Nov. 19, 2025 — If knee arthritis were a growth stock, you’d want to own a few shares.
Fifty percent of adults in the U.S. will develop knee osteoarthritis, which happens when the cartilage in the joint wears away and the bones rub more closely against one another. Once you have it, you can expect to live with it for 26 years, on average.
While the damage can’t be reversed, new research offers promising ways to mitigate the pain and perhaps even slow the disease’s progress by targeting what drives it — things like body weight and mechanical load.
Three recent studies exemplify the trend.
1. Consider Weight Loss Drugs
Excess body weight has long been linked with increased knee arthritis risk. People with obesity have higher rates of knee arthritis, get diagnosed younger, and experience more pain and physical limitations.
“Just telling people ‘go lose weight’ is not going to work,” said Elena Losina, PhD, a biostatistician and professor of orthopedic surgery at Harvard Medical School.
In a recent study, Losina’s research team created a model to project the cost effectiveness of five weight loss treatments for people with both obesity and knee arthritis:
- Diet and exercise
- Tirzepatide (Mounjaro, Zepbound), a type of weight loss drug called a GLP-1 agonist
- Semaglutide (Ozempic, Wegovy), another GLP-1 medication
- Gastric sleeve surgery
- Gastric bypass surgery
The model, which was based on a method called a Monte Carlo simulation, weighed each treatment’s price tag against its projected long-term impact on quality of life. For example, the more weight someone loses, the more pain relief they should experience, along with fewer movement limitations and a lower risk of health problems like type 2 diabetes and heart disease.
The study found that tirzepatide gave people more years of healthier life than semaglutide, diet and exercise alone, or the “usual care” for obesity and arthritis (which may mean no treatment beyond monitoring symptoms). Semaglutide could still be cost-effective for some patients, the study found, but tirzepatide was rated as the best nonsurgical option overall.
For people with a BMI of 35 or above, gastric bypass surgery scored highest. It produced the best results and cost less over a person’s lifetime than either of the medications, partly because surgery is a one-time cost rather than an ongoing expense.
“Bariatric surgery has very high efficacy in terms of weight loss for a very long time,” Losina said. But it’s a drastic procedure, with all the risks that entails. That’s why most people who have the choice opt for medication over surgery.
Since the study came out, the U.S. government announced an initiative to reduce the cost of GLP-1 medications — “an exciting development,” Losina said.
Still, exercise remains the cheapest treatment option, and a second new study may help make it less painful.
2. Change the Way You Walk
Exercise is the most commonly recommended treatment for knee arthritis, and walking is the most commonly recommended type of exercise.
But the repetitive stress of walking — never mind running, basketball, or tennis — can sometimes worsen knee pain.
Arthritis typically begins in the medial compartment of the knee — the part closest to the other knee.
Medial arthritis is three times more common than lateral arthritis, on the outer part of the knee. That’s because, when you walk, 70% of the compressive force lands on the medial compartment.
The way you walk can make the problem worse by shifting even more of that stress to the inside of the knee.
But a recent experiment from researchers at Stanford and the University of Utah showed that gait changes could help patients with medial compartment arthritis shift some of that force to the outside of the knee, reducing pain and making exercise a more viable option.
Participants took a gait retraining program where they learned to turn their toe in or out when landing and pushing off, whichever put less pressure on the medial compartment.
Most of them (82%) were trained to turn their toes in slightly — by 5 or 10 degrees — when they walked. The rest were trained to turn their toes out.
After six weeks, all of them reported mild to moderate reductions in walking-related pain. After a year of maintaining the modified gait, their pain had improved even more.
The Stanford protocol relies on experts and special equipment, so it can’t be replicated at home. But you can talk to your health care provider about making small changes to the way you walk. A physical therapist may be able to assess your gait to reduce pressure on your knee.
Fortunately, there is an exercise program that requires only internet access and a little floor space.
3. Try a Free Tai Chi Program
Physical therapist Kim Bennell, PhD, has been studying musculoskeletal injuries for three decades.
In recent years, she and her research team at the University of Melbourne in Australia have increasingly focused on exercise, as it’s the most effective nonpharmaceutical, nonsurgical arthritis treatment.
One continual challenge: too many barriers to exercise for the people they were trying to help.
Some live in remote areas without access to facilities or coaching. And some who live in cities and suburbs either don’t have transportation, aren’t mobile enough to get to a facility, or can’t afford to join a gym or pay a trainer.
“So we decided to design and test unsupervised programs that we could offer free,” said Bennell, a professor at the university’s Centre for Health, Exercise, and Sports.
Her team’s most recent study featured an online tai chi program designed for adults with knee arthritis. Participants were given access to a series of 45-minute tai chi videos, led by one of the study’s co-authors, and instructed to do three 45-minute sessions per week.
After 12 weeks, 73% of the participants reported a clinically meaningful reduction in knee pain while walking, along with improvements in physical and mental well-being.
This is the third online exercise program Bennell’s team has created for knee arthritis patients. The first was a six-month strength program, published in 2021. That was followed by a three-month yoga program in 2022.
All three are free to access for anyone who wants to try them. So far, Bennell said, they’ve had 60,000 users from 120 countries.
“The tai chi program seemed to give better results for pain, compared with the yoga program,” Bennell said. Research shows tai chi can improve strength, mobility, balance, and endurance, which may lead to more controlled movement patterns, with better joint stability. The strength program was similar to tai chi in terms of pain reduction.
Arguably the most important factor for the program’s success: “Participants did report high satisfaction with all three programs and were highly likely to recommend them to others,” Bennell said.
