The most effective approach to osteoarthritis pain combines regular movement, maintaining a healthy weight, and the right medications for your situation. No single treatment eliminates the pain entirely, but layering several strategies together can make a real difference in how your joints feel day to day.
Exercise Is the Foundation
Exercise is one of the most strongly recommended treatments for osteoarthritis of the knee, hip, and hand. That might sound counterintuitive when your joints hurt, but regular movement strengthens the muscles that support your joints, improves flexibility, and reduces stiffness over time. The key is choosing activities that don’t pound your joints.
Walking, swimming, water aerobics, and cycling are all good options. Tai chi is specifically recommended by the American College of Rheumatology for knee and hip osteoarthritis because it improves balance, posture, and joint flexibility while being gentle enough for people with significant pain. Yoga can work similarly. The goal isn’t intensity. It’s consistency: moving your joints through their range of motion most days of the week.
Why Losing Even a Little Weight Matters
If you carry extra weight and have knee or hip osteoarthritis, weight loss is one of the highest-impact changes you can make. Research published in Arthritis & Rheumatism found that every pound of body weight you lose removes roughly four pounds of force from your knee with each step. That adds up fast. Over the course of a day’s walking, even a 10-pound loss translates to tens of thousands of pounds of cumulative pressure taken off the joint.
Weight loss is strongly recommended by major rheumatology guidelines for anyone with knee or hip osteoarthritis who is overweight. You don’t need to reach an ideal body weight to see benefits. Modest, sustained loss makes a measurable difference in pain and function.
Topical Pain Relievers
For knee osteoarthritis specifically, topical anti-inflammatory gels and creams (like diclofenac gel, sold over the counter as Voltaren) are a strongly recommended first-line treatment. A meta-analysis of eight randomized trials covering over 2,000 patients found that topical anti-inflammatories are as effective as oral versions at reducing pain and improving physical function, with the advantage of delivering medication directly to the joint rather than throughout your entire body.
Capsaicin cream is another topical option. It works by desensitizing the nerve endings that transmit pain signals. A higher-strength formulation (0.25%) applied twice daily produced at least a 50% reduction in pain severity within just two days for 55% of users in a clinical trial. You’ll feel a burning or warming sensation at first, which fades with regular use. Capsaicin is available over the counter in various strengths.
Oral Anti-Inflammatory Medications
Oral anti-inflammatory drugs like ibuprofen and naproxen remain the go-to oral medications for osteoarthritis pain in any joint. They’re recommended as the initial oral medication of choice over all other available options. For people with hip osteoarthritis or pain in multiple joints, oral anti-inflammatories tend to work better than topical versions simply because a cream can’t easily reach deep joints like the hip.
Acetaminophen (Tylenol) is sometimes used, but current guidelines don’t recommend it as strongly because it reduces pain without addressing inflammation. If you need oral anti-inflammatories regularly, using the lowest effective dose helps minimize stomach, kidney, and cardiovascular risks over time.
Joint Injections
Corticosteroid injections directly into the knee or hip joint are strongly recommended for osteoarthritis that isn’t responding well enough to other treatments. They work fast, typically providing noticeable pain relief within days, and tend to be most effective in the first month. The relief gradually fades, and most people find injections are helpful for several weeks to a few months.
Hyaluronic acid injections take a different approach, supplementing the joint’s natural lubricating fluid. They’re slower to kick in but may provide longer-lasting relief. Studies comparing the two show corticosteroids win on short-term pain control (under one month), while hyaluronic acid tends to perform better at the six-month mark. Your response may vary, and some people cycle between the two.
Prescription Options for Persistent Pain
When standard anti-inflammatories aren’t enough, certain antidepressant medications can help with chronic osteoarthritis pain. Duloxetine, originally developed for depression, works by boosting the brain’s natural pain-dampening signals along the spinal cord. In people with chronic pain, these signals may be underactive, allowing excess pain input to reach the brain. Duloxetine is specifically approved for chronic musculoskeletal pain, including knee osteoarthritis, and is typically started at a low dose before being increased over a week or two.
Supplements: What the Evidence Shows
Glucosamine and chondroitin are the most popular supplements for joint health, but the largest and most rigorous trial on the topic, published in the New England Journal of Medicine with over 1,500 participants, found no significant benefit from either supplement alone compared to placebo for knee osteoarthritis pain overall. There was a hint of benefit in the subgroup with moderate-to-severe pain, but it didn’t reach statistical significance. Many people report feeling better on these supplements, but the clinical evidence is underwhelming.
Turmeric (specifically curcumin extract) has more promising data. A multicenter trial of 367 people with knee osteoarthritis compared 1,500 mg per day of turmeric extract to 1,200 mg per day of ibuprofen over four weeks. Turmeric matched ibuprofen for pain reduction and physical function improvement. An earlier trial using 2,000 mg per day of turmeric extract over six weeks found similar results. If you want to try turmeric, look for standardized curcumin extracts rather than the kitchen spice, which contains only about 3% curcumin by weight.
Braces, Canes, and Other Support
Assistive devices aren’t glamorous, but they’re strongly recommended when osteoarthritis significantly affects your ability to walk or causes joint instability. A cane used on the opposite side of your affected knee or hip takes a meaningful amount of load off the joint. Unloader braces for the knee work by shifting weight away from the damaged compartment of the joint, reducing the forces that cause pain during walking. People who experience a clear improvement in walking distance tend to stick with braces long-term, while those who don’t notice a difference often stop.
For osteoarthritis at the base of the thumb, a simple hand splint or orthosis can reduce pain during gripping and pinching tasks. These are available at most pharmacies or can be custom-fitted by a hand therapist.
Combining Approaches for Better Results
Osteoarthritis pain responds best to a layered strategy rather than relying on any single treatment. A practical starting point might look like regular low-impact exercise, a topical anti-inflammatory for flare-ups, and gradual weight loss if that applies to you. If pain persists, adding an oral anti-inflammatory or trying a joint injection can provide further relief. Self-management programs, which teach pacing strategies, joint protection techniques, and coping skills, are strongly recommended by rheumatology guidelines and can help you feel more in control of the condition over time.
What works best varies from person to person and often changes as the condition progresses. The treatments with the strongest evidence behind them, exercise, weight management, and anti-inflammatory medications, are worth prioritizing before moving to more specialized options.