Study finds knee braces beat drugs for arthritis pain

By Stephen Beech

People with painful arthritis of the knee are best off wearing a brace to ease discomfort, suggests new research.

Knee braces, water therapy, and exercise are the most beneficial non-drug therapies for the debilitating condition that affects millions of older people, say scientists.

Knee osteoarthritis causes pain and stiffening of the knee joint.

Treatment often includes anti-inflammatory drugs, but they can trigger unpleasant gastrointestinal and cardiovascular side effects.

Chinese researchers analysed the findings of more than 130 previous clinical trials of non-drug therapies for treating knee osteoarthritis, involving more than 9,000 people.

These included laser therapy, electrical stimulation, braces, insoles, kinesiology tape, water-based therapy, exercise, and ultrasound.

By combining results from all the studies, the team could rank the therapies based on how well they worked.

Their findings, published in the journal PLOS One, showed that knee braces, water therapy and exercise were the most promising non-drug therapies.

Study leader Professor Yuan Luo said: "Knee braces came out on top across most categories, including reducing pain, improving function, and relieving stiffness.

"Hydrotherapy - exercises or treatments performed in warm water - was particularly effective at easing pain and general exercise was also consistently effective, improving both pain and physical function.

"High-intensity laser therapy and shock wave therapy showed some benefits, while ultrasound consistently scored the lowest in effectiveness."

The researchers cautioned that differences in study design, small sample sizes, and variability in treatment duration between the 139 included studies may limit the precision of the rankings.

But they concluded that physical therapy has "promising" effects for knee osteoarthritis, offering potential treatments without the risks of anti-inflammatory drugs.

Luo, of the First People’s Hospital of Neijiang, said: “Knee braces, hydrotherapy, and exercise are the most effective non-drug therapies for knee osteoarthritis.

"They reduce pain and improve mobility without the gastrointestinal or cardiovascular risks linked to common pain medications.

"Patients and clinicians should prioritise these evidence-based options."

He added: “Our analysis of nearly 10,000 patients reveals that simple, accessible therapies like knee bracing and water-based exercise outperform high-tech options like ultrasound.

"This could reshape clinical guidelines to focus on safer, lower-cost interventions.”