Nonsurgical Treatment of Hip & Knee Arthritis

If you have hip or knee arthritis, surgery is rarely the first step — and often not a near-term step at all. Most patients begin with, and many stay with, nonsurgical care. Done well, it can keep you comfortable and active for years. This guide explains how the pieces fit together, what each realistically can and can't do, and how to know when replacement becomes the better option.

Nonsurgical care is a layered continuum

There's no single treatment that works for everyone. The best results come from a layered, individualized plan — starting with the simplest, best-supported steps and adding more as needed. It's also worth being clear up front about the goal: because cartilage can't be regrown, nonsurgical care doesn't reverse arthritis. What it does is reduce pain, improve mobility, and protect your quality of life — which, for years at a time, is often exactly what patients need.

The foundation: movement, strength, and load

Before any injection, the most durable gains come from how you move and load the joint. This foundation helps nearly everyone:

Activity modification

Favoring lower-impact activities — cycling, swimming, the elliptical, and walking over running and deep squatting — reduces the load that drives pain, without giving up an active life. The aim is to keep moving in ways the joint tolerates well.

Physical therapy, strength, and mobility

Strengthening the muscles around the hip or knee improves stability, reduces pain, and restores confidence in a joint that's been feeling unreliable. Targeted mobility work helps stiffness. Therapy is one of the most underrated — and best-supported — tools available.

Weight management, where relevant

For weight-bearing joints, even modest weight loss can meaningfully reduce the load — and the pain — with every step. Where it applies, it's one of the highest-impact things a patient can do.

Anti-inflammatory strategies

Simple measures — ice after activity, activity pacing, and anti-inflammatory medication when appropriate and approved by your doctor — can take the edge off day to day. These are supportive tools within the larger plan, used sensibly rather than continuously.

Injection options

When the foundation isn't enough on its own, injections can add meaningful relief for the right patient. None of them reverse arthritis — they're tools to improve comfort and function.

Cortisone (corticosteroid) injections

Cortisone calms inflammation and can quiet a painful, swollen flare, giving meaningful — if temporary — relief. It's especially useful for getting through a bad stretch or an important event, and it's used selectively rather than repeatedly. See our guide to cortisone injections.

Hyaluronic acid (gel) injections

These aim to supplement the joint's natural lubrication. They're more established for the knee than the hip, and they help some patients with mild-to-moderate arthritis — with realistic expectations, since they don't work for everyone. See our guide to gel (hyaluronic acid) injections.

PRP and regenerative options

Platelet-rich plasma (PRP) is an area of genuine interest and ongoing research. The honest, balanced view: PRP may help selected patients with mild-to-moderate symptoms, but it is not a cure for advanced arthritis and should be viewed as one part of a broader treatment strategy — not a replacement for proven options, and not the miracle it's sometimes marketed to be. Used thoughtfully and with clear expectations, it can be a reasonable option to discuss — see our evidence-based guide to PRP for hip & knee arthritis.

When nonsurgical care no longer helps

Nonsurgical treatment tends to follow a pattern of diminishing returns as arthritis advances: relief from injections gets shorter, therapy holds you steady but no longer improves things, and the activities you've given up keep adding up. That's not a failure — it's simply information. When the plan is no longer buying you meaningful quality of life, it's reasonable to talk about what's next.

When replacement becomes reasonable

Replacement isn't a last resort — it's the right tool when arthritis limits the life you want despite good nonsurgical care. Modern hip and knee replacement are among the most successful procedures in medicine. If you're reaching that point, it helps to read about your specific situation: hip osteoarthritis or knee osteoarthritis, the muscle-sparing direct anterior hip replacement, and how to prepare for surgery.

Realistic goals of treatment

At every stage, the goals are the same: relieve your pain, keep you moving, and protect the active life you want — whether that's with activity changes and an occasional injection today, or a well-timed replacement down the road. Most patients can manage their arthritis well for a long time, and with the right plan, get back to doing what they love.