Walking and cycling are good choices. But if land-based exercise is too painful, try an aquatic workout. The buoyancyof water is gentle on joints and may make it easier to work out. Aquatic exercise also provides a small but measurable decrease in pain and disability in people with knee and/or hip OA, according to another Cochrane review, published in 2016. Ask about physical therapy. If pain and swelling make it very challenging to be active or you're unsure which exercises are best for you, see a physical therapist. Glucosamine and chondroitin supplements. There's little evidence that these help knee OA, according to the AAOS guidelines. In addition, supplements aren't regulated by the Food and Drug Administration in the same way that medications are, and you can't be sure that what's on the label is what's in the bottle.

Apply ice or heat.Both can reduce pain; ice can also cut swelling, and heat can ease stiffness. For icing, place a towel or cloth on your skin, then top with a small bag of ice at least once a day for 20 minutes, recommends physical therapist Erica Fritz, P.T., D.P.T., manager of the Orthopedic Physical Therapy Center at the Hospital for Special Surgery in New York City. If your knee feels stiff but isn't swollen, apply a heating pad to the area for 20 minutes twice a day. Place a protective layer, such as a towel, between the heat source and your skin.Consider tai chi, too: A study published in 2016 in the Annals of Internal Medicine found that people with knee OA who practiced this mind-body form of exercise twice a week for 12 weeks reaped pain-relief benefits similar to those of people who did physical therapy twice a week for six weeks . Try some gentle stretches as well, which may ease stiffness and increase the range of motion in your knee joint.

Talk to your doc about a topical. For pain that's tolerable but not fully relieved by heat or ice and gentle activity, consider a topical prescription NSAID before you reach for an over-the-counter oral pain reliever. Why? Oral NSAIDs can cause side effectssuch as gastrointestinal upset and bleeding, and several are associated with an increased risk of cardiovascular events,so it's worth seeing whether you can get sufficient relief without them. Lose weight. If you are overweight or obese, try to lose at least 5 to 10 percent of your body weight. Many studies have found that this can help prevent pain—and some research suggests that each pound of weight lost reduces stress on the knee fourfold with each step taken. Keep up with exercise. Make regular physical activity, including low-impact aerobics and stretching, part of your life on an ongoing basis. (A little exercise can go a long way.) And be sure to include strengthening exercises, which can help stabilize your knee and possibly prevent discomfort, Bedard says. Injections. While injections of corticosteroids may ease inflammation and pain, relief is short-lived, and the therapy can cause side effects, such as bone thinning, tendon weakening, and nerve damage. The May 2018 Journal of the American Academy of Orthopaedic Surgeons study mentioned above reported that injections of hyaluronic acid, which is also sometimes used for knee OA, don't have a significant positive effect on pain and function.Get some low-impact activity. You may not feel much like being active when your knees hurt, but the evidence suggests that it can help. A 2015 review by the independent Cochrane Collaboration found that the short-term pain relief conferred by exercise is comparable to that achieved with use of a nonsteroidal anti-inflammatory drug (or NSAID, such as ibuprofen or naproxen).