How to diagnose and
treat osteoarthritis

How do clinicians diagnose osteoarthritis?

Most of the time, osteoarthritis is diagnosed based on your story and a simple joint exam, not a long list of tests.¹

A clinician will usually start by asking questions like:

• Where does it hurt, and what does it stop you from doing?
• Is the pain worse with walking, stairs, gripping, or getting up from a chair?
• Do you feel stiff after resting, and does it ease within about 30 minutes?
• Have you had a past injury or surgery in that joint?
• Are there “flare-ups” where symptoms temporarily get worse?

Then they will examine the joint. They may check:

• How far the joint moves, and whether certain movements trigger pain¹
• Tender areas, swelling, or warmth (warmth can suggest a different cause)¹
• Strength and how you walk, climb steps, or use your hand, depending on the joint¹

Do I need an X-ray or MRI? Often, no. Imaging is not routinely needed when symptoms and the exam fit osteoarthritis.¹ X-rays can show typical joint changes, but scan findings do not always match pain levels.¹ Magnetic resonance imaging is usually saved for situations where your symptoms are unusual, severe, or a different condition is suspected.¹

When clinicians may look for something else. They may order tests or refer you urgently if there are signs like fever with a hot, swollen joint, sudden inability to bear weight after injury, or other symptoms that do not fit typical osteoarthritis.¹

Clinical insight

Many guidelines recommend diagnosing osteoarthritis mainly from symptoms and an exam, and using imaging only when it will change the plan.¹ This matters because treating what you can control, like strength, confidence in movement, and daily activity habits, often helps more than chasing “perfect” scan results.¹

What are the treatment options for osteoarthritis?

Osteoarthritis care is usually step-by-step, starting with the lowest-risk options that help you move and function better¹. For many people, the foundation is education plus an exercise plan, and other treatments are added only if needed.^1-3

1. Education and activity

Learning how osteoarthritis behaves can reduce fear and help you stay active safely.¹ Many care plans include pacing strategies, gentle progression, and planning for flare-ups, rather than stopping activity entirely.^{1 3}

2. Exercise-based rehabilitation

Exercise is recommended as first-line care for osteoarthritis because it can improve pain and function.^1-4 Programs often include:

• Strengthening for the muscles around the painful joint^2-4
• Aerobic activity (like walking, cycling, swimming) to support stamina and overall health^{3 4}
• Mobility and balance work to help you move more smoothly and feel steadier^{2 3}

Benefits vary from person to person, and keeping some form of exercise going long-term helps the benefits last.^{3 4}

3. Weight management (when relevant)

If someone has osteoarthritis and higher body weight, weight loss can reduce pain and improve function, especially for knee and hip osteoarthritis.³

4. Medications

Medications are typically used to make daily movement easier, so you can stay active and participate in exercise therapy.^1-3

Common options include:

• Topical anti-inflammatory gels or creams (applied to the skin over the joint), often recommended first because they can help pain with fewer whole-body side effects than oral options.^{1 5}
• Oral anti-inflammatory medicines, sometimes used when topical options are not enough, but clinicians usually weigh risks like stomach, kidney, and heart side effects.^{1 2}

Some medicines are generally discouraged for routine, long-term osteoarthritis use in many guidelines, because benefits may be small or risks can be higher than expected.^{1 2}

5. Injections (if used)

For knee osteoarthritis, corticosteroid injections can provide short-term pain relief for some people.⁶ They are usually considered a temporary tool, often to help someone get through a flare-up and keep moving^{1 6}. Hyaluronic acid injections have shown very small average pain benefit in large evidence reviews, and some guidelines discourage routine use.⁷

6. Surgery (when clinically relevant)

Joint replacement can be an option when pain and loss of function remain severe despite well-used non-surgical care.¹ Arthroscopy (“clean-out” surgery using small holes and a camera) is generally not recommended for degenerative knee osteoarthritis in most people, because it does not usually beat non-surgical care for pain and function.⁸

After joint replacement, rehabilitation is still important. A pilot study involving people having hip replacement for hip osteoarthritis found a home-based digital rehabilitation approach was feasible, with meaningful improvements in mobility and patient-reported outcomes.¹⁰

Sword's approach

Sword Health helps people manage pain and movement issues with expert-guided AI care you can use from home. Our model combines clinical support with modern technology, designed to work around your life.

Sword makes recovery easier and more accessible. You get high-quality care at home, guided by clinicians and supported by smart technology.

• Care that adapts to your progress in real time
• Licensed experts guiding every step
• Simple, non-invasive, evidence-based programs
• Proven results for pain relief, movement, and satisfaction

How can I find pain relief for osteoarthritis?

These options are low-risk and commonly recommended as part of osteoarthritis self-management:^1-3

• Keep joints moving daily, even on sore days. Short, frequent movement breaks are often better than long periods of rest.^{1 3}
• Use pacing: do a little, rest, then do a little more, instead of pushing until pain spikes.¹
• Try heat or cold: heat can help stiffness, and cold can help after activity when a joint feels irritated.¹
• Choose joint-friendly activity: walking, cycling, or water exercise can build fitness without heavy joint impact for many people.^{3 4}
• Expect flare-ups, and plan for them: a flare does not always mean damage, it often means the joint is irritated and needs a short-term change in load while you keep moving in tolerable ways.^{1 3}

If pain, swelling, or function limits are not improving, or if symptoms change suddenly, it is a good idea to check in with a clinician to make sure nothing else is going on.¹