid out of the cartilage. When you take the weight off, fluid gets pulled back in, carrying fresh nutrients with it. This cycle of loading and unloading is the only way cartilage feeds itself. A joint that stays still for long periods is essentially starving its own cartilage. That’s why prolonged sitting or bed rest tends to make joint stiffness worse, not better.
Exercise That Protects Your Joints
Exercise is one of the few interventions that every major arthritis guideline strongly recommends. The goal isn’t to run marathons. It’s to keep the joint’s pumping mechanism active and to build the muscles that absorb shock before it reaches the cartilage.
Three categories matter most:
- Low-impact aerobic movement like walking, swimming, or cycling keeps synovial fluid circulating and cartilage nourished without excessive pounding.
- Strength training using body weight, resistance bands, or light weights builds the muscles around joints so they share more of the load.
- Balance and flexibility work like tai chi and yoga improves joint stability and range of motion. Both are specifically recommended for knee and hip osteoarthritis.
Daily exercise is ideal, but shorter sessions add up. Three 10-minute walks spread through the day provide similar cumulative benefits to a single 30-minute session. The important thing is consistency. Joints that move regularly maintain better lubrication, and the muscles around them stay strong enough to protect cartilage from excessive wear.
Weight Loss Makes a Measurable Difference
Losing weight is strongly recommended for knee and hip joint pain because every pound of body weight translates to roughly three to four pounds of force on the knee during walking. Even modest weight loss, in the range of 5 to 10 percent of body weight, can significantly reduce pain and improve function. This is one of the few interventions where the benefit is nearly proportional to the effort: the more weight lost, the less stress on weight-bearing joints.
Over-the-Counter Pain Relief
For flare-ups, anti-inflammatory medications like ibuprofen and naproxen are strongly recommended for hand, knee, and hip osteoarthritis. Topical versions (gels or creams applied directly to the skin) are strongly recommended for knee pain and conditionally recommended for hand pain, with fewer systemic side effects than pills.
Acetaminophen is conditionally recommended as a milder alternative. Topical capsaicin, derived from chili peppers, is conditionally recommended for knee pain.
One important caution with anti-inflammatory pills: serious side effects, including cardiovascular risks, can appear as early as the first few weeks of daily use, and the risk increases the longer you take them. The safest approach is the smallest effective dose for the shortest time possible.
Supplements: What the Evidence Shows
Glucosamine and chondroitin are the most widely marketed joint supplements, but the evidence is mixed. A large analysis of 29 studies with over 6,000 participants found that each supplement reduced pain when taken alone, but the results were inconsistent across individual studies. When taken together, the combination showed no significant benefit. The American College of Rheumatology strongly recommends against using glucosamine, chondroitin, or the combination for knee or hip osteoarthritis, stating that the best available data don’t show meaningful benefits. One exception: chondroitin alone is conditionally recommended for hand osteoarthritis, and pharmaceutical-grade formulations showed better results than typical retail products.
Curcumin, the active compound in turmeric, works by blocking several inflammatory pathways in joint tissue. It appears to slow the activity of enzymes that break down cartilage. A systematic review of studies on knee osteoarthritis found dosages ranging from about 90 milligrams to 2 grams per day, but there’s no consensus on the best dose or formulation. Results are promising but not yet definitive.
Omega-3 fatty acids from fish oil have anti-inflammatory properties, but achieving a therapeutic effect requires relatively high doses, typically 3 to 5 grams per day of the active components EPA and DHA combined. That’s considerably more than what most standard fish oil capsules provide. The ACR conditionally recommends against fish oil for osteoarthritis, though some people with inflammatory joint conditions report benefits.
If you do try supplements, patience matters. Oral joint supplements generally take at least one to two months before any improvement becomes noticeable, and omega-3 fatty acids need two to three months to integrate into cell membranes and reach effective levels in the body.
Injections for Moderate to Severe Pain
When oral treatments aren’t enough, steroid injections directly into the joint are strongly recommended for knee and hip osteoarthritis. They reduce inflammation quickly and can provide weeks to months of relief, though the effect is temporary and repeated injections may be limited.
Hyaluronic acid injections aim to restore the joint’s natural lubrication. In head-to-head comparisons, both injection types improved pain and function similarly at three and six months. However, the ACR conditionally recommends against hyaluronic acid injections for knees, reflecting uncertainty about whether the benefit justifies the cost and procedure.
Other Therapies Worth Considering
Several non-drug approaches have enough evidence to earn conditional recommendations from the ACR. Acupuncture is conditionally recommended for hand, knee, and hip osteoarthritis. Cognitive behavioral therapy can help with the emotional and psychological toll of chronic joint pain. Kinesiotaping and bracing can provide structural support, with knee braces and thumb splints earning strong recommendations for their respective joints. Heat and cold therapy are conditionally recommended across joint types for temporary symptom relief.
A few popular therapies lack strong support. Massage therapy, TENS units (electrical nerve stimulation devices), special shoe insoles, and manual therapy are either conditionally recommended against or, in the case of TENS, strongly recommended against based on current evidence. Platelet-rich plasma and stem cell injections are strongly recommended against due to insufficient proof of benefit.
Combining Strategies for Best Results
No single intervention solves joint problems on its own. The most effective approach layers multiple strategies. Regular movement keeps cartilage nourished and joints lubricated. Strengthening muscles around the joint absorbs shock that would otherwise wear down cartilage. Maintaining a healthy weight reduces the mechanical load on hips and knees. Anti-inflammatory medications or topical treatments manage flare-ups. And supportive devices like braces or a cane can reduce strain during daily activities.
The common thread across all the strongest recommendations is that they either reduce the forces acting on cartilage, maintain the biological processes that keep cartilage healthy, or both. Joints are designed to move under load. Giving them the right kind of movement, at a manageable body weight, with adequate muscle support, is the foundation everything else builds on.