Introduction

Osteoarthritis of the knee is a common condition where the cartilage—the cushioning between the bones—gradually wears down. This causes pain, stiffness, and swelling, making everyday movements like walking or climbing stairs difficult. It mostly affects older adults, with millions in the UK and worldwide living with it. Factors such as getting older, being overweight, previous knee injuries, and genetics can increase the risk.

Many people believe that knee surgery, especially replacement, is inevitable. However, today’s approach focuses much more on holistic, non-surgical methods that help relieve symptoms, improve function, and build resilience. It’s important to challenge common misconceptions so people feel empowered to explore alternative, effective treatments.

Understanding Osteoarthritis in the Knee

Knee osteoarthritis develops gradually through four stages, starting with minor cartilage damage and eventually leading to severe joint space loss where bones may rub directly against each other. Early signs include occasional pain and stiffness, which worsen over time into persistent pain, swelling, and reduced movement. This can seriously impact daily life.

Doctors diagnose the condition based on a physical exam and imaging tests like X-rays or MRI scans, which show the extent of joint damage. Early diagnosis is crucial because prompt treatment can help slow its progress and improve long-term outcomes.

Exercises and Physical Activity: What Helps and What to Avoid

Exercise is key in managing knee osteoarthritis. Strong muscles—especially around the knee—support the joint, reduce pain, and may slow further cartilage damage. Targeting the quadriceps, hamstrings and calves is particularly beneficial.

Here are five gentle exercises you can try at home:

• Straight Leg Raises: Strengthen the front thigh muscles without bending the knee.
• Hamstring Curls: Work the muscles at the back of the thigh to support the knee.
• Heel and Calf Raises: Build strength in your lower legs and improve balance.
• Wall Squats: A low-impact way to strengthen legs without overloading the knee.
• Step-Ups: Help improve mobility by mimicking everyday movements like climbing stairs.

It’s wise to avoid high-impact activities such as running or jumping, and movements that involve deep knee bends or twisting, as these can aggravate the knee. Adjust exercises to fit your comfort level—for example, by sitting while doing leg lifts or cutting down repetitions.

Current evidence suggests that low-impact, steady strengthening and aerobic exercises, like swimming and cycling, offer the best benefits for arthritic knees, improving joint function without putting too much strain on them.

Supplements, Nutrition and Latest Treatment Options

In the UK, glucosamine sulfate is one of the most popular supplements used to support knee joint health. Taking around 1,500 mg daily may help ease symptoms and improve function for some people. Other supplements like chondroitin sulfate and omega-3 fatty acids might also benefit joint health, though research results are mixed.

Beyond supplements, new treatment options are emerging as alternatives to surgery for those with advanced osteoarthritis. These include injections such as corticosteroids for easing pain briefly, and hyaluronic acid to help lubricate the joint. Orthobiologic treatments like platelet-rich plasma (PRP) and stem cell therapy aim to encourage cartilage repair, but evidence is still developing and results vary.

It's also worth noting traditional therapies gaining attention. A recent review states, “Many studies have reported that moxibustion, a treatment in traditional Chinese medicine, is effective in treating KOA.” Although more research is needed, this highlights that complementary therapies might offer additional relief when standard treatments don’t suffice.

For patients with severe (‘bone-on-bone’) arthritis or deformities, surgery remains important. In these cases, “navigated total knee arthroplasty (TKA) can effectively correct deformities, relieve pain, and improve postoperative joint function and quality of life compared with conventional methods.” Advanced computer-assisted surgery is becoming a vital tool to provide better precision and outcomes in complex cases.

Supportive devices such as knee braces or specially designed insoles are also used, but a comprehensive review found that “evidence was inconclusive for the benefits of bracing for pain, stiffness, function and quality of life.” They add that “the optimal choice for an orthosis remains unclear, and long-term implications are lacking.” So, braces and insoles might be useful as part of a wider strategy but are not a guaranteed solution on their own.

Lifestyle measures, including managing weight and consistent, tailored exercise, remain the foundation of effective osteoarthritis care.

Self-Management and Prevention Strategies

Protecting your knees from further damage means avoiding overuse or activities that put excessive strain or twisting force on the joint. Listening to your body is key—don’t push through persistent pain as this can worsen the condition.

Many people successfully manage their symptoms by staying active, maintaining a healthy weight, and fostering a positive mindset. These habits build resilience and can lead to better day-to-day wellbeing without relying solely on medical treatments.

To prevent osteoarthritis from worsening, focus on weight management to reduce joint stress, maintain good posture, wear supportive footwear, and engage in balanced physical activity. Regular check-ups with healthcare professionals can help tailor your treatment plan as your needs evolve.

Conclusion

Managing knee osteoarthritis works best when multiple strategies come together—exercise, nutrition, supplements, emerging therapies, and self-care all play a role. Today’s approach moves away from viewing surgery as the only option and instead empowers people to take control of their own health with practical, effective solutions.

If you’re living with knee osteoarthritis, it’s important to consult healthcare professionals before beginning new treatments or exercise programmes to ensure they’re safe and appropriate for you. With the right care and commitment, thriving with knee osteoarthritis is absolutely possible.

References

• Wang, X., Jiang, Y., Xiong, J., Yuan, T., Yang, J., Zhou, X., Liao, K., & Xu, L. (2020). Moxibustion for treating knee osteoarthritis. Medicine, 99(19), e19974. https://doi.org/10.1097/md.0000000000019974
• Meng, C., Li, C., & Xu, Y. (2024). Progress in computer‐assisted navigation for total knee arthroplasty in treating knee osteoarthritis with extra‐articular deformity. Orthopaedic Surgery, 16(11), 2608-2619. https://doi.org/10.1111/os.14216
• Duivenvoorden, T., Brouwer, R. W., van Raaij, T. M., Verhagen, A. P., Verhaar, J. A. N., & Bierma-Zeinstra, S. (2015). Braces and orthoses for treating osteoarthritis of the knee. Cochrane Database of Systematic Reviews, 2015(3), CD004020. https://doi.org/10.1002/14651858.cd004020.pub3