What helps against osteoarthritis (joint degeneration)?
Supervised exercise therapy and diclofenac gel have the strongest evidence base in osteoarthritis. Paracetamol and opioids work less well than many people think; discuss medication choices with your doctor, especially if you have heart or stomach complaints.
Supervised exercise therapy has the strongest evidence base of all non-surgical treatments for knee and hip osteoarthritis. Its pain-relieving effect is at least as large as that of pain medication, without serious side effects. It requires at least two sessions per week for a minimum of six weeks. Another notable finding: the effect is present even when the degeneration looks severe on an X-ray. In people with excess weight, losing weight amplifies the effect of exercise, particularly in knee osteoarthritis.
For pain medication, a clear hierarchy exists. Diclofenac as a gel or patch applied to the skin is the best first choice for knee osteoarthritis: it works well and has few side effects because very little of it enters the bloodstream. Oral anti-inflammatory drugs (such as diclofenac tablets or etoricoxib) also work well, but are not suitable for long-term use and are discouraged in people with cardiovascular disease or stomach problems. Paracetamol, which many people consider an obvious first step, has not demonstrated a convincing effect in osteoarthritis and is now conditionally advised against by a leading international guideline. Strong painkillers such as opioids are strongly discouraged in osteoarthritis: the risk of side effects is high, and the chance of meaningful pain relief is limited.
Corticosteroid injections into the knee can provide temporary relief in certain situations. They are not recommended for the hip or when multiple joints are affected simultaneously. Cognitive behavioural therapy is listed in European guidelines as one of the most consistently effective additions to exercise. Structured education about osteoarthritis and self-management helps people stay motivated for long-term treatment.
Supplements such as chondroitin show a modest improvement in pain and function compared with a placebo in a large analysis of thirty studies, and are safe. Glucosamine has shown an effect only on stiffness, not on pain. The combination of the two does not perform better than a placebo. Whether they are worth taking is a matter of debate. No agents exist that genuinely stop or reverse osteoarthritis: drugs aiming to do so are being actively researched but have not yet been approved.
This answer is based on multiple international guidelines and a large analysis of thirty randomised studies on supplements, supplemented by a large comparative analysis of pain medication in osteoarthritis and a randomised trial. The recommendations for exercise therapy and topical anti-inflammatory drugs are robust and consistent. For paracetamol and opioids the evidence is also solid, but in a negative direction. For supplements and psychological interventions the evidence is less clear-cut and is based on fewer studies.
How do I keep my joints supple and prevent osteoarthritis?
Exercise and maintaining a healthy weight are the best-supported ways to prevent osteoarthritis and manage symptoms; however, no treatment stops the disease once it has begun.
What actually helps with chronic lower back pain?
Strength and stabilisation exercises have the strongest evidence base for chronic lower back pain. If those do not help enough, pain relievers that also reduce inflammation are the first step. Opioids and surgery can almost always be avoided.
Does collagen help your joints and your skin?
For joint pain due to knee osteoarthritis and for active athletes, collagen is worth trying: 10 grams of collagen peptides per day for 6 months, preferably in combination with exercise. For the skin, 2.5 to 5 grams per day is recommended, but some of the research comes from manufacturers.
Does exercise help with Parkinson's disease?
Exercise demonstrably helps with Parkinson's disease: motor symptoms decrease and quality of life improves. Dance and aquatic exercise have the strongest evidence base; flexibility training offers little benefit. Discuss with your healthcare provider which form best suits your situation.
Can I prevent or slow down early-stage hearing loss?
Noise-induced hearing loss is largely preventable with well-fitting hearing protection. Age-related hearing loss cannot be stopped, but damage from environmental factors can certainly be limited.
How do I keep my eyes healthy and prevent cataracts or macular degeneration?
Green leafy vegetables, oily fish, and quitting smoking offer the strongest protection against macular degeneration. For cataracts in people with diabetes, keeping blood sugar well controlled is the most concrete step you can take.