Non-Operative Treatment Options

Dr. Tauchen will commonly ask, “What are you hoping to get back to doing?”

The answer is different for everyone. Some patients want to walk comfortably around the neighborhood. Others want to golf, travel, cycle, hike, play pickleball, or simply get through a workday without constantly thinking about their knee. The goal of treatment is not necessarily to eliminate every ache and pain. The goal is to improve quality of life and maintain activity. Fortunately, there are many tools available to help accomplish that.

It may sound counterintuitive, but movement is often one of the best treatments for arthritis. Many patients become less active because of pain, which can lead to muscle weakness, stiffness, reduced balance, and worsening function.

A structured exercise program can help:

• Strengthen the muscles around the knee
• Improve flexibility
• Maintain range of motion
• Improve balance
• Reduce stress on the joint

Physical therapy can be particularly helpful for patients who need guidance on how to exercise safely. Strong muscles help to act like natural shock absorbers for the knee.  Exercise will not reverse arthritis, but it can dramatically improve how the knee functions.

The knee experiences several times a person’s body weight with every step, especially when going up and down stairs. Even modest weight loss can significantly reduce stress across the joint. Patients are often surprised to learn that they do not need to lose 50 pounds to notice improvement. Sometimes relatively small changes can make a meaningful difference. Weight loss is not a cure for arthritis, but it remains one of the most effective ways to reduce joint loading and improve symptoms.

Activity modification does not mean giving up the things you love.  It means finding smarter ways to stay active.

For example:

• Cycling may be better tolerated than running
• Swimming may be easier on the knee than high-impact exercise
• Using a golf cart may extend time on the course
• Shorter, more frequent activities may be better tolerated than long sessions

As a lifelong athlete, Dr. Tauchen understands how important activity is for both physical and mental health.

The goal is usually not to stop moving.  The goal is to keep moving in a way that the knee tolerates.

Anti-inflammatory medications remain one of the most common treatments for knee arthritis.

Examples include:

• Ibuprofen
• Naproxen
• Meloxicam
• Celecoxib
• Diclofenac

These medications help reduce inflammation and may improve comfort during daily activities. Like all medications, they are not appropriate for everyone and should be used thoughtfully. For the right patient, however, they can be very effective.

Tylenol is another option that may help reduce pain, particularly for patients who cannot safely take anti-inflammatory
medications. While it does not reduce inflammation, it can be a useful part of a comprehensive treatment plan. Sometimes the simplest treatments still have value.

For patients with arthritis isolated primarily to one side of the knee, unloading braces may provide meaningful relief. These braces are designed to shift forces away from the damaged compartment of the knee. Not every patient loves wearing a brace. But for some individuals, the improvement can be significant. Think of it as an external tool that helps redistribute stress within the joint.

Corticosteroid injections remain one of the most common treatments for knee arthritis. These injections work by reducing inflammation within the joint.

Benefits may include:

• Reduced pain
• Improved function
• Increased activity tolerance

Relief varies from patient to patient. Some patients experience improvement for several weeks. Others may enjoy several months of relief. One important point Dr. Tauchen discusses with patients is that cortisone treats symptoms—not the underlying arthritis itself.  It does not regrow cartilage.  The arthritis remains present even if the knee feels better.

These injections, sometimes called gel injections, are designed to supplement the natural lubricating fluid within the knee. Results can be somewhat unpredictable. Some patients report significant improvement, while others notice little change. While not a miracle treatment, gel injections remain a reasonable option for selected patients hoping to delay surgery.

One of the newer options available for knee arthritis is Iovera®, a treatment that uses controlled cold therapy to temporarily interrupt pain signals from specific sensory nerves around the knee. Think of it as temporarily turning down the volume on the pain pathway, or using a dimmer switch to decrease the intensity of the pain. The underlying arthritis does not disappear, but the knee may become more comfortable.

Iovera can be particularly useful for:

• Patients hoping to delay surgery
• Patients who are not ideal surgical candidates
• Patients looking for additional pain relief options

Relief is temporary, but some patients experience meaningful improvements in pain and function. Dr. Tauchen does not perform this procedure himself, but he has a fellowship-trained pain management partner to whom he refers patients interested in this option.

Another emerging treatment option is Genicular Artery Embolization, commonly referred to as GAE. Like Iovera, Dr. Tauchen does not perform this himself but likes to make certain patients aware that this may be an option for them.

This minimally invasive procedure is performed by specialized interventional radiologists.

The goal is to reduce abnormal inflammation within the arthritic knee by targeting small blood vessels that contribute to the inflammatory process.

GAE does not reverse arthritis. However, some patients experience significant pain relief and improved function. Dr. Tauchen occasionally discusses GAE with patients who are looking for alternatives to surgery or who may not be ideal candidates for joint replacement.

One of the more unique treatments Dr. Tauchen occasionally recommends is high-power laser therapy, commonly known as red light laser therapy. A local option that many patients prefer is OrthoLazer in Oak Brook, Illinois. Laser therapy is designed to stimulate cellular activity and potentially reduce inflammation and pain.

The scientific literature continues to evolve, and while the data is not as robust as it is for treatments like injections or knee replacement surgery, there is growing interest in this technology.

Dr. Tauchen views laser therapy as one of several emerging options that may be worth considering for selected patients. In particular, he recommends this for post-operative patients as a means of decreasing early inflammation and swelling.
Some patients report meaningful improvement, while others may not notice as much change

Patients frequently ask about:

• Glucosamine
• Chondroitin
• Turmeric
• Fish oil
• Collagen supplements

The scientific evidence is mixed. Some patients swear by them, while others notice no benefit whatsoever. Similarly, treatments such as acupuncture, massage therapy, and other complementary approaches may help certain individuals. While none of these treatment options reverse arthritis, they may play a role in an overall management strategy.

Perhaps the most important thing to understand is that there is no perfect time for knee replacement.

Dr. Tauchen often asks patients:

“Do you have lifestyle-limiting pain on a daily basis?”

If the answer is no, continued non-surgical treatment may make complete sense. If the answer is yes, it may be time to discuss surgical options. The goal is never to rush someone into surgery, but rather to help patients understand their options and make the decision that is right for them.

Whether that means years of successful non-operative management or eventually moving forward with a partial or total knee replacement, the focus remains the same: helping patients stay active, maintain independence, and get back to the activities they enjoy most.