What can you do for your knee pain? People with arthritis have relatively few good options for relief. Often, they may feel as if they are stuck between a rock and a hard place. Hip and knee pain make it difficult to get around, but the treatments can create problems of their own.
Arthritis Drugs and Their Complications:
Nonsteroidal anti-inflammatory drugs such as diclofenac (Cataflam, Voltaren), ibuprofen (Advil, Motrin IB) or naproxen (Aleve) can cause gastrointestinal injury that may result in ulcers. In addition, such drugs raise blood pressure and may increase the risk of cardiovascular complications, including heart attacks. If you as an arthritis patient complain of stomach upset, you might be advised to use acetaminophen, the active ingredient in Tylenol.
Study Shows Acetaminophen Won’t Help Your Knee Pain Much:
A review evaluating results from 10 randomized placebo-controlled trials found that acetaminophen (aka paracetamol) offers limited, short-term relief for people with knee or hip osteoarthritis (Cochrane Database of Systematic Reviews, Feb. 25, 2019). The investigators were less clear on the risk of serious adverse effects such as changes in liver function. However, they were not enthusiastic about the idea of using acetaminophen as the first line of pain relief for people with arthritis.
Non-Drug Approaches:
Given the problems associated with medications, you may want to consider non-drug approaches. Physical therapy may be able to help you keep moving, which is one of the most important factors in maintaining your ability to function. Although it may not seem obvious, activity is also helpful in controlling your knee pain.
Although there will never be good clinical trials of home remedies, many people tell us that some inexpensive remedies are also helpful for easing knee pain. Some may be worth a try. People differ in what approaches are most helpful: your Aunt Martha may be enthusiastic about gin-soaked raisins, and you may find that boswellia or curcumin is better for you. It can take some experimentation to find what works best in your own case.
Physical Therapy for Knee Pain:
Intensive physical therapy could offer many people with knee pain as much relief as arthroscopic surgery. This randomized controlled trial included 350 people over 45 with osteoarthritis or tears in the meniscus of the knee (New England Journal of Medicine, May 2, 2013). Half were assigned to arthroscopy and the other half to physical therapy. After a year, patients in both groups were doing equally well.
The investigators did note that roughly one-third of those assigned to physical therapy eventually opted for surgery, since the therapy had not provided adequate relief. For the others, though, the cost differential is impressive: About $2000 for several weeks of physical therapy compared to $4500 for surgery.
To figure out the best way to manage your knee pain, you should talk with your doctor about the pros and cons of all these treatments. You will find information to help you with that conversation in our Guide to Alternatives for Arthritis.
