Thinking about knee surgery? 5 things to try first

Living with osteoarthritis knee pain can be frustrating. But it doesn't mean you have to give up the things you enjoy, like traveling or shopping. And it doesn't necessarily mean you need knee surgery, either. 

When pain medication isn’t quite working—but you're not ready to take the plunge into knee replacement—it might be time for something new. Studies have shown the following therapies and tips may help you relief.

Every extra pound you carry puts up to four pounds of pressure on your knees, according to the Arthritis Foundation. To relieve that burden, look for a program that combines weight loss and exercise, which studies show is one of the best ways to improve joint pain and function. 

The key is sticking with low-impact activities, like walking on flat surfaces. Walking regularly can help you manage your weight and help keep the big muscles in your legs in shape. These muscles are the quadriceps (on the front of your thigh) and hamstrings (the backs of your thighs). Strong thigh muscles act like shock absorbers for your knees, giving them extra support. Just 10 minutes a day can help, but the longer you walk and the faster your pace, the better.

Healthcare providers (HCPs) agree that a sensible diet focuses largely on vegetables, whole grains, fresh fruits, nuts, beans, and lean proteins like fish. It also limits processed foods and saturated fats. While there's no specific osteoarthritis diet, the Mediterranean diet incorporates these principles.

You can also try adding some foods that may help control inflammation to your shopping list. Look for foods rich in docosahexaenoic acid (DHA), a form of omega-3 fatty acid. These include walnuts, avocado, flaxseeds, salmon, and trout. Aim to consume 3 to 4 ounces of fish two times each week, as well as a handful of unsalted nuts each day. Pine nuts, walnuts, pistachios, and almonds are all wise choices. 

All fruits and veggies impart health benefits. For inflammation, it may help to select the most colorful varieties, including blackberries, blueberries, cherries, strawberries, broccoli, kale, and spinach. Fill up with fibrous foods, including carrots and peppers. Onions are also wise choices. When you’re cooking, choose olive oil, which contains healthy fat as well as oleocanthal, an anti-inflammatory compound. 

Even if you manage your weight and exercise regularly, you may have tough days if you have knee osteoarthritis. Be sure to wear a knee brace when needed. It can ease pain, help you recover from injury, and help you continue to be active. 

There are several kinds of braces. Studies have shown that valgus knee braces (the kind with hinges on the sides), also called unloader or offloader braces, help people walk farther, with less pain. HCPs also suggest trying a simple elastic-sleeve knee brace, which may be more comfortable and affordable. It might provide some compression, and may also offer a feeling of support, as well as a reminder to be mindful of your knee when you’re out and about.

Spa therapy is one of the most popular drug-free ways to treat osteoarthritis in countries in Europe and the Middle East. Research has suggested it may help with knee pain, stiffness, and function for several months, especially when used along with an exercise program. 

Common spa treatments include knee massage, mud packs, mineral water baths, hot showers, and mobilization exercises in a heated pool. A 2023 review published in Rheumatology International suggested that hydrotherapy can be useful for relaxing muscles and treating pain.

The benefits of a spa treatment may last between three and nine months. Be sure the spa staff is experienced in caring for people with osteoarthritis or ask your HCP for a referral to a licensed massage therapist.

Before committing to knee surgery, speak with your HCP about your other options. A specialist trained to treat knee osteoarthritis, like an orthopedic surgeon, can talk you through the benefits and risks of injections and other therapies.

Remember, pain can't be easily measured, like your blood pressure or temperature. So, your HCP may not realize how much pain you're in. Be honest and clear about your symptoms and how they're affecting your life, so you can get the relief you deserve.