A surprisingly simple way to ease knee arthritis pain without drugs or surgery

NEW YORK, 12 OCTOBER 2026 —

What if easing knee arthritis pain did not require another pill, an injection, or surgery, but simply changing how you walk?

They also showed encouraging signs of slower deterioration in their knee cartilage. The pain relief was comparable in magnitude to benefits reported for some commonly used medications. More importantly, the approach may help address something painkillers cannot: the excessive pressure on knee joints that contributes to osteoarthritis progression. Osteoarthritis affects roughly 22% of adults over age 40 and is one of the leading causes of disability.

The condition gradually damages cartilage, the smooth, protective tissue that cushions the ends of bones and allows joints to move with minimal friction. As cartilage deteriorates, everyday activities such as walking, climbing stairs, and getting out of a chair can become increasingly painful. Although exercise, physical therapy, weight management, and medications can help manage symptoms, there is currently no established treatment that reliably restores cartilage lost to osteoarthritis.

People with advanced disease may eventually need joint replacement surgery. Researchers from the University of Utah, New York University, and Stanford University have investigated a different strategy called gait retraining. Rather than focusing only on relieving pain, this approach changes the mechanics of walking to reduce pressure on vulnerable parts of the knee.

The findings, published in August 2025, came from the first randomized, placebo-controlled clinical trial to demonstrate the effectiveness of personalized gait retraining for knee osteoarthritis over a full year. The research was co-led by Scott Uhlrich, an assistant professor of mechanical engineering at the University of Utah's John and Marcia Price College of Engineering, with collaborators at Stanford and New York University. The work received support from federal research agencies, with the U.S.

Department of Veterans Affairs listed as the trial's funder. "We've known that for people with osteoarthritis, higher loads in their knee accelerate progression, and that changing the foot angle can reduce knee load," said Uhlrich, an assistant professor of mechanical engineering.

"So the idea of a biomechanical intervention is not new, but there have not been randomized, placebo-controlled studies to show that they're effective." The secret lies in how body weight moves through the knee with each step. The knee has an inner section, called the medial compartment, and an outer section, known as the lateral compartment. During normal walking, the inner section typically carries more of the load.

This helps explain why osteoarthritis affecting the inside of the knee is especially common. For people with this type of arthritis, repeatedly placing excessive pressure on the already damaged area can accelerate deterioration. Changing the direction in which the toes point during walking can redistribute some of that pressure. Turning the toes slightly inward or outward alters the forces acting on the knee, potentially reducing stress on the affected cartilage.

However, there is an important catch: the same adjustment does not work for everyone. Some people benefit from turning their toes inward, while others respond better when their toes point farther outward. Making the wrong adjustment could fail to help or even increase pressure on the damaged joint. "Previous trials prescribed the same intervention to all individuals, resulting in some individuals not reducing, or even increasing, their joint loading," Uhlrich said.

"We used a personalized approach to selecting each individual's new walking pattern, which improved how much individuals could offload their knee and likely contributed to the positive effect on pain and cartilage that we saw." The researchers focused on people with mild to moderate osteoarthritis affecting the inner part of the knee.

At their first two laboratory visits, participants underwent MRI scans and walked on a specialized treadmill equipped with sensors that measured the forces generated during each step. Motion capture cameras recorded their movements in detail, allowing the researchers to analyze how different walking styles affected the knee. Participants tested small changes in their foot position, turning their toes inward or outward by either 5° or 10°.

The scientists then identified which adjustment reduced pressure on the affected knee most effectively for each person. Not everyone qualified. Some prospective participants were excluded because none of the tested adjustments successfully reduced their knee loading. Including such individuals in earlier studies may help explain why previous attempts at gait retraining produced inconsistent results. After the initial assessments, 68 participants were randomly divided into two groups of 34.

One group received personalized instructions designed to minimize stress on the inner knee. The other received a sham treatment, meaning they went through the same training process but were instructed to maintain their natural foot angle. This comparison allowed the researchers to separate the benefits of changing walking mechanics from improvements caused by expectations, attention from researchers, or participation in a structured walking program. Both groups attended six weekly training sessions.

During these visits, participants walked on a treadmill while wearing a small device on their shin. The device provided biofeedback, delivering gentle vibrations whenever their foot moved outside the prescribed angle. Biofeedback is a technique that uses immediate signals to help people recognize and gradually control movements they normally perform without thinking. Over time, participants learned to maintain their assigned foot position without needing constant reminders.

After completing the six weeks of supervised training, they were encouraged to practice their walking technique for at least 20 minutes each day until it became a natural habit. Follow-up assessments indicated that participants were remarkably consistent. On average, they maintained their prescribed foot angles to within approximately one degree. That consistency is important because the potential benefits depend on continuing the altered walking pattern during ordinary daily activities, not just during laboratory sessions.

One year after starting the program, participants returned for another MRI and reported how much knee pain they were experiencing.

Related: Scott Uhlrich