The Best Way to Relieve Knee Arthritis Pain

There’s no shortage of medications that can be used to treat the pain of knee osteoarthritis, so you may feel confused about which treatment option is best for you.

Treatment of knee osteoarthritis can ease symptoms and slow degeneration. Watch: Knee Osteoarthritis Video

A meta-review of studies may shed some light on which oral or injectable medications are the most effective.

See Knee Osteoarthritis Treatment

Researchers compared 137 studies that involved more than 33,000 participants. These studies compared 10 common treatments for knee osteoarthritis, including over-the-counter and prescription non-steroid anti-inflammatory drugs (NSAIDs) and injectable medications.

¹
"Comparative Effectiveness of Pharmacologic Interventions for Knee Osteoarthritis: A Systematic Review and Network Meta-analysis." Ann Intern Med. 2015 Jan 6; 162(1):46-54.

See: Pain Medications for Arthritis Pain Relief

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The results revealed the most and least effective treatments:

• Most effective: corticosteroid and hyaluronic acid injections
• Least effective: acetaminophen

So what does this mean for you? If you have knee osteoarthritis and have not tried corticosteroid or hyaluronic acid injections to relieve your pain, you may want to ask your doctor if it’s right for you.

See Therapeutic Injections for Knee Arthritis

Keep in mind that there are several non-pharmacological treatments that have been shown to help with the pain and mobility difficulties of knee OA, including:

• Knee exercises
• Physical therapy for knee OA
• Heat and ice therapy
• Topical medications
• Weight loss

See How Effective is Weight Loss for Treating Knee Arthritis Pain?

Another point to keep in mind is relieving the pain of a degenerating joint though medication—oral or injectable—does nothing to improve the condition of the joint. In fact, too many cortisone injections can actually harm the joint’s soft tissues, which is why your doctor will restrict how often you can receive them.

See Cortisone Injection Risks and Side Effects

In order to improve the joint’s condition, the best method is to use the window of pain relief provided by medication to get going with a physical therapy or exercise program.

Learn more:

4 Knee Stretches to Reduce Arthritis Pain

Why Do My Knees Pop?

Knee Osteoarthritis Symptoms

Stephanie Burke is the CEO, Co-Founder, and Editor-in-Chief of Veritas Health. She and her brother, Dr. Peter F. Ullrich, started Spine-health in 1999 with the vision of providing people with high-quality health information online.

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Editor’s Top Picks

• 6 Little-Known Remedies for Knee Arthritis Pain

• Topical Pain Relief for Arthritis

• Home Treatments to Decrease Knee Osteoarthritis Symptoms

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• Supplements and Medications for Knee Osteoarthritis Video

6 Little-Known Remedies for Knee Arthritis Pain

The first line of treatments for knee arthritis pain often include physical therapy, periodic rest, and non-steroidal anti-inflammatory medications. In some cases, these first-line treatments do not work, and people must continue to look for ways to reduce their knee pain. Below are 6 lesser known, nonsurgical treatments for arthritis knee pain.

See Knee Osteoarthritis Treatment

1. Switch from the Sidewalk to the Treadmill

Walking or jogging on a sidewalk made of concrete can be hard on the knees. A treadmill has a little more spring and decreases the overall compressive load on the knees. When walking on a treadmill, resist the urge to walk at an incline.

Walking on a groomed earthen trail (such as packed dirt) will have a similar positive effect.

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2. Get Shoe Inserts

When the foot under- or over-pronates, the knee joint can become misaligned. Specifically, the top of the tibia (shin bone) may not line up properly with the bottom of the femur (thigh bone). The misalignment causes friction and puts excess strain on soft tissues. A shoe insert can help correct under- or over-pronation, encouraging proper knee alignment.

A physician or podiatrist can help identify what type of insert is best suited for a person’s body mechanics. In some cases, a custom insert may be ordered.

3. Try Gait Retraining

Gait refers to how a person walks. Some people’s gaits produce poor knee alignment, which can lead to worsening knee arthritis and pain. A doctor or physical therapist can look at a patient’s gait and decide if specific changes to gait could make long-term differences in knee pain and joint degeneration.

A physical therapist can help a person change their gait. Some institutions have gait retraining programs.

Changing gait can be challenging and requires active thinking while walking. However, changes to gait can lead to positive changes to knee alignment, improved function, and possibly reduce pain.
Similarly, making changes to how a person climbs stairs can reduce knee pain.

¹
Yocum D, Weinhandl JT, Fairbrother JT, Zhang S. Wide step width reduces knee abduction moment of obese adults during stair negotiation. J Biomech. 2018 May 15. pii: S0021-9290(18)30350-6. doi: 10.1016/j.jbiomech.2018.05.002. [Epub ahead of print] PubMed PMID: 29776821.

4. Take Vitamin D

Several studies have examined the effects of taking vitamin D supplements on knee osteoarthritis. Results are generally mixed, with some studies suggesting a benefit and others not. More study is needed in this area, but some experts recommend that patients who have both low vitamin D and knee osteoarthritis try taking a supplement.

²
Khalaj N, Abu Osman NA, Mokhtar AH, Mehdikhani M, Wan Abas WA. Effect of exercise and gait retraining on knee adduction moment in people with knee osteoarthritis. Proc Inst Mech Eng H. 2014 Feb;228(2):190-9. doi: 10.1177/0954411914521155. Epub 2014 Jan 23. Review. PubMed PMID: 24458100.

5. Start a Food Journal

Certain foods can cause inflammation in the body. This inflammation can cause pain in the knees or other joints, particularly if there is already arthritis damage. Inflammatory foods can be hard to identify because:

• Which foods cause inflammation varies is individual, meaning it varies from person to person
• Inflammation may not appear for the day or two after eating the food

See An Anti-Inflammatory Diet for Arthritis

Keeping a food journal can help a person identify if specific foods or categories of foods, such as dairy, exacerbate knee pain.

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6. Lose Weight

Truthfully, losing weight is not a little-known remedy for knee pain. Rather, it is a well-known and effective but under-utilized treatment for knee pain. Weight loss takes pressure off the damaged knee joint.

See How Effective is Weight Loss for Treating Knee Arthritis Pain?

Specifically, losing weight reduces friction between the bottom of the femur (thigh bone) and top of the tibia (shin bone), where protective cartilage has been damaged or worn away. Losing weight also puts less strain on the knee’s soft tissues, including ligaments and tendons.

See Tips for Losing Weight to Treat Knee Pain

Patients interested in reducing knee pain through nonsurgical treatments are encouraged to talk to their doctor.

Dr. Lee Kneer is a physiatrist specializing in sports medicine and musculoskeletal injuries. He practices at Emory Orthopaedics & Spine Center and serves as an Assistant Professor of Orthopaedics at Emory University School of Medicine. Dr. Kneer has several years of experience in diagnosing and treating acute injuries.

• 1
  Yocum D, Weinhandl JT, Fairbrother JT, Zhang S. Wide step width reduces knee abduction moment of obese adults during stair negotiation. J Biomech. 2018 May 15. pii: S0021-9290(18)30350-6. doi: 10.1016/j.jbiomech.2018.05.002. [Epub ahead of print] PubMed PMID: 29776821.
• 2
  Khalaj N, Abu Osman NA, Mokhtar AH, Mehdikhani M, Wan Abas WA. Effect of exercise and gait retraining on knee adduction moment in people with knee osteoarthritis. Proc Inst Mech Eng H. 2014 Feb;228(2):190-9. doi: 10.1177/0954411914521155. Epub 2014 Jan 23. Review. PubMed PMID: 24458100.

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Editor’s Top Picks

• An Anti-Inflammatory Diet for Arthritis

• How Effective is Weight Loss for Treating Knee Arthritis Pain?

• Tips for Losing Weight to Treat Knee Pain

• Ways to Get Exercise When You Have Arthritis

• Knee Osteoarthritis Treatment

• Physical Therapy for Knee Osteoarthritis Video

Knee pain – what pharmaceuticals can help?

The knee is a unique mechanism that nature has endowed us with. The knee joint is both simple and complex at the same time, we live with it and, unfortunately, we often notice it only when it starts to hurt. Of all the joints in the body, the knee is at the highest risk of injury, wear and tear, and inflammatory disease.

The structure of the knee joint is not easy – it is a complex of ligaments, muscles, nerves, blood vessels, cartilage and bones. The basis of the joint is 3 bones: the femur (top), tibia (bottom) and the patella, or patella (in front). They are connected to each other by tendons and ligaments, the main task of which is to securely hold the bones and ensure the stability of the knee during any type of movement. The surfaces of the bones inside the joint are covered with cartilage, and all together it is surrounded by the articular bag, the inner shell of which produces synovial fluid into the joint cavity, which includes hyaluronic acid. Synovial fluid is essential for lubricating and nourishing the joint. It is its sufficient presence that ensures the ability of the knee to fully move, without pain and crunch.

The service life of cartilage depends on many factors: a person’s lifestyle, weight, nutrition, past injuries, work, and most often is 40-60 years.

The main symptoms by which you can understand that something is wrong with the knee are: swelling, a change in the temperature of this part of the body, impaired mobility of the joint, and, of course, pain during movement and even at rest.

Pain can be acute or chronic. Acute pain occurs suddenly, causes severe discomfort, accompanied by swelling and difficulty in movement. The most common cause is injury or overexertion.

Chronic pain – can last for a long time, is characterized by an undulating course: periods of inflammation and intensification of symptoms are replaced by remission, when pain in the knee may not remind of itself or manifest itself only as stiffness of movement in the morning. Chronic pain is more insidious. A person gets used to living with them, does not go to the doctor, and at this time the processes of destruction of the joint are hidden.

Why do my knees hurt?

1. Injuries:

• bruises;
• stretching;
• dislocations;
• fractures.

2. Degenerative-dystrophic diseases:

• arthrosis – “drying” and destruction of cartilage. Initially, pain appears, and then the range of motion decreases. The most common joint disease.
• osteochondropathy is a violation of the nutrition of bone tissue, which causes bone destruction.

3. Inflammatory diseases:

• arthritis – inflammation of the joint and periarticular tissue, which leads to joint deformity and cartilage destruction;
• bursitis is an inflammation of the joint capsule, due to which the amount of synovial fluid in it increases and its composition changes;
• tendovaginitis – inflammation of the synovial membranes of the tendon;
• synovitis is an inflammation that affects the synovial membrane of the joints and the sheath of the ligaments, in which excess fluid accumulates in the joint.

How to treat knee pain?

There is no one effective way to solve knee problems. We need a set of measures. Medicines, orthopedic products, physiotherapy exercises and physiotherapy are the main means that help to cope with the disease.

Before you get rid of the pain yourself, it is advisable to be examined by a specialist. The doctor will identify the causes of the disease and prescribe the necessary treatment for you.

Medicines and dietary supplements:

1. Non-steroidal anti-inflammatory drugs (NSAIDs) relieve pain and inflammation of the joint. These are drugs containing diclofenac, meloxicam, ketoprofen, nimesulide and others.

2. Local irritants are topical agents in the form of ointments, gels or rubs that are applied to the skin of a problem joint. They relieve pain and have a pain-relieving effect. Also, due to the medicinal substances contained in their composition (methyl salicylate, allyl isothiocyanate, dimethyl sulfoxide), the capillaries of the skin expand, more oxygen enters the tissues and the removal of toxins is accelerated.

It should be remembered that locally irritating medications are used for chronic pain. With severe swelling and inflammation, you can not use them!

3. Chondroprotectors stimulate the formation of collagen, stop the process of cartilage destruction. They can be used in the form of injections, intramuscular injections and gels. These are drugs based on glucosamine and chondroitin.

4. Synovial fluid prostheses are substances that replace lost synovial fluid. They are administered by a doctor, by injection, directly into the joint bag. The main active ingredients used for these procedures are sodium hyaluronate and collagen.

5. Biologically active additives (BAA) are prescribed as an additional treatment. Most often, they contain plant components and methods of traditional medicine.

Orthopedic products for the knee.

1. The main orthopedic product is a knee brace. It is put on the knee joint and is designed to fix it, stabilize it, unload it and reduce pain when moving. Wearing a knee brace can significantly shorten the period of treatment and recovery of the knee. The range of knee pads is huge! We will talk more about how to choose a knee brace below.

2. In addition to knee pads, it is useful to wear orthopedic insoles, which reduce the shock load on the diseased joint and shorten the period of exacerbation. It is possible to choose insoles taking into account various additional features, such as: for different seasons, in different shoes, and so on. You can read more about insoles in the article.

Therapy.

1. Physiotherapy is a treatment with the help of devices and various procedures: laser therapy, magnetotherapy, current therapy, therapeutic massage, ultrasound, etc. The treatment is aimed at interrupting pain, reducing inflammation and accelerating joint recovery.

2. Exercise therapy (physiotherapy exercises) – special physical exercises during the period of treatment and rehabilitation, the most important task of which is to restore the blood circulation of the joint. And the normalization of blood circulation will restore the nutrition of the joint, eliminate the oxygen deficiency in the tissues of the joint, remove the edema and stabilize the joint.

In order for the pain to decrease already in the first day, you need to fix the joint and thereby remove the load from it when walking. This is what knee pads are for.

The knee brace is an important orthopedic device that shortens the period of treatment and rehabilitation, and may also be needed for permanent wear in case of chronic diseases of the musculoskeletal system. In our pharmacy you will find knee pads of various types, differing both in their functions and in price.

To make a decision: which of the knee pads to buy, you should understand how they differ from each other and what problems they solve.

Material .

Knee pads are made from different materials: natural and synthetic. The main requirement: to fix the joint well, to be wear-resistant, to pass air and moisture.

Classics are woolen and cotton knee pads. Wool has a massage and warming effect, improves blood flow to the joint, thereby reducing knee pain. Cotton “breathes” well and is comfortable when wearing the retainer for a long time.

An alternative to natural fibers is synthetic materials made using modern technologies. They are resistant to wear, hypoallergenic, durable and lightweight.

The most popular polyamide and elastane: provide air and moisture permeability, strength and lightness. Knee pads made of them do not rub in places of bends, do not wrinkle, dry quickly and are not subject to the formation of fungus.

Aeroprene or neoprene: has a pronounced massage and warming effect. And in order to prevent excessive overheating of the joint, they are perforated (with many micro-holes) throughout the surface.

The main difference between different knee pads is in the degree of fixation of the joint and in the design, due to which fixation is ensured.

The main principle of the use of orthopedic products: the more serious the damage, the stronger the fixation.

And we will start with products of easy fixation.

Light hold products.

Made from elastic fabric that helps reduce swelling, massages and reduces pain.

As a rule, this is bandage – an elastic fitting knee bandage. Fits snugly to the leg and distributes the load on the joint, while maintaining full mobility. The degree of fixation of the bandage can be increased with the help of additional tension tapes.

Warming bandage – made of neoprene or knitwear with the addition of natural wool. It has micromassage and warming effects, enhances the effect of ointments, gels and other agents applied to the joint.

Important! Woolen bandages are not used in the acute period after injuries or in the first week of an exacerbation of a chronic disease – heat dilates blood vessels, and with them the focus of inflammation increases.

Medium hold products.

Most of these fasteners are on the market. Also, like bandages, they are made of elastic materials. Often they have inserts: silicone or flexible metal.

Another name for them: Orthosis is a bandage that, due to a more complex design, coordinates the biomechanics of the injured joint. Orthoses differ in their effect on the joint, which is ensured by such structural elements as:

• Suprapatellar ring in the area of ​​the patella. The ring supports the kneecap, reduces swelling or prevents its occurrence.
• Stiffeners and metal plates. Thanks to them, the fixation of the joint will be even stronger. These inserts limit the “reeling” of the joint in a certain plane, prevent pathological movements and prevent the bandage from twisting.
• Detachable design. Facilitates donning, redistributes pressure above and below the knee.
• polycentric hinges. They are used in such a product as a brace. This is an even more complex orthosis that fixes the joint at a certain angle of extension. Adjustment of flexion/extension occurs simultaneously in different planes, which corresponds to the natural physiology of movements.
• Telescopic side rails. Allows you to adjust the height of the product.

Strong hold products.

The main task of such products is to immobilize the joint as much as possible for a certain time, to ensure the conditions of orthopedic rest necessary for treatment. They have powerful stiffening ribs and they are made of dense low-stretch or completely in-stretch fabric, because their main task is to immobilize the knee until it is fully restored. Also in such products there are additional belts for better fixation.
Splint or immobilizing splint – has no amplitude of flexion and extension of the knee joint, and completely limits the movement of the limb. Such devices are used instead of gypsum.

Warning! The degree of fixation of the orthosis on the first day after a severe injury is selected by the doctor.

How to find out the size of the knee brace?

To choose the right size knee brace, you need to follow a simple algorithm of actions:

1. Measure the circumference of the knee joint (at the level of the patella), in a slightly bent position at the knee;
2. Measure the circumference of the leg 5 cm below and 15 cm above the kneecap.

Each manufacturer of goods on our website has its own size chart.

How to wear an orthopedic knee brace?

1. Carefully read the instructions on the packaging to avoid confusion;
2. Put on the orthotic immediately after sleep, before the leg begins to swell;
3. Sit in a comfortable position, bend your leg, and carefully slide the brace onto it so that the kneecap does not move. Tighten the straps starting at the joint;
4. Do not overtighten the leg with the straps. The product should sit tightly, but not to the point of pulsation.

If a knee brace is needed to prevent and relieve pain when moving, then it is better to wear it during activity. In this mode, you can use it for a long time – about 12 hours and periodically remove it.

The orthosis is worn approximately the same way: up to 12-14 hours a day. Unless, of course, the doctor prescribes otherwise.

If this is a splint, then you do not need to remove it – the doctor will determine the period of wearing.

Unfortunately, it is not always possible to prevent knee pain. And sometimes, after treatment, it can resume again and develop into a chronic one. Therefore, always remember about prevention and support measures:

• Move more. Walk, walk, use every opportunity to move! And of course, always warm up before your workout;
• Eat right. If necessary, take vitamins and special food supplements;
• Watch your body weight. Remember that every extra kilogram increases the risk of injuries and diseases of the joints;
• Try to periodically change the position of the body and the load – standing or sitting in one position for a long time does not load the knees correctly and evenly;
• Seek help from experts in a timely manner. Get regular medical check-ups.
• Buy and use in work and sports orthopedic devices that will help protect your joints.

PHARMEKONOM pharmacies have a large selection of knee pads and other orthopedic products. Here you will always be helped with the choice, advise on the selection of the size.

Regularly pay attention to the state of your body and be healthy!

list of top 4 inexpensive and effective products according to KP

A typical “portrait” of a patient with arthrosis is an elderly plump woman. But this does not mean that thin people, men or youth are insured against arthrosis. Arthrosis occurs even in adolescents. It’s just that in older women who are prone to fullness, this disease is much more common.

In any case, arthrosis requires solving several problems at once: relieve pain, strengthen the muscles around the diseased joint, increase its mobility. Therefore, various means are involved in the treatment. Effective pills for arthrosis, as such, do not exist. But there are a number of drugs for the symptomatic treatment of this disease ¹ .

List of top 4 tablets for arthrosis according to KP

Different groups of drugs are used in the treatment of arthrosis: analgesics, non-steroidal inflammatory drugs (NSAIDs), slow-acting disease-modifying drugs (better known as chondroprotectors) ² . They are selected individually, taking into account the stage of the disease, the age of the patient, concomitant diseases and are prescribed by a doctor after examination and analysis. Consider the main drugs.

Important! All drugs have side effects and contraindications. Our material is an overview and does not serve as a guide to action. Before buying drugs, consult your doctor.

Analgesics

Patients with arthrosis (ostearthrosis) may suffer from pain, which impairs joint mobility and, as a result, quality of life. Analgesics such as paracetamol can be used to control pain. It is an analgesic-antipyretic with analgesic and antipyretic effects. It acts on the centers of pain and thermoregulation in the brain and helps to reduce the intensity of pain or eliminate them.

Therapeutic doses are considered to be reasonably safe and generally well tolerated. Paracetamol has few contraindications : idiosyncrasy, severe liver and kidney dysfunction.

Helps to combat arthrosis pain, well studied, they have relatively few contraindications.

Work only with the symptoms of the disease.

Non-steroidal anti-inflammatory drugs

NSAIDs are a large group of drugs with a similar mechanism of action. They block enzymes, under the influence of which an inflammatory reaction is triggered in the body and pain occurs.

Commonly prescribed NSAIDs for osteoarthritis include diclofenac, ibuprofen, ketoprofen, meloxicam, nimesulide, celecoxib. These drugs help fight pain and inflammation and can improve joint mobility, although they do not affect the development of the disease, but are referred to as adjuvant therapy.

Most NSAIDs are not recommended for long-term use due to the risk of side effects, primarily from the gastrointestinal tract and the cardiovascular system.

The most common contraindications to the use of NSAIDs: hypersensitivity, active bleeding (including history), erosive and ulcerative lesions of the gastrointestinal tract, bleeding disorders.

Commonly used remedies for pain and inflammation in arthrosis.

They do not affect the development of the disease, they have quite a few contraindications.

Chondroprotectors

Chondroprotectors are slow-acting drugs, that is, their therapeutic effect appears over time. The group of chondroprotectors includes drugs that maintain the normal state of our cartilage tissue. These are glucosamine, chondroitin and hyaluronic acid.

Upon entering the body, chondroprotectors take part in the synthesis of connective tissue and the formation of a new cartilage matrix, contribute to the production of synovial fluid, which serves as a natural “lubrication” for the joints. In addition, chondroprotectors inhibit the activity of those enzymes that cause cartilage destruction.

With the help of chondroprotectors, it is possible to reduce pain in arthrosis and reduce the amount of painkillers that the patient takes. The advantage of chondroprotectors is good tolerance, so they are suitable for long-term use.

Contraindications : hypersensitivity, childhood and adolescence, severe renal insufficiency, pregnancy and lactation.

Helps maintain normal cartilage and is considered to be well tolerated.

Symptomatic, in some countries they are not included in the protocols for managing patients with osteoarthritis.

Glucocorticosteroid injections

Glucocorticosteroids are synthetic hormonal preparations with potent anti-inflammatory effects. GCS for arthrosis can be prescribed in tablets, as well as in the form of injections into the damaged joint. In this case, the drug enters exactly the focus of inflammation and begins to act more actively. Patients with arthrosis may be prescribed hydrocortisone, betamethasone and other corticosteroids.

Glucocorticosteroids inhibit the development of the inflammatory response and help relieve symptoms such as pain, swelling and limited movement. The effect of injections into the joint can persist for a long time.

Possible contraindications to the use of corticosteroids: hypersensitivity, pregnancy, intra-articular infection, tendency to thrombosis, Itsenko-Cushing’s syndrome.

Like NSAIDs, they inhibit the development of inflammation, they act targeted when injectable.

They are also an element of symptomatic therapy.

How to choose pills for arthrosis

It is not the patient who chooses pills for arthrosis, but the doctor, taking into account concomitant diseases – especially diseases of the cardiovascular system, liver, kidneys, bone marrow. All this is clarified during questioning and examination of the patient, on the basis of laboratory tests.

Important! Non-steroidal anti-inflammatory drugs help relieve pain and create a favorable environment for other treatments. But you can’t take these drugs for too long, so as not to create the illusion that the disease is gone. Under the influence of NSAIDs, not arthrosis goes away, but pain. In addition, long-term use of NSAIDs may cause unwanted side effects.

– Treatment of arthrosis cannot be limited to drug therapy, it must be complex, – says rheumatologist Alexander Elonakov . – It is necessary to identify the factors that led to this disease in order to contain its progression. The goal of therapy is not only to relieve the inflammatory process and pain, but also to maintain muscle strength and motor activity.

Popular questions and answers

Rheumatologist Alexander Elonakov answers popular questions about the treatment of arthrosis.

What tests should be done if the joints hurt?

– CBC, urinalysis, biochemical analysis of several parameters: creatinine, glucose, bilirubin, ALT, AST, gamma-GTP, alkaline phosphatase, total protein, proteinogram, C-reactive protein. This is the minimum laboratory tests that will help assess the condition. Further, according to the indications, other tests are prescribed.

Which doctor treats arthrosis?

— A rheumatologist and an orthopedic traumatologist can prescribe conservative treatment. If surgery is required, the surgeon is involved.

What foods should be removed from the diet for joint pain?

— The most important recommendation is to avoid carbohydrates and fatty foods, which contribute to weight gain and, consequently, stress on the joints.