A major new scientific review has found that knee braces are among the most effective ways to alleviate pain and improve mobility for people suffering from osteoarthritis—a degenerative joint disease that affects millions in Thailand and worldwide. The study, which analyzed the results from nearly 10,000 participants across 139 randomized controlled trials, provides a much-needed evidence-based update to common knee pain management practices and offers valuable guidance for the many Thais living with this disabling condition. Despite bracing’s demonstrated benefits, medical experts emphasize that regular exercise and maintaining a healthy weight remain critical for both symptom relief and slowing disease progression.
Knee pain is one of the most common complaints among Thai adults, particularly those over the age of 50. According to the Thai Ministry of Public Health, osteoarthritis—caused by the gradual breakdown of cartilage in the knee joint—accounts for a significant proportion of mobility limitations in the aging populationthainhf.go.th. Traditionally, patients have been prescribed a wide range of treatments, from painkillers and physical therapies to more invasive options like injections and surgery, but confusion persists about which approaches truly work.
The new study, published in the peer-reviewed journal PLOS One and led by a rehabilitation research team in China, sought to cut through this confusion by systematically ranking a dozen commonly recommended treatments for knee osteoarthritis. The results place the humble knee brace firmly at the top: it ranked highest in alleviating pain, stiffness, and improving function among all non-surgical interventions assessed. The braces work by supporting the knee joint and shifting the load away from the most damaged areas, often providing rapid relief. “A knee brace can be very effective in people who have arthritis in certain compartments of the knee because the brace can shift the load to another part of the joint,” explained a Harvard Medical School orthopedic surgeon washingtonpost.com.
However, simply recommending braces is not enough—many patients struggle to wear them consistently due to discomfort, particularly in Thailand’s hot and humid climate. The director of musculoskeletal research at a major US rehabilitation hospital noted: “The challenge is getting patients to actually wear knee braces." For those who find braces intolerable, the study identifies hydrotherapy (or water-based exercises) and land-based physical activity (such as weightlifting and yoga) as the next best options, both of which finished just behind bracing in the rankings.
Thai physiotherapists have long advocated for targeted exercise routines to preserve joint health. Maintaining an active lifestyle and healthy body weight are widely acknowledged as the gold standards in arthritis care. Every extra kilogram of body weight adds roughly four kilograms of pressure to the knee joints with every step, according to biomechanics laboratory experts at Wake Forest University. A leading Thai orthopedic specialist at Siriraj Hospital explained in a recent medical seminar: “People often underestimate the power of simple activities like walking, swimming, or stretching. These can reduce pain, improve mobility, and even stave off surgical intervention for many years.”
The new evidence echoes these observations. Crucially, exercise of any type—when performed regularly—was associated with significant symptom relief, irrespective of style. “It really doesn’t matter what type of exercise you do, just so you’re being active. They all will reduce pain,” noted a US-based arthritis researcher. Existing guidelines from the international Osteoarthritis Research Society also place movement at the forefront of non-drug interventionsOARSI Guidelines.
Beyond braces and exercise, the review compared other popular options such as low-level or high-intensity laser therapy, TENS (electrical nerve stimulation), ultrasound, shortwave diathermy, kinesiology taping, and lateral wedged insoles. Many of these failed to show meaningful effectiveness. Notably, ultrasound therapy—a staple in some private Thai clinics—ranked the lowest across symptoms, while wedged insoles, once believed to offer relief by altering joint mechanics, did not outperform simple neutral insoles in pain reduction.
These findings have far-reaching implications for Thailand. Nationwide, there is widespread use of insoles, taping, and various unproven devices, with urban Thais frequently exposed to aggressive marketing claims. Experts caution patients to be wary of expensive “miracle” gadgets that lack solid scientific backing. A faculty member in the Department of Rehabilitation Medicine at Chulalongkorn University commented: “This type of research helps clarify what is truly worth our healthcare resources, especially as our population ages.”
Painkillers, particularly non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, continue to be used by many patients despite the risks. The US Centers for Disease Control and Prevention (CDC) notes that about 33 million American adults have osteoarthritis; the situation in Thailand, though less formally tracked, is similarly concerningcdc.gov. While NSAIDs can provide temporary relief during acute pain flares, clinicians warn against long-term use due to the risk of gastrointestinal bleeding and kidney damage. “You should not be taking these every day,” advised the director of musculoskeletal research quoted in the Washington Post, and echoed by leading Thai pharmacists.
Surgery, particularly knee replacement, remains the gold standard for those with severe joint damage, but recovery can take up to a year and may not be feasible for all, given the waiting lists in Thai public hospitals and the financial costs in private ones. Emerging treatments such as targeted nerve ablation and blood vessel embolization, which aim to reduce knee pain by blocking pain signals or blood flow, are under investigation, but not yet widely used in Thailand.
One crucial caveat to the new study is the short duration of many analyzed trials—often just 6 to 12 weeks. This means most evidence supports only short-term benefits of bracing and other conservative treatments. The long-term impact remains uncertain, and there is no evidence that these interventions can “reverse” or repair cartilage damage. As a Thai geriatrician at Ramathibodi Hospital notes, “We can support the joint and relieve pain, but regeneration of cartilage remains out of reach with current medical science.”
Importantly, the research underscores that effective management of knee osteoarthritis requires a personalized approach. Two people with identical levels of joint damage on X-ray may report drastically different pain experiences; individual factors such as pain tolerance, activity level, underlying health conditions, and lifestyle all play a role. For Thais, traditional therapies like herbal compresses, massage, and temple-based rehabilitation programs remain popular, often used alongside modern medical approaches. While these traditional modalities may offer comfort and mild relief, independent studies emphasize their limitations compared to structured exercise and bracing.
In rural regions where access to physiotherapists or advanced bracing may be limited, local health volunteers (Aor Sor Mor) play a vital role in educating the elderly community about safe movement strategies and self-management techniques. The integration of these grassroots efforts with evidence-based recommendations represents a promising public health direction.
Looking ahead, experts anticipate that the growing burden of osteoarthritis in Thailand—driven by an aging population, increased obesity, and more sedentary urban lifestyles—will necessitate innovative solutions and more robust long-term research. Investments in public exercise spaces, expansion of affordable physical therapy services, and education campaigns that debunk medical myths could help mitigate this trend. There is also strong potential for local manufacturing of affordable knee braces adapted to the Thai climate, drawing on partnerships between hospitals, universities, and technology firms.
For Thai readers living with knee pain or caring for elders with osteoarthritis, the takeaway is direct: Focus on staying active, maintain a healthy body weight, and consult with a physiotherapist before investing in braces or devices. Knee braces can provide short-term relief and support function, especially in the early to moderate stages of osteoarthritis. However, consistent physical activity—tailored to individual needs and capabilities—remains the single most effective long-term strategy. Where possible, integrate physical activity into daily life: brisk walking in local parks, swimming, gentle Thai stretching exercises, or group dance sessions at community centers. If considering a knee brace, seek professional guidance for proper fitting and usage. And always be wary of unproven “miracle” cures that promise instant results.
For policymakers and healthcare providers, continued efforts are needed to update hospital and community health center practices based on emerging global evidence. Regular training for primary care teams in non-drug pain management, expansion of public rehabilitation services, and improved access to affordable braces and exercise programs could deliver major public health gains.
For more resources, patients can consult the Thai Orthopedic Association or the Ministry of Public Health’s arthritis information site.
Sources: washingtonpost.com | PLOS One | cdc.gov | thainhf.go.th | OARSI Guidelines