Managing Arthritis Pain Without Surgery: What Your Doctor May Not Tell You

More than 54 million Americans have arthritis. For adults over 55, it is the leading cause of disability in the United States. Many people believe surgery is the only real answer. That is not true.

Research from the past decade shows that non-surgical treatments can reduce arthritis pain by 30 to 50 percent for most people. Some of these options work as well as surgery for mild to moderate cases. Yet many doctors spend less than 15 minutes per visit, leaving little time to explain them all.

Here is what the science says about managing arthritis pain without going under the knife.

Physical Therapy Works Better Than Most People Expect

A 2024 study in the New England Journal of Medicine found that physical therapy was just as effective as arthroscopic surgery for knee osteoarthritis. Patients who did 12 weeks of targeted exercises had the same pain relief and mobility gains as those who had surgery.

Physical therapy for arthritis focuses on three things:

Strengthening muscles around the joint. Stronger muscles absorb more shock, which means less stress on worn cartilage.
Improving range of motion. Gentle stretching keeps joints from stiffening up.
Teaching joint protection techniques. A therapist can show you how to move in ways that reduce pain during daily tasks.

Most insurance plans, including Medicare, cover physical therapy. You typically need a referral from your doctor. Ask for a therapist who specializes in orthopedic or geriatric care.

The key is consistency. Going once or twice will not help much. Plan on two to three sessions per week for at least six weeks. Then continue the exercises at home.

Exercise Is Medicine (Even When It Hurts)

It sounds wrong: move the joint that hurts. But the Arthritis Foundation calls exercise “the most effective non-drug treatment for reducing pain and improving movement.”

You do not need to run marathons. Low-impact activities make a real difference:

Walking for 30 minutes, five days a week, reduces knee pain by up to 40 percent in studies.
Water aerobics takes weight off joints while building strength. The warm water also relaxes stiff muscles.
Tai chi improves balance and reduces pain. A Tufts University study found that tai chi twice a week cut arthritis pain scores by 35 percent over 12 weeks.
Cycling (stationary or outdoor) strengthens the quadriceps without pounding the knees.

Start slow. Ten minutes a day is fine at first. Add five minutes each week. If a joint swells after exercise, you did too much. Scale back and try again.

Weight Loss Takes Pressure Off Joints

Every extra pound puts four pounds of pressure on your knees. That means losing just 10 pounds removes 40 pounds of force from each knee with every step.

A Wake Forest University study of overweight adults with knee arthritis found that those who lost 10 percent of their body weight had 50 percent less pain than those who did not lose weight. They also had lower inflammation markers in their blood.

You do not need a crash diet. Small changes add up:

Cut 250 calories per day. That is roughly one soda and a handful of chips.
Add a 20-minute walk. Combined with the calorie cut, this produces steady weight loss of about one pound per week.
Focus on anti-inflammatory foods: fatty fish, leafy greens, berries, nuts, and olive oil.

Supplements: What the Research Actually Shows

The supplement aisle is full of arthritis products. Most have weak evidence. A few stand out:

Glucosamine and chondroitin: The largest clinical trial (the GAIT study) found this combination helped people with moderate to severe knee pain but not mild pain. The dose that worked was 1,500 mg glucosamine plus 1,200 mg chondroitin daily.

Turmeric (curcumin): Several clinical trials show that 1,000 mg of curcumin per day reduces knee pain about as well as ibuprofen. Look for products with piperine (black pepper extract), which helps your body absorb curcumin.

Omega-3 fatty acids: Fish oil at doses of 2,000 to 3,000 mg per day can reduce joint stiffness and tenderness, especially for rheumatoid arthritis. It takes six to eight weeks to see results.

What to skip: Collagen supplements have limited evidence. Same for MSM and SAMe, though some people report benefits.

Always tell your doctor about supplements you take. Some interact with blood thinners and other medications.

Injections Can Buy Time

When pills and therapy are not enough, injections can help:

Corticosteroid injections reduce inflammation quickly. Most people feel relief within 48 hours. The effect lasts two to four months. Doctors limit these to three or four per year because repeated injections can weaken cartilage over time.

Hyaluronic acid injections (sometimes called gel shots) add cushioning fluid to the joint. They work best for mild to moderate knee arthritis. Relief builds over several weeks and can last six months. Insurance coverage varies.

Platelet-rich plasma (PRP) uses your own blood, concentrated and injected into the joint. Early research is promising, but results are mixed. Most insurance does not cover it, and it costs $500 to $1,500 per injection.

Heat, Cold, and Other Simple Tools

Do not overlook the basics. They work, and they are free or cheap:

Heat (warm towel, heating pad, warm bath) relaxes muscles and eases stiffness. Best used in the morning or before activity.
Cold packs reduce swelling and numb sharp pain. Best used after activity or during flare-ups. Wrap ice in a towel and apply for 15 to 20 minutes.
Compression sleeves support the joint and reduce swelling. Available at any pharmacy for $10 to $30.
Topical creams with menthol, capsaicin, or diclofenac (Voltaren gel, now available over the counter) can ease pain without the stomach side effects of oral medications.

When to Talk to Your Doctor About Changing Your Plan

Non-surgical treatments do not work for everyone. See your doctor if:

Pain wakes you up at night regularly.
You cannot do basic tasks like climbing stairs, getting dressed, or walking to the mailbox.
Over-the-counter pain relievers are not helping at full doses.
A joint looks deformed or feels unstable.
You have tried physical therapy, weight loss, and injections with no improvement after six months.

Surgery may be the right choice at that point. But for millions of people with arthritis, the treatments above can delay or prevent surgery while improving quality of life right now.

The Bottom Line

Arthritis pain is real, but it does not always require a surgical fix. Physical therapy, regular exercise, weight management, and the right supplements can cut pain significantly. Talk to your doctor about building a plan that uses these tools together. The combination often works better than any single treatment alone.

Reported by Sarah Thornton with additional research from the SeniorDaily editorial team. For corrections or updates, please contact us.