Arthritis management

Hip and knee arthritis management Gold Coast

Osteoarthritis is the gradual wearing of the smooth cartilage that lets a joint glide. As the cartilage thins, the joint can become painful, stiff and swollen, and the change is usually slow. Most hip and knee arthritis can be managed for years without surgery, and that’s where treatment should start.

Written and reviewed by Dr Jason Tsung, FRACS (Orth) · Last reviewed June 2026

A degenerative meniscus tear is often part of the same wear in the knee, and is usually managed the same way. More on meniscus tears.

Start with your GP

Your GP is the first port of call. They can diagnose arthritis, start treatment, and refer you to a specialist if you need one. First-line care is well established, and for many people it controls the pain well enough that surgery never becomes necessary. It works best as a combination, not any single measure on its own.

Exercise and physiotherapy. Exercise has the strongest evidence of any non-drug treatment for hip and knee arthritis. Strengthening the muscles around the joint, along with aerobic and balance work, reduces pain about as much as anti-inflammatory tablets but without the side effects, and improves how the joint moves.¹ Both land-based and water-based programs help.² A structured course of six to twelve weeks with a physiotherapist or exercise physiologist, such as the GLA:D program available on the Gold Coast, is a good way to start. The benefit depends on keeping it going.

Weight management. If you carry extra weight, losing some takes load off the joint and reliably reduces pain. Every kilogram lost removes roughly four kilograms of force from the knee with each step. Losing around 10% of body weight can cut knee pain by about half, and is linked to a lower chance of needing a joint replacement.³ Your GP, a dietitian or an exercise physiologist can help with a plan, and some of this is subsidised under a chronic disease management plan.

Pain-relief medication. Medication manages symptoms while you keep the exercise and weight work going. For knee arthritis, anti-inflammatory gels rubbed into the joint, such as diclofenac gel, are a sound first choice: about as effective as anti-inflammatory tablets, with far fewer side effects.⁴ They work less well for the hip, which sits too deep for the gel to reach. Anti-inflammatory tablets also help, at the lowest dose for the shortest time, though they carry risks to the stomach, kidneys, heart and blood pressure that your doctor will weigh up.⁵ Paracetamol has only a small effect on arthritis pain and is better as a top-up than a mainstay.⁶ For pain that anti-inflammatories don't control, a specialist may suggest other options, including medication that acts on the pain pathways themselves.⁷

Other measures. Depending on your joint, a brace, a walking stick, supportive footwear, or simple changes to how you go about daily activity can take pressure off the joint and help you keep moving. Your GP or physiotherapist can advise what's worth trying.

Less-invasive options before surgery

When physiotherapy, weight management and simple pain relief stop giving enough relief, there are less-invasive options worth discussing before joint replacement. These are used mainly for knee arthritis. They manage symptoms rather than reversing the arthritis, the evidence behind them varies, and they help some people more than others.

Corticosteroid injection. A corticosteroid (cortisone) injection delivers anti-inflammatory medication straight into the joint to settle pain and swelling. It's the most familiar of the joint injections, and it can help calm a flare or get you through a particular event while other treatments take effect. In placebo-controlled trials it gives clear pain relief in the short term, usually over a few weeks, after which the benefit fades.⁸,⁹ Repeated injections aren't recommended: the relief is short-lived, and frequent use may speed up cartilage wear.¹⁰ It settles the symptoms rather than changing the arthritis. Dr Tsung will advise whether a cortisone injection is worth it in your situation.

Viscosupplement injection (hyaluronic acid). Viscosupplementation injects hyaluronic acid, a substance found naturally in joint fluid, to improve lubrication and reduce pain. Dr Tsung uses a single-dose, high-molecular-weight preparation, given as one injection rather than the three weekly injections that older low-molecular-weight products require.¹¹ In randomised trials, a single high-molecular-weight injection gives modest but worthwhile improvements in pain and function compared with a dummy injection, mostly in early to moderate arthritis.¹²,¹³ Results vary, and not every trial shows a clear benefit,¹⁴ so it helps some people more than others. It's well tolerated, and reactions at the injection site are uncommon.¹²,¹³ Treatment guidelines differ on it: some advise against routine use, while others support it for selected patients.¹⁵,¹⁶ It manages symptoms rather than reversing the arthritis, and the effect isn't permanent. Dr Tsung offers it for selected patients, and will give you a straight view on whether it's worth trying for your knee.

Platelet-rich plasma (PRP) injection. PRP uses a small sample of your own blood, spun to concentrate the platelets, which is then injected into the joint. The concentrated growth factors are intended to reduce inflammation and ease pain. Studies show PRP improves function, and reduces pain over three to six months, compared with a dummy injection, with better results from more concentrated preparations.¹⁷ The evidence isn't settled: a large Australian trial using a lower-concentration preparation found no benefit over placebo.¹⁸ It treats symptoms rather than the arthritis itself, and results vary from person to person. A course is usually two or three injections over a few weeks.

Genicular nerve ablation. This targets the small nerves that carry pain signals from the knee, using heat (radiofrequency) to interrupt them. It's an option for people with moderate to severe knee arthritis whose pain hasn't settled with other treatments, or who aren't suitable for surgery. Of these four options, it has the strongest evidence when tested against a dummy (sham) procedure: trials show meaningful pain relief and improved function for about six months,¹⁹,²⁰ and around half to two-thirds of people keep at least half of their pain relief for six to twelve months.²¹ It treats the pain, not the arthritis, and the nerves can recover over time. Dr Tsung performs this procedure for selected patients.

A note on hip arthritis

For hip arthritis, management centres on the first-line measures above, with joint replacement considered when those stop working. Injection options are more limited for the hip and are discussed case by case.

When surgery becomes an option

If arthritis is advanced and these measures no longer control the pain, joint replacement may be worth considering. It isn't automatic, and the decision is yours. When it's the right step, hip replacement and knee replacement, including partial knee replacement and robotic-assisted options, give most people substantial, lasting relief. Dr Tsung will talk you through whether you're at that point. More on how the decision is made.

What to expect

These treatments manage the symptoms of arthritis. None cures it, the injections carry small risks your specialist will explain, and results vary between individuals.

Common questions

Can hip and knee arthritis be managed without surgery?

For many people, yes. Most hip and knee arthritis can be managed for years without surgery, and that is where treatment should start. The combination with the strongest evidence is exercise and physiotherapy, weight management if you carry extra weight, and simple pain relief such as anti-inflammatory gels for the knee. These work best together rather than as any single measure, and surgery is considered only when they stop giving enough relief.

Do cortisone injections help knee arthritis?

A cortisone injection can settle pain and swelling and help calm a flare. In placebo-controlled trials the relief is clear but short-term, usually over a few weeks, after which it fades. Repeated injections are not recommended, because the relief is short-lived and frequent use may speed up cartilage wear. It settles the symptoms rather than changing the arthritis, and Dr Tsung will advise whether it is worth it in your situation.

Is a viscosupplement or PRP injection worth trying?

Both can give modest, variable relief for knee arthritis, and they manage symptoms rather than reversing it. A single high-molecular-weight viscosupplement injection gives modest improvements in pain and function for some people, mostly in early to moderate arthritis. PRP can improve pain and function over three to six months, though the evidence is not settled and a large Australian trial found no benefit. Results vary from person to person, and Dr Tsung will give you a straight view on whether either is worth trying.

What is genicular nerve ablation?

Genicular nerve ablation uses heat (radiofrequency) to interrupt the small nerves that carry pain signals from the knee. It is an option for moderate to severe knee arthritis when pain has not settled with other treatments, or when surgery is not suitable. Of the injection and ablation options it has the strongest evidence against a sham procedure, with meaningful relief for about six months. It treats the pain rather than the arthritis, and the nerves can recover over time. Dr Tsung performs this for selected patients.

When should I consider a joint replacement?

Joint replacement is worth considering when arthritis is advanced and first-line measures no longer control the pain. It is not automatic, and the decision is yours. When it is the right step, hip and knee replacement gives most people substantial, lasting relief, and Dr Tsung will talk you through whether you are at that point. More on how the decision is made.

Book or refer

To see Dr Tsung you’ll need a referral from your GP or another specialist. Call reception on (07) 5676 9930 to book your first appointment, or email hello@sgco.au. New patients can pre-register online before the visit; the form prepares your records and does not book an appointment. For costs, see fees and health funds.

Call (07) 5676 9930Patient forms

References

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2. Bartels EM, Juhl CB, Christensen R, et al. Aquatic exercise for the treatment of knee and hip osteoarthritis. Cochrane Database of Systematic Reviews. 2016;(3):CD005523.
3. Messier SP, Mihalko SL, Legault C, et al. Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes in overweight and obese adults with knee osteoarthritis: the IDEA randomised clinical trial. JAMA. 2013;310(12):1263–1273.
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