What to Do About Pain in Your Knees and Hips

For joint pain, and slowing the progression of OA, physical activity “is at the very top of the list,” says Jennifer Hankenson, MD, a specialist in physical medicine and rehabilitation at Yale Medicine in New Haven, Conn. One reason: Exercise helps increase the body’s production of synovial fluid, which helps reduce friction between joints. But pain may make it hard to want to exercise. “It hurts to move, so people become more sedentary, which causes them to stiffen up even more,” Hankenson says.

Some research suggests that inflammatory substances in your body can worsen OA, Prather says. What you eat may help. A 2022 review of 14 studies, published in the European Journal of Rheumatology, found that a plant-based diet reduces OA pain and slows cartilage changes in joints, and lowers inflammatory “markers” in the body, such as interleukin-1 (IL-1) and IL-6.

“There’s definitely a benefit in following a diet rich in foods that decrease inflammation, like fruits, veggies, and beans, and is low in fatty, processed, and fried foods, all of which promote inflammation,” Hankenson says. One good option: a Mediterranean-style eating pattern, which is rich in produce and beans, along with whole grains, nuts, and healthy fats like avocado and olive oil.

Seafood, especially fatty fish like salmon, is also a good move. It contains omega-3 fatty acids, which reduce joint inflammation and pain, says Julia Iafrate, DO, clinical assistant professor in the department of orthopedic surgery and the department of rehabilitation medicine at the NYU Grossman School of Medicine in New York City. Consume foods with vitamin K (which is important for cartilage), like kale and spinach, too.

Considering taking a supplement? The spice turmeric may have an anti-inflammatory effect, Iafrate says. A 2021 review published in the journal BMJ Open Sports & Exercise Medicine found that it improved knee OA pain compared with a placebo, and in some cases, was as effective as NSAIDs. If you decide to try it (ask your doctor), Iafrate recommends 500 mg daily.

If you’re overweight, losing even 5 or 10 pounds can significantly reduce joint pain. “Just 1 pound of weight puts 5 to 6 pounds of pressure on your hips and knees,” says Anthony DiGioia, MD, medical director of the Bone and Joint Center at the University of Pittsburgh Medical Center Magee-Womens Hospital.

But depending on your overall weight, losing more may be better. A study published in the journal Arthritis Care & Research found that obese and overweight people who lost at least 5 percent of their body weight reported less pain and could walk farther in a 6-minute test than those who lost less than 5 percent of their total weight.

Attending to both is key. Too little sleep heightens pain sensitivity and dulls your brain’s pain-killing response, according to a 2019 study published in the Journal of Neuroscience. But too much may be a problem, too: A 2020 study published in PLOS One found that people who slept less than 7 hours, or 9 hours or longer, per night were more likely to report joint pain.

As for stress, a study published in 2021 in the International Journal of Environmental Research and Public Health found that it may be associated with chronic knee pain. “When you’re stressed, your body releases hormones like cortisol that promote inflammation and lead to worse pain,” Prather says. Consider doing activities to help you relax, whether it’s a minute or two of deep breathing to ease tension, or a formal stress-reduction class.

Hip and knee replacements can be quite effective and long-lasting, and some research suggests that even those in their 80s may benefit. But they are major surgical procedures, and often require weeks or months of recovery.

So “they’re truly only recommended for people who experience joint pain with every single activity, even just getting out of a chair, and have gone through physical therapy and other non-operative options,” says orthopedic surgeon Lee Rubin, MD, of Yale Medicine in New Haven, Conn. Talk to an orthopedic surgeon about the pros and cons. And get a second opinion.

If you decide to move forward, it should be with a surgeon who does at least 25 hip or knee operations a year at a medical center where hundreds or thousands are performed annually.

Experiencing a worse-than-usual flare-up of osteoarthritis pain? First consider an over-the-counter topical treatment, such as Voltaren or Zostrix, says Martine Sanon, MD, associate professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai in New York City.

For additional relief, you can try an over-the-counter medication such as acetaminophen (Tylenol and generic). You can also rotate acetaminophen with an OTC nonsteroidal anti-inflammatory medication such as ibuprofen (Advil, Motrin, and generic) or naproxen (Aleve and generic).

But first ask your doctor if NSAIDs are safe and appropriate for you. “We don’t like to use them long-term in older adults, but for a few days, it’s often fine,” DiGioia says.

If you’re still miserable, ask your doctor if one or two glucocorticoid (steroid) injections is reasonable. Injections of hyaluronic acid may also help with mild to moderate OA, but the American Academy of Surgeons doesn’t advise it for routine use. Platelet-rich plasma, an experimental treatment that uses your blood platelets, has shown only mixed effectiveness.