No Pills, No Surgery: Scientists Discover Simple Way To Relieve Arthritis Pain

A new study led by researchers at the University of Utah, New York University, and Stanford University shows that gait retraining can reduce pain and slow cartilage damage.

Understanding Osteoarthritis and Its Impact

Almost one in four adults over the age of 40 live with painful osteoarthritis. This condition has become one of the leading causes of disability. Osteoarthritis gradually wears away the cartilage that cushions joints. Currently, there is no way to restore this damage. Treatment typically focuses on pain management with medication, followed eventually by joint replacement.

The Promise of Gait Retraining

Scientists from the University of Utah, New York University, and Stanford University are now pointing to a promising alternative: gait retraining. In a year-long randomized controlled trial, participants who adjusted the angle of their foot while walking reported pain relief comparable to medication. Importantly, these individuals also showed slower cartilage deterioration in their knees compared with those who received a placebo treatment.

These findings come from the first placebo-controlled study to demonstrate the effectiveness of a biomechanical intervention for osteoarthritis. It is well-known that for people with osteoarthritis, higher loads in their knee accelerate progression. Changing the foot angle can reduce knee load. However, the idea of a randomized, placebo-controlled biomechanical intervention is novel.

Tailoring Treatment to Each Patient

Backed by the National Institutes of Health and other federal agencies, the researchers focused on patients with mild-to-moderate osteoarthritis in the medial compartment of the knee (the inner side of the leg), which carries more weight than the lateral (outer compartment). This type of osteoarthritis is the most widespread. The best foot angle to lessen stress on the medial knee varies for each individual, depending on their natural gait and how it shifts when they adopt a new walking style.

Previous trials have prescribed the same intervention to all individuals, resulting in some individuals not reducing, or even increasing, their joint loading. This novel approach used a personalized analysis to select each individual’s new walking pattern. This improved how much individuals could offload their knee and likely contributed to the positive effect on pain and cartilage.

The Protocol for Gait Retraining

Using motion capture cameras, the researchers tracked the degree to which participants walked with their toes pointed inward or outward. Researchers could then calculate the loading in participants’ knees and prescribe the change in foot angle that reduced each individual’s loading. During weekly gait training visits, participants received vibrations on their lower leg after each step, teaching them to walk precisely with their prescribed foot angle.

During their first two sessions, participants underwent a baseline MRI and practiced walking on a pressure-sensitive treadmill while motion-capture cameras tracked their movements. These assessments revealed whether turning the foot inward or outward reduced knee loading more effectively. They also determined whether a 5° or 10° adjustment was most suitable.

This individualized evaluation also excluded participants for whom no foot angle adjustment could reduce knee stress. Including such individuals in earlier studies may explain why those trials produced inconclusive results on pain reduction.

The Importance of Personalized Exercise

As previously posited, personalized, prescribed exercise is always superior. A proprietary approach provides customized guidance, leading to greater efficiency and safety. This approach focuses on individual needs and prevents injury through real-time form correction. It also offers more accountability and flexibility in scheduling, catering to specific goals. This results in quicker, more effective progress and a more enjoyable experience.

Customization & Efficiency

• Tailored to You: A personalized plan is designed specifically for one's fitness level, body type, and unique goals, rather than a generic, one-size-fits-all approach.

• Targeted Results: By eliminating irrelevant exercises and focusing on what is best for the body, individuals achieve their goals more quickly and effectively.

  
  

Individualized Attention

• Real-Time Guidance: Providing undivided, real-time attention ensures correct form and technique to prevent injuries. This is a difficult task in a group setting with many participants.

  
  

Immediate Feedback

• Maximizing Effectiveness: Immediate correction for mistakes maximizes the effectiveness of each exercise and builds a strong fitness foundation.

  
  

Greater Accountability

• Staying Committed: A customized plan provides the motivation and accountability needed to stay committed and on track with fitness aspirations.

  
  

Flexibility and Pace

• Work at Your Own Pace: Individuals can work at their own pace and adjust schedules to fit their lifestyle, which is not possible in a fixed group class timetable.

  
  

Quicker Progress

• Faster Improvements: The combination of proper form, relevant exercises, and focused attention leads to faster and more significant improvements.

  
  

Focus on Your Needs

• Meaningful Experience: A personalized approach removes external distractions and allows individuals to focus on their workout, making it a more meaningful and enjoyable experience.

  
  

Conclusion

The study from the University of Utah, New York University, and Stanford University highlights the potential of gait retraining as an effective intervention for osteoarthritis. By focusing on personalized treatment plans, individuals can experience significant pain relief and slower cartilage deterioration. This approach not only enhances the effectiveness of the intervention but also aligns with the growing recognition of the importance of individualized care in managing chronic conditions.

Reference

“Personalized gait retraining for medial compartment knee osteoarthritis: a randomized controlled trial” by Scott D Uhlrich, Valentina Mazzoli, Amy Silder, Andrea K Finlay, Feliks Kogan, Garry E Gold, Scott L Delp, Gary S Beaupre and Julie A Kolesar, 12 August 2025, The Lancet Rheumatology. DOI: 10.1016/S2665-9913(25)00151-100151-1)