How you can ease the agony of knee pain – and even avoid surgery – with these six simple steps that medical experts say really work

When keen runner Jon Reeves, 54, began struggling to get down the stairs in the morning, he knew his knee pain was more than just sports injuries.

The father of two from Oxfordshire had gone from daily runs and regular badminton matches to strapping up his inflamed joints and dosing himself on painkillers just to get through the day.

In 2020 doctors confirmed the cause: osteoarthritis – the degenerative joint disease that affects about ten million Britons. More than half of cases strike the knee, with 100,000 people a year ending up on the NHS waiting list for joint replacement surgery.

‘Getting the diagnosis was devastating,’ says Jon. ‘I thought it was an old person’s disease and I was worried it would only get worse.’

Initially prescribed anti-inflammatory drugs and exercises that were painful and brought little relief, Jon’s condition worsened until doctors warned him that he would need a double knee replacement. But by combining acupuncture, weight training and a Mediterranean-style diet, he was able to slash his pain level and postpone surgery.

‘I am now managing amazingly – largely pain-free and back to hiking, swimming, cycling and long walks with my dalmatian Oscar,’ he says.

Experts say thousands more like Jon could delay or even avoid surgery with simple lifestyle changes.

 Last week, Mail on Sunday columnist Dr Ellie Cannon wrote she was ‘worried that not enough osteoarthritis patients realise there are steps they can take to avoid knee replacement surgery’. In response she had a flood of letters and emails from readers sharing their own remedies.

One, Bill Ellis, 81, from Suffolk, who suffers from osteoarthritis in his knees, said a combination of supplements ‘has certainly made a difference in reducing my pain’ adding: ‘I also do 20 squats every other morning, not too deep I hasten to add, and it keeps the muscles stronger, which helps.’

Eddie Boyle, 77, from Bedfordshire, swears by capsaicin cream – which contains extracts from chillis – for reducing his pain.

So from diet swaps to supplements that work and exercises to ease the agony, here is the experts’ guide to managing the pain.

1. FOLLOW THE MED DIET 

Hailed as a key to longevity, a Mediterranean diet has also been shown to help reduce the symptoms of arthritis.

The eating style, common in Greece, Italy and Spain, is focused on fresh fruit and vegetables, fish and chicken, whole grains and olive oil, while cutting back on red meat and sweets.

A 2016 study of more than 4,000 people with osteoarthritis in their knees found those who stuck most closely to the diet were significantly less likely to suffer crippling joint pain. They also scored better on overall physical health and showed fewer signs of depression.

Experts say the diet’s anti-inflammatory properties can help soothe swollen joints, while also protecting heart health and supporting weight control – two key risk factors for arthritis.

While the Mediterranean diet won’t ‘cure’ osteoarthritis, scientists suggest it offers a simple, natural way to ease symptoms and improve day-to-day well-being.

‘The Mediterranean diet can be really beneficial for patients,’ says Dr Wendy Holden, medical advisor for Arthritis Action.

‘A diet rich in fruit and veg as well as fish and whole grains, in addition to cutting down on ultra-processed foods, is key to cutting inflammation.’

Protein intake is another crucial part of the puzzle.

‘From the age of 40 our muscle mass declines by 2 to 3 per cent per year, so we need to take in more protein from different sources in our diet – ideally at least 40 grams daily,’ says Dr Lucy Donaldson, Director of Research at Versus Arthritis.

‘This can be a challenge for many of us, but fortunately our research shows that an essential building block for protein called leucine – found in fish, nuts and legumes – is very potent at stimulating muscle protein levels, helping to maintain skeletal muscle.’

Other experts argue that the type of diet matters less than weight loss itself.

‘The real benefit to any diet, in relation to osteoarthritis symptoms, is maintaining a healthy weight,’ says Professor Philip Conaghan, an arthritis specialist at the University of Leeds.

‘This is because it reduces the load on the joints, which in turn eases pain.

‘But excess fat also drives inflammation, which makes symptoms worse.’

Research backs this up. Studies show weight loss reduces levels of inflammatory chemicals released by fat tissue, and can slow cartilage damage even in non-weight-bearing joints such as the hands.

Anecdotally, doctors say patients who shed excess pounds often report less wrist or finger pain – clear evidence the benefits go beyond simply lightening the load on knees and hips.

2. TRY WEIGHT-LOSS JABS

Mounting evidence suggests weight-loss injections may ease the pain of osteoarthritis – and in some cases this may be due to more than just losing excess fat.

For 54-year-old Sian Rios, who suffers from arthritis in her hip, a private prescription for Mounjaro has meant she can finally ditch her walking stick.

Before starting the jabs, the care home manager from Swindon was in such severe pain she was unable to walk more than a few metres. At night the throbbing pain would wake her repeatedly, leaving her exhausted and sleep-deprived.

Four months on, she has shed six stone to weigh just over 17st.

‘I feel like it has given me my life back,’ says Sian. ‘Within weeks of using Mounjaro I was suffering from less pain, but now I very rarely have flare-ups and use pain relief far less often.

‘I have lost a lot of weight since May, but what I have really gained is mobility, confidence and hope. I’ve gone from barely being able to walk to taking strolls around the lake. It’s night and day compared with the start of the year.’

Her hip replacement scheduled for later this year is now on hold thanks to her progress.

Research backs her experience. A 2025 Taiwanese study of nearly 1,000 patients with osteoarthritis in knees found weight-loss injections reduced the risk of needing joint replacement surgery.

‘Preliminary studies have suggested there is a benefit to weight-loss injections beyond just weight reduction,’ adds Dr Holden at Arthritis Action. ‘It appears they can help protect cartilage from wear and tear, slowing the progression of disease. The benefits are increasingly being reported by patients, and we are likely to see greater use of the drugs for arthritis going forwards.’

Currently, however, arthritis is not included in the prescribing guidelines for weight-loss jabs.

3. BUILD STRENGTH FIRST

Experts say the key to managing osteoarthritis pain – and preventing it in the first place – is building strength.

Strictly Come Dancing star Joanne Clifton, 41, who was diagnosed with osteoarthritis in both knees in 2015, is one of those who credits strengthening exercises as preventing her from needing surgery.

Professor Philip Conaghan regularly sees patients aged 40 to 75 with knee, hip or other joint pain, and says muscle weakness is “almost universal”.

His advice is simple: ‘First, get strong, then get fit. Just telling people to walk round the block is a bad starting point – because they are weak, they can’t walk at a brisk pace and they’re not getting any benefit.

‘Once they’ve built some muscle strength, they can start on aerobic fitness, such as on an exercise bike or cross trainer, or swimming. Walking laps in a pool is a fabulous exercise for weak people.’

He warns that difficulty undoing a jar, or struggling to get out of a chair or bath, are red flags – even before joint pain sets in – that muscles are weakening and putting too much strain on joints.

The benefits are clear. A review last year in the Annals of Physical and Rehabilitation Medicine concluded there was ‘overwhelming evidence’ that strength training significantly reduces pain and improves function, performance and quality of life in people with knee and hip osteoarthritis.

Exercise works because joints depend on the network of muscles and tendons around them. Isaac Selby-Burton, a personal trainer who specialises in arthritis coaching, says: ‘It can be hard for people to take that initial step with exercises, because of the pain the condition causes.

‘I recommend starting with resistance bands, focusing on range of motion and muscles like the quads, which are vital for people with knee problems.’

4. USE ACUPUNCTURISTS

Many patients swear by acupuncture to manage osteoarthritis pain, saying it allows them to do the strengthening exercises that bring long-term relief.

The ancient Chinese therapy involves inserting fine needles into specific points in the body, and is said to encourage the release of natural pain-relieving chemicals, improve circulation and reduce stiffness.

The evidence is mixed, but growing. A review in 2025 of 18 studies involving 14,000 people found acupuncture was effective in reducing pain and improving function in osteoarthritis. Other research has shown modest short-term benefits.

‘For many people the pain of osteoarthritis has the greatest impact on their lives,’ says Dr Donaldson at Versus Arthritis. ‘Exercise can have very positive effects on pain but isn’t suitable for everyone.

‘Although National Institute for Health and Care Excellence guidelines do not recommend acupuncture for osteoarthritis, rheumatoid arthritis or other inflammatory forms of arthritis, we know many people living with chronic pain and inflammation use it. Our recent survey on complementary treatments found one in two people who tried acupuncture for arthritis reported some level of pain relief.’

5. USE SUPPLEMENTS THAT WORK

Patients often swear by supplements to help ease arthritis pain – but experts say the evidence is thin.

Among the most popular are turmeric (or sometimes just curcumin, the chemical compound that it contains), glucosamine sulphate (which is produced commercially from shellfish exoskeletons) and chondroitin.

‘There is very little evidence to suggest that these supplements will help relieve osteoarthritis,’ says Dr Wendy Holden, medical advisor for Arthritis Action, who is also honorary consultant rheumatologist at Basingstoke and North Hampshire NHS Foundation trust.

‘The issue is that although the compounds themselves may have some benefit, supplements don’t usually contain enough of the key ingredient to make a real difference.’

The only two supplements with any evidence behind them are cod liver oil and rosehip – though even here, results are mixed.

Cod liver oil is rich in omega-3 oils, which are thought to have anti-inflammatory effects, but trials in osteoarthritis have generally failed to show clear benefit.

Rosehip powder – which is made from the seed pods of a rose bush – has shown more promise, with several small studies and reviews suggesting it can modestly reduce pain and stiffness, though the effects are limited and further research is needed.

6. SPECIALIST BRACES CAN EASE SYMPTOMS 

Specialist knee braces can also help to improve osteoarthritis symptoms.

A 2017 study followed 63 patients awaiting total knee replacement who were fitted with an ‘unloading’ or ‘offloading’ brace.

After eight years, 40 per cent of those who had worn their brace consistently for two years said they no longer needed surgery.

The brace, made of lightweight plastic and fabric, straps around the knee to apply a gentle sideways pull that helps realign the joint. A hinge on the side absorbs some of the downward force, reducing pressure and allowing patients to be more active.

Patients in the trial initially wore the brace almost constantly, before using it selectively for activities needing extra support.

Those who wore it for more than six months were half as likely to require surgery as those who gave up within three months.

The same model – the Unloader One, made by Icelandic company Ossur – has even been worn by TV star Ant McPartlin, 49.

McPartlin revealed he turned to it after his struggle with painkiller addiction following his ‘botched’ knee surgery.