A comprehensive review of knee osteoarthritis shows that knee braces are among the most effective non-surgical options for reducing pain and improving mobility. The analysis covered nearly 10,000 participants across 139 randomized trials, offering an evidence-based update for managing knee pain in Thailand and worldwide. While braces provide significant relief, experts emphasize that regular exercise and a healthy weight are essential to slow disease progression and sustain improvements.
Knee pain is a leading concern for Thai adults, especially those over 50. Thailand’s Ministry of Public Health highlights osteoarthritis as a major source of mobility limitations among older populations. Patients traditionally receive a mix of treatments—from medications and physical therapy to injections or surgery—yet questions remain about which methods work best in real life.
The new study, published in PLOS ONE and conducted by a rehabilitation research team, systematically ranked common knee osteoarthritis treatments. Bracing topped the list for pain relief, stiffness reduction, and functional improvement among non-surgical options. By supporting the knee and redistributing load away from damaged areas, braces can offer rapid benefits. A Harvard Medical School orthopedic expert notes that braces can be particularly effective when arthritis affects specific compartments of the knee.
Yet wearing a brace is not always comfortable, especially in Thailand’s heat and humidity. Clinicians acknowledge that adherence is a major barrier. For those who cannot tolerate bracing, hydrotherapy and land-based activities such as weight training and yoga emerged as the next best options, ranking just behind bracing in the review.
Thai physiotherapists have long advocated targeted exercise to protect joint health. Maintaining activity and a healthy weight is widely regarded as the cornerstone of arthritis care. Biomechanics researchers at Wake Forest University estimate that each extra kilogram of body weight adds substantial pressure to the knee with every step. A senior Thai orthopedic specialist at a prominent Bangkok hospital emphasizes that simple activities—walking, swimming, or gentle stretching—can reduce pain, improve mobility, and delay the need for surgery.
The evidence aligns with these views. Regular exercise of any form produced meaningful symptom relief, as long as it is performed consistently. The exact type of exercise is less important than staying active. International guidelines on non-drug interventions for osteoarthritis stress movement and physical activity as central to care.
Besides braces and exercise, the review evaluated treatments like laser therapy, transcutaneous electrical nerve stimulation (TENS), ultrasound, and kinesiology taping. Many of these showed limited effectiveness. Notably, ultrasound therapy—still used in some clinics—ranked lowest for symptom relief, while wedged insoles did not outperform neutral insoles for pain reduction.
For Thailand, the findings have practical implications. Widespread use of insoles, taping, and other devices marketed aggressively should be approached with caution. A rehabilitation medicine expert at a leading university hospital urges scrutiny of claims and careful resource allocation, especially as the population ages.
NSAIDs remain common for short-term relief but carry risks with long-term use. Health authorities caution against daily use due to potential gastrointestinal and kidney harms. Clinicians indicate that safer, longer-term strategies focus on sustained activity and weight management, rather than chronic reliance on medications.
Knee replacement remains the definitive option for advanced cases, though recovery can be lengthy and costly, with access varying across Thailand. Research into targeted nerve blocks and related approaches is ongoing, but these methods are not yet mainstream in Thai care.
The study’s limitations include short trial durations, with most evidence supporting only brief benefits from braces and other conservative measures. There is no proof that these interventions reverse cartilage damage, and long-term outcomes remain uncertain. A geriatrician from a major Bangkok hospital notes that while joint support and pain relief are achievable, cartilage regeneration is not currently within reach.
A personalized approach is crucial. People with similar X-ray damage can experience very different pain levels, shaped by factors like pain tolerance, activity, and overall health. Traditional Thai practices—herbal compresses, massage, and temple-based rehab—continue to be used alongside modern medicine. While these therapies may provide comfort, they should complement—not replace—structured exercise and proper bracing when appropriate.
In rural areas, local health volunteers play a key role in teaching safe movement and self-management to older adults. Integrating these community efforts with evidence-based guidance could strengthen public health outcomes.
Looking ahead, Thailand’s aging population, rising obesity, and more sedentary urban lifestyles point to growing osteoarthritis challenges. Expanding public exercise spaces, increasing access to affordable physical therapy, and promoting evidence-based self-management could help mitigate the trend. The development of affordable knee braces suited to Thailand’s climate—developed through partnerships among hospitals, universities, and industry—offers promising potential.
For individuals living with knee pain or caring for elders with osteoarthritis, the practical takeaway is clear: stay active, manage body weight, and consult a physiotherapist before purchasing braces or devices. Knee braces can provide short-term relief and support, especially in early to mid-stages, but long-term success hinges on consistent activity tailored to ability. Incorporate daily movement—brisk walks in parks, swimming, gentle stretching, or community group fitness—and seek professional guidance for proper fitting and usage when braces are considered. Be cautious of unproven “miracle” solutions.
Policymakers and healthcare providers should integrate evolving global evidence into practice. Enhancing primary care training in non-drug pain management, expanding rehabilitation services, and improving access to affordable braces and structured exercise programs can yield meaningful public health gains.
For further context, Thai readers can consult national orthopedic and health information resources from the Thai Orthopedic Association and the Ministry of Public Health.