Non-surgical treatments worth trying first

Cartilage doesn't grow back. No injection, supplement, exercise or diet has been shown to regenerate the cartilage that arthritis has worn away. What conservative care can do — and do well — is reduce pain, improve function, and buy time while you decide what's right.

For some patients, that's enough for years. For others, it's a bridge to the surgery they were always going to need. Both are legitimate uses of the conservative path.

Across every major guideline — OARSI, ACR, AAOS — the strongest recommendation for hip and knee arthritis is structured exercise. Not because it's harmless filler, but because it consistently reduces pain and improves function.

A useful mix is: low-impact aerobic work (walking, stationary bike, pool), strengthening (especially quadriceps and glutes), and range-of-motion / balance work. A physiotherapist familiar with arthritis can build the program around your specific joint.

For every kilogram of body weight, four kilograms of force pass through each knee with every step. The maths is unflattering but honest: modest weight loss meaningfully reduces joint load and pain. We say "where it applies" because plenty of patients with arthritis are not overweight — telling everyone to lose weight is neither accurate nor kind.

Topical anti-inflammatories (diclofenac gel, for example) get surprisingly far for knee arthritis, with very little systemic risk. Oral anti-inflammatories work, but stomach, kidney and heart risks need to be weighed honestly — especially for patients in their 70s and 80s.

Acetaminophen helps some patients and not others. Opioids have a very limited role in chronic arthritis pain; better pain plans rely on multimodal approaches.

Corticosteroid injections can settle a flare for weeks to a few months. They're a reasonable tool when you need to get through a specific event or buy time. Repeated frequent steroid injections aren't a long-term plan.

Hyaluronic acid injections ("gel" injections) help some knee-arthritis patients modestly and others not at all. Hip evidence is weaker. They are not covered by AHCIP and are generally an out-of-pocket cost.

PRP and stem-cell injections are widely marketed but, at the time of writing, do not have evidence strong enough to recommend routinely. We try to be straight with patients about this.

A well-fitted unloader brace can take meaningful load off a knee with single-compartment arthritis. A cushioned shoe with a stable heel often helps more than a high-tech orthotic. A cane held in the opposite hand reduces hip load by roughly 25% — a useful tool when distance is the limit.

A fair conservative trial is usually 8–12 weeks of consistent movement, weight strategies if relevant, and an honest test of medications. If pain, sleep and function aren't improving — or your life is meaningfully smaller than it should be — it's time to talk about what surgery would actually offer.

You can see how that conversation typically unfolds in what to expect at your first consultation, or read the overview of the private path in Alberta.