Best Approach to Managing Osteoarthritis

According to a study in Arthritis Care & Research , people with hip and knee OA use oral pain medications far more than nondrug alternatives. Of the nearly 1,200 patients in the study, 70 to 82 percent took pain relievers; fewer than half tried physical therapy or other nondrug options. Most were overweight, and none got the minimum 150 minutes of physical activity a week the Centers for Disease Control and Prevention recommends for good health.

That’s a problem, says Laith Jazrawi, MD, an orthopedic surgeon and chief of sports medicine at NYU Langone Medical Center in New York City. “We know that compared to people who are sedentary, patients who are more active have less pain and better function.”



Dr. Jazrawi recommends 150 minutes a week of brisk walking , cycling and weight training for people with arthritis. Even 45 minutes a week of moderate to vigorous physical activity might improve function, according to a 2017 study.

Here are the American College of Rheumatology’s recommendations for managing hip and knee OA symptoms:

Nondrug Therapies

Strong recommendations:

• Land-based or water exercises


• Weight loss , if needed

Secondary recommendations:

• Self-management programs


• Manual therapy in combination with supervised exercise (physical therapy)


• Psychosocial therapies, such as cognitive behavioral therapy (CBT)


• Hot and cold packs


• Tai chi


• Acupuncture or transcutaneous electrical nerve stimulation (TENS) for knee (not hip) OA patients with severe pain who aren’t joint replacement candidates

Drug Therapies

Strong recommendations:

• None

Secondary recommendations:

• Acetaminophen


• Oral or topical NSAIDs


• Corticosteroid joint injections