top of page
  • taralmarshall7

Bone On Bone Arthritis - Top 5 tips to find pain relief


So you’ve had x-rays and been told that your arthritis is “bone on bone”…. Now what? Many people are left feeling confused or hopeless after hearing this diagnosis and may have been told that they should no longer participate in the activities that they enjoy. There are many options to find pain relief but first you should understand what the term “bone on bone” means and then you will learn 5 ways you can find pain relief!

What does bone on bone mean?

This can be scary to hear about your joint but it isn’t as scary as it sounds. When your joint is considered bone on bone it simply means that you have decreased cartilage cushioning inside your joints and this can lead to higher levels of bone and joint lining irritation. That bone and joint lining irritation is exacerbated by higher levels of inflammation in your body. However, it is possible to have bone on bone osteoarthritis and not experience high levels of pain or limitation in activities. There are other factors that can contribute to pain other than actual bone pain.

This is good news because pain can be reduced if these other factors are addressed! Inflammation can negatively affect the bone and cartilage repair process and make surrounding tissues hypersensitive. There are many different factors that contribute to increased irritation when it comes to bone on bone pain. Here are a few causes of joint irritation that can be improved upon: 

  • Muscle weakness, leading to decreased support of the joint and more stress going to the bones and tissues

  • High levels of inflammation in your body from weight gain, the foods you eat, lack of sleep, high stress, and more

  • Altered movement patterns that put more stress on one area of the joint

The idea is that once you reduce these causes of irritation, your pain should diminish.  

Here are 5 ways you can reduce pain and inflammation if you have bone on bone arthritis: 

1. Get stronger

This is easier said than done when you are experiencing joint pain. But it is still possible! Strengthening your muscles can help to support your joints immensely.

A study published in 2015 looked at over 2,000 people with knee osteoarthritis. They found that x-ray images of knees did not actually correlate with the severity of knee pain as much as previously thought. What did? Quadriceps (thigh muscle) strength! The less strength the participants had in their quads, the worse their knee pain was. The quadriceps are vital in stabilizing the knee. So, when it is weak the joint has to accept more of the stress. This also can apply to other joints such as the hip and lower back. Without muscle support, there isn’t much to lessen the stress to the joint and the tissues inside of the joint.

Contrary to popular belief, exercise is actually good for your joints and cartilage. The right exercise will not cause more damage! We like to say “Motion is Lotion” because exercise can help keep your joint lubricated. It can also help build strength in the muscles that support the joint. What’s the best way to get stronger? Start finding ways you can move without flaring up your pain. An exercise plan can be hard to start because you may be unsure about which exercises are safe and which to avoid. Consulting with a physical therapist to help identify the right exercises for you is a great first step!

2. Eat to reduce inflammation

What you are putting into your body can dramatically impact the way your joints feel by affecting your levels of inflammation. What you are fueling your body with can help or further irritate your joints. 

What are some foods that have been shown to increase irritation in your joints? 

  • Processed sugars (natural sugars are okay)

  • Gluten and refined carbohydrates 

  • Processed foods 

  • Excessive alcohol

If you are frequently consuming any of the above, try to start making a few substitutes with anti-inflammatory foods. Check our our blog post for more on Anti-Inflammatory Diet.

Protein is also extremely important, especially if you have arthritis. Many people aren’t eating enough protein, especially if they are not eating enough due to lack of appetite or dieting. If you aren’t, it can actually lead to more pain and a harder time losing weight too. 

Instead of focusing on starting a strict diet, we recommend focusing simply on making a couple of healthy additions or substitutions to your day to day such as adding an extra serving of vegetables to each meal. This will make you more likely to be successful than trying to change to a new, strict diet that leaves you feeling deprived.

3. Improve your balance

Balance can become very important with bone on bone arthritis, especially if it is in your lower body. Pain impacts the way your muscles work. It can also delay your balance reactions, leading to a higher risk for falls. If you have osteoporosis, this can also increase your risk for serious injury if a fall were to occur. Improving your balance can actually improve your pain levels too.

4. Compression

Compression can help to provide support and pain relief especially in the knees, ankles, feet, and hands. If you are bone on bone in any of these areas there are specific compression sleeves to help. Compression sleeves can be worn during activity so when walking, running errands, exercising, when working, etc. Compression sleeves are helpful to reduce pain and mitigate swelling during activity. 

5. Be consistent

Consistency is key when it comes to making a change to arthritis pain. Many times, people give up too early - it is important to remember that your bone on bone arthritis did not occur overnight and it takes time putting these tips into practice to see results. Pain management is a long game. It is so important to find an exercise plan that you love as well as anti-inflammatory foods that you can easily add into your diet. Both of these can significantly reduce your bone on bone pain.

The most powerful way to stay consistent is to understand why you are doing something. If you knew that you were making these changes to decrease your pain and continue doing the activities you love (walking, dancing, playing with your grandchildren, or just going up and down the steps) it can be easier to stay consistent. 


Bone on bone arthritis pain does not need to be the end of your active life. You may need to temporarily modify or change some activities but don’t give up hope! There are ways you can reduce irritation in your joints. Please remember your x-rays aren’t everything and likely aren’t telling the whole story.

By building proper strength, balance, and confidence you may find bone on bone pain dictating less and less of what you can do.


If you are dealing with bone on bone arthritis pain, the PTs at Restorative Therapy Co are here to help! Please give us a call at 757-578-2958 to set up an appointment or head on over to our website. There, you will learn more about the team, and services offered as well as a list of insurances we currently accept and cash rates.

Hope to see you soon!

Contributed by Tara Pandiscia, PT, DPT, Geriatric Clinical Specialist

287 views0 comments


bottom of page