Osteoarthritis (OA) is caused by wear and tear on your joints and can be painful and frustrating. It typically occurs in your:

  • knees
  • hips
  • lower back
  • neck
  • shoulders

OA causes the cartilage that pads the bones in your joints to deteriorate. It’s common to have decreased mobility as a result.

About 27 million Americans have OA. It’s the most common type of arthritis. Arthritis is the No. 1 cause of work-related disability in the United States.

It’s important to find the right approach to manage and treat your OA so it doesn’t worsen over time.

Dr. Nels Carlson, an associate professor in the department of orthopedics and rehabilitation at Oregon Health Sciences University, suggests taking this six-step approach:

Symptoms of OA include:

Many people with OA experience pain first thing in the morning. It can often last for a few hours or more.

Visit an OA specialist for a physical exam if you think you have OA. Your doctor may also recommend an X-ray or an MRI. Other conditions that can have similar symptoms to OA include:

Carlson believes it’s best for most people with OA to start with a conservative treatment approach. “Lifestyle changes are key,” he says. These include:

Losing weight

This reduces the stress on your joints, particularly in your knees.


Aquatics and other low impact forms of exercise are ideal. You may require cold and hot compresses after exercise or to manage inflammation.

Wearing a splint, shoe insert, or brace

“It can unload the arthritic component of an affected area,” Carlson notes. But if you wear one of these and you’re still unable to control inflammation and pain, you may need to take medication.

Many people with OA find that over-the-counter (OTC) medications like acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce joint pain, stiffness, and swelling. Ibuprofen (Advil), naproxen (Aleve), and aspirin are all NSAIDs.

However, Carlson warns around-the-clock use of these medications can cause other problems, such as gastrointestinal distress and stomach ulcers.

If these medications don’t help, you have severe pain, or you can’t tolerate OTC remedies, your doctor might recommend prescription medications, such as opioids.

Dietary supplements like glucosamine and chondroitin sulfate may help. Studies are mixed about how effective these supplements are, but Carlson says there’s no harm in trying them.

Your doctor may suggest an injection of hyaluronic acid if there’s little or no improvement from using a brace or taking OTC medications. Hyaluronic acid is only approved for use on knees.

Your doctor may also suggest corticosteroids. Corticosteroids don’t eliminate pain directly but can reduce inflammation and swelling. However, cortisone injections could result in side effects like:

  • soreness
  • sweating
  • insomnia
  • temporary rise in blood sugar in people with diabetes
  • temporary rise in heart rate
  • flushing of the skin on your palms or face

Long-term side effects can include:

A physical therapist can provide treatments and exercises like stretching and strengthening that help alleviate the inflammation and pain associated with OA, Carlson notes. You could also visit an experienced massage therapist who can focus on problem areas.

If other treatment options haven’t worked, you may need a joint replacement or surgery to resurface or realign your ankle or knee, Carlson points out. In people with advanced osteoarthritis, these procedures are usually effective. But there’s no guarantee they’ll eliminate the inflammation and pain. “The recovery time can stretch into months. There’s usually a lot of work with a physical therapist, and it won’t be pain free,” Carlson explains.

Postoperative rehab typically involves range-of-motion exercises and strengthening techniques. “The goal is to get a person back to his or her usual routine.” Your doctor might also prescribe medication to help you manage pain, including opioids.

There’s no one-size-fits-all approach to managing and treating OA. Carlson emphasizes the need to keep weight down, keep muscles strong, and improve range of motion.

“It’s important to discuss various options and treatments with your doctor, and understand the pros and cons before making any decision,” he says. “You must be comfortable with the game plan and know that it’s right for you.”