Arthritis comes in various forms. However, the most common type is osteoarthritis, a condition caused by wear and tear and inflammation. If you’re unlucky enough to develop osteoarthritis, we need to know how to prevent its progression or mitigate damage. Can osteoarthritis be reversed? 

What is Osteoarthritis?  

Osteoarthritis is a type of arthritis where the cartilage in the joint gradually erodes, leading to bone-on-bone rubbing. This rubbing causes joint pain and swelling.

Generally, osteoarthritis affects the hips, knees, and fingers, although any joint can be affected.

Can Osteoarthritis be Reversed? 

Generally, joint damage can’t be reversed once it occurs. However, the good news is that you can halt the progression through lifestyle factors such as exercise and weight loss. Improvements in your diet can also help.

Recent studies suggest that getting a diagnosis of osteoarthritis does not necessarily mean you’re headed toward a joint replacement. For example, of those who develop knee osteoarthritis, only 30% require a knee replacement in their lifetime. Additionally, gaining weight increases your risk of needing a knee replacement by 25%. Making good choices now reduces your chances of needing future surgery.

Top Tips to Stop the Progression of Osteoarthritis

How do you make good choices to stop the progression of osteoarthritis?

Can osteoarthritis be reversed? Follow these basic guidelines:

Diet

A well-balanced diet that provides sufficient vitamins, minerals, and antioxidants supports joint health.

Recent studies suggest that a diet rich in plant-based foods, including plenty of fruits, vegetables, and legumes, may help reduce pain associated with osteoarthritis. Moreover, other studies suggest that certain nutrients, such as ginger, green tea, turmeric, and pomegranate, protect cartilage from further damage.

Weight loss

Obesity is a leading cause of the progression of osteoarthritis. Weight gain increases your risk of a knee replacement by at least 25%. However, losing even a small amount of weight can significantly reduce pain associated with hip and knee osteoarthritis. Studies suggest that a 5% weight reduction leads to an 18% reduction in pain. Moreover, a 10% weight reduction results in a 50% reduction in pain.

Can osteoarthritis be reversed through exercise therapy? 

squats after myositis ossificans

Generally, we recommend both strength training and aerobic conditioning.  

Symptom improvement results from reduced chronic inflammation, weight loss, and increased muscle strength. Additionally, strengthening the muscles around the knee helps offload the joint and reduce pressure on it. Finally, studies suggest combining gym, Pilates, yoga, and Tai Chi is the most effective for improving pain and function.

Generally, exercise works best for the following:

  • Younger patients, as well as older patients, still benefit.
  • Knee arthritis. There are over 50 high-level studies demonstrating that exercise is an effective way to manage knee arthritis.
  • An exercise program that follows the American College of Sports Medicine guidelines. We combine aerobic, resistance training, and balance exercises with progressive strength training. Generally, the stronger you get, the better. Additionally, a supervised program with a personal trainer is most effective.

Additionally, you may need to modify your existing exercise routine. For example, consider replacing the impact activity with non-impact or low-impact activities such as swimming, cycling, rowing, cross-country skiing, yoga, and Pilates. Additionally, a recent study found that Tai Chi enhances quadriceps strength in older adults.

Braces

Supportive devices can help reduce joint load and enable you to remain active. Examples include knee braces, walkers, and shoe inserts.

A new shoe insert, APOS therapy, has recently received NICE recommendations for the treatment of severe knee arthritis. These shoes have unique rounded pods on the undersurface. We hypothesise that APOS therapy alleviates knee pain by modifying forces at the foot and knee and correcting abnormal walking patterns. NICE highlighted that clinical evidence from a high-quality trial shows improvements in knee pain and function compared to a sham device. The cost of the footwear and associated treatment provided by trained professionals is estimated at £875 per person.

Supplements 

There is increasing evidence that some supplements may improve knee arthritis pain:

Boswellia serrata is an herb derived from the Indian frankincense tree. Boswellic acids inhibit 5-lipoxygenase, an enzyme with anti-inflammatory effects. In some studies, Boswellia serrata has been shown to reduce pain and stiffness associated with knee arthritis. We recommend 100-250mg daily for four weeks.

Curcumin is obtained from the Curcuma longa plant. Curcumin exerts anti-inflammatory effects through multiple pathways, including inhibition of inflammatory mediators such as COX-2. Studies suggest that Curcumin is effective for knee arthritis and should be taken for 12 weeks. 

Medication

Overall, careful use of anti-inflammatory medication can improve symptoms. First, try simple NSAIDS such as ibuprofen. Studies suggest that Voltaren or Acoxyl are the most effective tablets for arthritis. Topical ibuprofen cream is as effective as tablets. A review of topical NSAID creams found that they were effective and safe for treating chronic musculoskeletal conditions for up to two weeks. Other creams, such as lidocaine patches or capsaicin cream, can be effective.

However, you need to be careful with NSAIDs because of potential side effects such as stomach ulcers, high blood pressure, heart disease, or kidney damage. Always consult your doctor to determine if you can use these medications frequently.

Can Osteoarthritis be reversed with Injections? 

Generally, we use injections only as an adjunct to other therapies. We use three different types of injections for Osteoarthritis:

Cortisone 

Corticosteroids are potent anti-inflammatory drugs that reduce inflammation and pain in Osteoarthritis. Overall, studies suggest cortisone has a mild and short-lived effect on Osteoarthritis. However, there are some concerns with cortisone. For example, one study found that frequent cortisone injections for knee arthritis reduced cartilage thickness. Additionally, other studies suggest that receiving a cortisone injection for knee arthritis may accelerate the time to knee joint replacement.

Hyaluronic acid 

Hyaluronic acid is a naturally occurring substance in joints, tendons, and ligaments. Injecting hyaluronic acid into joints reduces inflammation and acts as a lubricant.

Overall, studies indicate a moderate effect of Osteoarthritis on pain that can persist for up to 6 months. However, a particular type of hyaluronic acid with a high molecular weight and cross-linking is more effective for knee arthritis. Specific brands with high molecular weights include Durolane and Synvisc-1. Additionally, there are minimal side effects, aside from occasional allergic reactions. Additionally, recent studies suggest that hyaluronic acid may delay the need for total knee replacement by up to 3 1/2 years. 

Overall, hyaluronic acid is a viable option for managing mild-to-moderate knee arthritis.

Platelet-rich plasma

Platelet-rich plasma (PRP) is increasingly used to treat arthritis and tendonitis.

We obtain PRP from whole blood. Then, we spin the blood to separate the plasma from red and white cells. Plasma contains a high concentration of platelets that are rich in growth factors. Finally, we inject the plasma into the joints.

Overall, 23 studies show a positive effect of PRP on knee osteoarthritis. Furthermore, compared with other injectables, such as hyaluronic acid, PRP has a greater impact. Not all PRP systems are the same. Arthrex ACP Max is a second-generation PRP system that provides a high platelet concentration and dose, meaning you only need one injection. 

Finally, PRP combined with hyaluronic acid yields better results at 1, 6, and 12 months compared to PRP alone.

Arthrosamid injeciton for knee arthritis 

Arthrosamid is a unique hydrogel of water molecules attached to a polyacrylamide backbone. The injectable is non-degradable, meaning the body does not break it down.

It works by coating the synovial lining of the knee joint, reducing inflammation and providing lubrication.

Recent studies have shown improvement in pain scores that lasts for up to 5 years. Additionally, compared with hyaluronic acid, it is more effective in younger, slimmer patients. However, we need more long-term data before recommending Arthrosamid as a first-line injection for knee arthritis. Currently, we recommend Arthrosamid after trying other injectables. 

Can Osteoarthritis be Reversed? Other Frequently Asked Questions

Is glucosamine or chondroitin sulfate helpful for Osteoarthritis? 

Contrary to popular opinion, studies indicate that neither supplement is effective in alleviating osteoarthritis pain.

Do stem cell injections reverse cartilage damage in Osteoarthritis?

No. No evidence that stem cells or other injections reverse cartilage damage. Therefore, it is advisable to exercise caution when sourcing these injections for cartilage reversal. Recent evidence from randomised trials suggests that stem cell injections are no more effective than cortisone injections.

How can I reverse Osteoarthritis naturally? 

Although you cannot reverse the existing damage, you can slow its progression by adopting a healthy lifestyle, such as losing weight, building muscle, and managing sugar and cholesterol levels.

Final Word from Sportdoctorlondon: ‘Can Osteoarthritis be Reversed?’

We can’t reverse osteoarthritis changes. However, by changing your lifestyle and exercising regularly, you can stop the progression of this disease.

Related conditions: