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Osteoarthritis affects an estimated 32.5 million adults in the United States, and the hip and knee are among its favorite targets. The good news is that it’s also one of the most manageable chronic conditions in orthopedics — with a wide range of options before surgery ever needs to be on the table.
What’s actually happening in the joint
Osteoarthritis is the gradual breakdown of cartilage, the smooth tissue that cushions the ends of bones and lets joints move without friction. As cartilage wears down, bones can begin to rub against each other, causing pain, stiffness, and inflammation. It’s often described as “wear and tear,” but genetics, previous joint injuries, and repetitive stress from certain occupations or sports all play a role beyond simple aging.
Recognizing the early signs
Early hip and knee osteoarthritis tends to show up as stiffness first thing in the morning or after sitting for a while, which loosens up once you get moving. Pain that increases with activity and improves with rest is another hallmark, along with a gradual loss of flexibility. As it progresses, patients often notice grinding or clicking sensations, swelling after activity, and pain severe enough to affect walking, stairs, or sleep.
Lifestyle changes that make a real difference
Weight management is one of the most impactful things a patient can do — every pound of body weight translates to roughly four pounds of additional pressure on the knee joint during walking, so even modest weight loss can meaningfully reduce pain. Low-impact exercise like swimming, cycling, and walking helps strengthen the muscles supporting the joint without adding stress, and can improve pain and function more than rest does. Physical therapy tailored to your specific joint can also improve strength, flexibility, and biomechanics in ways that reduce daily discomfort.
Medical and minimally invasive options
Beyond lifestyle changes, treatment typically escalates through several tiers. Over-the-counter or prescription anti-inflammatory medications can reduce pain and swelling. Corticosteroid injections deliver targeted relief directly into the joint, though effects are temporary and injections are typically spaced out over time. Hyaluronic acid injections, sometimes called “gel shots,” aim to improve joint lubrication, particularly in the knee. Bracing or supportive devices can also offload pressure from the more affected side of a joint.
When surgery enters the conversation
Joint replacement is generally reserved for cases where conservative treatments no longer provide adequate relief and quality of life is significantly affected — not a first-line response to an arthritis diagnosis. Most orthopedic surgeons will work through the full spectrum of non-surgical options over months or years before recommending replacement, and the decision ultimately comes down to how much the pain and stiffness are limiting your daily life.
If joint pain has been slowing you down, use our directory to find an orthopedic surgeon who specializes in arthritis management and can build a treatment plan around your specific joint and activity goals.