Osteoarthritis is one of the most common causes of long-term joint pain around the world. The condition affects millions of people, especially adults over the age of 40.
It happens when the smooth cartilage that cushions the joints slowly wears away. Without enough healthy cartilage, bones begin rubbing against each other, causing pain, stiffness, swelling, and difficulty moving.
Over time, osteoarthritis can make everyday activities such as walking, climbing stairs, or standing for long periods much harder.
The knees are one of the joints most often affected by osteoarthritis because they carry much of the body’s weight. Many people with knee osteoarthritis experience worsening pain over the years.
Current treatments mainly focus on reducing symptoms instead of repairing the damaged cartilage. Doctors often recommend exercise, weight management, pain medicines such as ibuprofen, physical therapy, or steroid injections. In severe cases, patients may eventually need knee replacement surgery.
Because there is still no cure for osteoarthritis, scientists have been searching for safer and more effective ways to slow the disease and reduce pain before surgery becomes necessary.
Researchers from the University of Utah, New York University, and Stanford University now believe they may have found a surprisingly simple solution: changing the way people walk.
Their new study, published in The Lancet Rheumatology, found that slightly adjusting foot angle while walking can reduce knee pain and even slow damage to cartilage inside the joint. The researchers say this method, known as gait retraining, may become an important new treatment for people with osteoarthritis.
The study was co-led by Dr. Scott Uhlrich from the University of Utah’s College of Engineering. According to the research team, earlier studies had already suggested that pressure inside the knee joint plays a major role in osteoarthritis. When pressure becomes too high, cartilage damage may worsen more quickly.
Scientists also knew that changing foot position during walking could alter the amount of pressure placed on the knee. However, until now, there had not been a large placebo-controlled clinical trial proving that this approach could truly help patients.
The new trial focused on people with mild-to-moderate osteoarthritis affecting the inner part of the knee, called the medial knee compartment. This is the most common area where knee osteoarthritis develops.
One important difference between this study and earlier research was that the treatment was personalized. Previous studies often instructed everyone to walk using the same foot position, such as turning the toes slightly inward or outward. But the new research showed that different people benefit from different walking styles.
To find the best walking adjustment for each participant, the researchers used pressure-sensitive treadmills and motion-capture cameras. These tools allowed the team to study exactly how each person walked and how much pressure was placed on their knees.
The scientists then tested whether turning the toes slightly inward or outward would reduce knee pressure. They also compared small adjustments of about 5 degrees and larger changes of about 10 degrees.
This detailed analysis helped researchers identify which participants were most likely to benefit from gait retraining. It also allowed them to avoid including people whose knee pressure would not improve with a walking adjustment.
The researchers believe this personalized approach may explain why the results were more successful than earlier studies.
A total of 68 participants took part in the year-long clinical trial. The volunteers were randomly divided into two groups. One group received real gait retraining designed to reduce pressure on the knee.
The second group received a placebo-style treatment that matched their normal walking pattern and was not expected to change knee pressure.
For six weeks, participants attended training sessions where they learned their new walking style using wearable biofeedback devices attached to the leg.
These devices helped guide participants so they could practice the correct movement pattern. After the training period ended, participants were encouraged to continue walking this way every day during normal life.
At the end of the year, the participants reported their pain levels and underwent MRI scans to examine the condition of their knee cartilage.
The results were encouraging. People in the gait retraining group reported pain relief similar to what some patients experience with pain medicines such as ibuprofen or even stronger medications.
Even more importantly, MRI scans showed slower cartilage degeneration in the knees of people who changed their walking style. This suggests the treatment may not only reduce pain but also help protect the joint from further damage.
Many participants liked the simplicity of the treatment because it did not involve surgery, drugs, or bulky medical devices. One participant said the new walking style simply became part of daily life and could stay with them permanently.
Dr. Uhlrich explained that gait retraining may be especially valuable for adults in their 30s, 40s, and 50s who are often too young for joint replacement surgery but may still suffer from knee pain for many years. For these people, gait retraining could help fill an important treatment gap.
Although the results are promising, researchers say there is still work to do before this therapy becomes widely available in clinics.
The current technology used in the study, including motion-capture systems and pressure-sensitive treadmills, is expensive and time-consuming. Scientists are now working on simpler and cheaper ways to deliver the treatment.
Future systems may use smartphone cameras, wearable sensors, or “smart shoes” to analyze walking patterns and guide patients at home or in regular clinics. Researchers hope these technologies will make personalized gait retraining easier to access for large numbers of people.
Osteoarthritis affects quality of life for millions of people worldwide, and many patients rely heavily on pain medicines for years. A simple, non-drug treatment that can reduce pain and slow joint damage could become an important new option for patients trying to stay active and avoid surgery for as long as possible.
If you care about pain, please read studies about vitamin K deficiency linked to hip fractures in old people, and these vitamins could help reduce bone fracture risk.
For more information about wellness, please see recent studies that Krill oil could improve muscle health in older people, and eating yogurt linked to lower frailty in older people.
The study was published in the medical journal The Lancet Rheumatology.
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