Researchers looked at 39 recent studies about treating osteoarthritis (wear-and-tear joint damage) without surgery or heavy medications. They found that exercise works well for knee arthritis, combining diet with exercise helps with weight loss, and digital programs can work as well as in-person therapy. Interestingly, the researchers also noticed that most studies didn’t properly track whether treatments worked differently for men versus women—something that could be important for personalized care. This review gives us a clear picture of which non-drug treatments actually help arthritis patients feel better.

The Quick Take

  • What they studied: Which non-surgical, non-medication treatments work best for osteoarthritis (the wear-and-tear type of joint damage), and whether doctors properly track if treatments work differently for men and women.
  • Who participated: This was a review of 39 high-quality studies published between March 2024 and March 2025. These studies included thousands of arthritis patients across different age groups and joint types (knees, hips, and others).
  • Key finding: Exercise is proven effective for knee arthritis. Combining diet with exercise helps people lose weight. Digital (online) rehabilitation programs work just as well as going to a physical therapist in person. However, most studies didn’t check whether these treatments worked differently for men versus women.
  • What it means for you: If you have knee arthritis, exercise should be your first choice of treatment. If weight loss is a goal, combining diet changes with exercise is more effective than either alone. You can do rehabilitation exercises at home using digital programs if that’s more convenient. However, talk to your doctor about your specific situation, as results vary by person and joint type.

The Research Details

Researchers searched three major medical databases for studies published in the past year about treating osteoarthritis without surgery or medications. They looked for studies that were well-designed and important to the field. Two researchers independently reviewed thousands of study titles and abstracts to decide which ones to include. They ended up with 39 studies that met their quality standards.

The researchers organized these 39 studies into groups based on their treatment type: exercise and diet changes, add-on treatments like electrical stimulation or massage, combination treatments, and others. They carefully read each study and pulled out the key findings, then looked for patterns across all the studies.

This approach is called a ’narrative synthesis,’ which means the researchers read and summarized the studies rather than doing a statistical combination of numbers. This method is useful when studies are too different from each other to combine mathematically.

This type of review is important because it helps doctors and patients understand which treatments actually work, based on the best available evidence. By looking at many studies together, researchers can spot patterns and see which treatments are consistently helpful. This year-in-review approach also catches the newest research, so the information is current.

The researchers only included studies they judged to be moderate-to-high quality, which means they looked for studies with good research designs. Two people independently reviewed the studies to reduce bias. However, this is a narrative review rather than a systematic review with strict statistical rules, so some judgment was involved in deciding which studies to include. The fact that only 39 studies made the final cut from thousands screened shows they were selective about quality.

What the Results Show

Exercise proved to be effective for knee osteoarthritis, helping reduce pain and improve function. However, exercise had mixed results for hip arthritis—it helped some people but not others, suggesting that hip arthritis may need different treatment approaches.

When people combined diet changes with exercise, they lost weight more effectively than with either treatment alone. Interestingly, weight loss didn’t always reduce pain directly, even though losing weight is generally recommended for arthritis.

Digital rehabilitation programs (exercises done at home using apps or videos) worked just as well as going to a physical therapist’s office in person. This is good news for people who can’t easily get to appointments.

Electrical stimulation treatments (like TENS units) and manual therapy (like massage) showed inconsistent results that varied depending on which joint was being treated. Orthoses (special braces or shoe inserts) seemed to help with pain, but the best type varied from person to person.

Mind-body treatments and behavioral therapy didn’t show added benefits beyond standard care. Acupuncture and blood flow restriction training (a special exercise technique) showed promise in single studies, but more research is needed. Treatment packages that combined multiple approaches had varied results—some worked well while others didn’t, suggesting that one-size-fits-all approaches may not be best.

These findings generally align with previous research showing exercise is beneficial for arthritis. The finding that digital programs work as well as in-person therapy is newer and reflects changes in how healthcare is delivered. The mixed results for hip arthritis versus knee arthritis suggest that previous research may have focused too much on knees, and hip arthritis may need more study.

The researchers noted a major limitation: most studies didn’t properly track whether treatments worked differently for men versus women. Only 23 studies even reported sex (biological characteristics), and only 11 reported gender (social identity). This means we don’t know if some treatments might work better for one group than another. Additionally, the studies looked at different types of arthritis treatments in different ways, making it hard to directly compare them. The review only included studies published in the past year, so older important research wasn’t included.

The Bottom Line

If you have knee osteoarthritis, exercise is recommended with high confidence. Combining diet changes with exercise is recommended for weight loss, though it may not directly reduce pain. Digital rehabilitation programs are a good option if you can’t attend in-person therapy (moderate-to-high confidence). Talk to your doctor before starting any new treatment, especially if you have hip arthritis or other joint problems, as results vary by individual.

Anyone with osteoarthritis should care about these findings, especially those with knee arthritis. People looking for non-medication options will find this helpful. Healthcare providers treating arthritis patients should use this information to guide treatment recommendations. However, if you have hip arthritis specifically, results are less clear, so work closely with your doctor. These findings may not apply to other types of arthritis like rheumatoid arthritis.

Most people see some improvement from exercise within 4-6 weeks, though maximum benefits may take 8-12 weeks. Weight loss from combined diet and exercise typically takes 8-12 weeks to show meaningful results. Digital programs show benefits on a similar timeline to in-person therapy. Individual results vary, so patience and consistency are important.

Want to Apply This Research?

  • Track weekly exercise sessions (type, duration, and intensity) and pain levels before and after exercise on a 0-10 scale. Also track weekly weight if weight loss is a goal. This data helps identify which exercises work best for your specific situation.
  • Use the app to schedule regular exercise sessions (aim for at least 3 times per week based on research), set reminders for diet-related goals if pursuing weight loss, and log pain levels to see patterns. If using digital rehabilitation programs, track completion of prescribed exercises and note any changes in joint function or pain.
  • Review your exercise and pain data monthly to see if your current routine is working. If pain isn’t improving after 6-8 weeks of consistent exercise, talk to your doctor about adjusting your program. Track whether digital programs are as effective as in-person therapy would be for you by comparing your progress over 12 weeks.

This review summarizes research on arthritis treatments but is not medical advice. Osteoarthritis affects different people differently, and what works for one person may not work for another. Before starting any new exercise program, diet change, or treatment for arthritis, consult with your doctor or physical therapist. This is especially important if you have other health conditions, take medications, or have hip arthritis, where results are less clear. The research reviewed does not include information about how treatments may differ between men and women, so discuss with your healthcare provider whether any findings apply to your specific situation.