Not everyone with hip or knee arthritis needs surgery immediately. In many cases, a structured non-operative programme can delay the need for joint replacement by months or even years — and meaningfully improve quality of life in the meantime. Every conservative option should be explored and optimised before surgery is considered.
Exercise and Physiotherapy
Exercise is the single most important non-operative intervention for hip and knee arthritis. Strong muscles around the joint reduce load on the articular surfaces, slow the progression of arthritis, and reduce pain — often dramatically. A supervised physiotherapy programme tailored to your arthritis pattern is the starting point.
The exercise does not need to be aggressive or painful. Low-impact options — cycling, swimming, hydrotherapy, walking, and resistance training — are all effective and well-tolerated. The key is consistency over time.
Weight Management, Analgesia & Injections
Weight management — every kilogram of body weight lost reduces knee joint load by approximately 4 kilograms during walking. Even small reductions (5–10kg) can make a significant difference to symptoms. Diet and low-impact exercise together are the most effective combination.
Analgesia — simple pain relief used strategically around activity (not continuously) can allow patients to remain more active. Paracetamol, NSAIDs (if tolerated and appropriate), and topical agents all have a role.
Joint injections — corticosteroid injections provide meaningful short-term relief in appropriate patients. Hyaluronic acid (viscosupplementation) injections provide a longer-duration effect in some patients. These are not cures, but they can buy meaningful time.
Supplements — Glucosamine Sulphate 1000mg and Fish Oil have shown symptomatic benefit in some studies. They are safe, inexpensive, and worth trialling for 3 months.
Watch Dr Chien-Wen Liew discuss this topic.
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