Arthritis Treatment

Arthritis Is Not One Condition

Osteoarthritis is the most common form. It involves gradual loss of cartilage and changes in the underlying bone, most often in the knees, hips, hands, and spine, and it typically causes pain with use that eases with rest, plus short-lived morning stiffness.

Inflammatory arthritis is a different category. Rheumatoid and psoriatic arthritis are immune-driven diseases, and gout is caused by crystal deposition. These can damage joints if left untreated and are managed with entirely different medications, usually with a rheumatologist. Sorting this out early matters far more than any injection decision.

• Which joints are involved, and whether the pattern is symmetric
• How long morning stiffness lasts
• Visible swelling, warmth, or redness
• Prior injury or surgery to the joint
• Any imaging or records you have already had

What the Evidence Supports First

Exercise is the most consistently supported treatment for knee and hip osteoarthritis. The ACR and Arthritis Foundation guideline treats walking, strengthening, neuromuscular training, and aquatic exercise as reasonable options without ranking one above another, and it supports self-management and education programs alongside them; supervised programs tend to do better than unsupervised ones. The practical obstacle is rarely disagreement about this. It is that painful joints make people move less, which weakens the muscles protecting the joint. Part of our job is finding a starting point you can sustain.

Medication has a role too. Topical and oral anti-inflammatories, acetaminophen, and intra-articular corticosteroid injections are standard tools, and each carries trade-offs — gastrointestinal, kidney, blood pressure, and cardiovascular considerations with NSAIDs, and short-term blood sugar effects after steroid injections. Which of these fits you depends on your other conditions and your current prescriptions, so we review both before anything is prescribed. We do not publish dosing instructions for patients to follow on their own.

Weight, Metabolic Health, and Joint Load

Your knees and hips carry your body weight with every step, and excess weight also contributes to the low-grade inflammation that accompanies osteoarthritis. That is why weight management appears as a strong recommendation in the osteoarthritis guidelines rather than as a footnote.

There is newer trial evidence here as well. The STEP 9 trial, published in the New England Journal of Medicine in October 2024, randomized 407 adults with obesity and knee osteoarthritis to once-weekly semaglutide 2.4 mg or placebo for 68 weeks, both alongside a reduced-calorie diet and increased activity. Average WOMAC pain scores improved by 41.7 points with semaglutide versus 27.5 with placebo, and physical function improved more as well. Those are group averages from a controlled trial, not a prediction for any individual, and gastrointestinal side effects were the most common reason participants stopped treatment.

Two points are worth stating plainly, because they are blurred constantly online. Semaglutide is the active ingredient in Ozempic, Wegovy, and Rybelsus; the 2.4 mg dose is approved for chronic weight management, not for arthritis, and compounded semaglutide is not an FDA-approved product. Tirzepatide is the active ingredient in Mounjaro and Zepbound, and there is no FDA-approved generic tirzepatide. Whether any of this is appropriate for you is a physician decision made after evaluation.

Regenerative and Device-Based Therapies: An Honest Look

Platelet-rich plasma is the most studied of these. The RESTORE randomized trial, published in JAMA in 2021, compared intra-articular PRP with saline in mild to moderate knee osteoarthritis and found no significant difference in symptoms or joint structure at 12 months, and the American Academy of Orthopaedic Surgeons does not recommend PRP for knee osteoarthritis. Other trials and meta-analyses have been more favorable, and PRP preparations vary enormously between clinics, which is part of why the literature disagrees with itself.

Stem cell and exosome products deserve a blunter statement. The FDA has not approved any exosome product for any use, has issued warning letters to companies marketing them, and has warned the public about unapproved products derived from human cells and tissue following reports of serious infections.

Acoustic sound wave therapy raises a similar question. At AMI it is used mainly in men's health, and for erectile dysfunction it is not FDA-approved: the American Urological Association guideline describes low-intensity shockwave therapy as investigational, and the quality of the published studies varies widely. If any of these therapies come up during your visit, you will hear the same thing you are reading here.

Who Is a Candidate, and What Your First Visit Looks Like

This program suits adults whose joint pain is interfering with walking, sleep, work, or exercise, who want a structured non-surgical plan and are willing to do the movement and strength work it will include. It is a reasonable place to start for early to moderate osteoarthritis.

It is not the right first stop for everyone. Joints with advanced structural damage, mechanical locking, or instability may need an orthopedic surgical opinion, and we will tell you that and refer rather than delay you. Suspected inflammatory arthritis belongs with a rheumatologist. A hot, swollen, painful joint with fever needs urgent evaluation, not an appointment next week.

Your first visit is a conversation, an examination of the affected joints, a review of any imaging you bring, labs if the history suggests an inflammatory or metabolic cause, and then a written plan with a follow-up date.

• Bring your full medication and supplement list
• Bring prior imaging reports and records of past injections or surgery
• Note what makes the pain better and worse, and what you want to get back to doing

Safety, Monitoring, and How This Fits with Your Other Care at AMI

Ongoing monitoring matters as much as the initial plan. Anti-inflammatory medications are reviewed periodically against your blood pressure, kidney function, and other prescriptions. Steroid injections are spaced deliberately and are not a long-term strategy for most joints. If a weight-management medication is part of your plan, it comes with scheduled check-ins for tolerance and progress. Tell us about every supplement you take, and call us at (404) 264-9553 if a joint suddenly becomes hot or swollen or gives way.

All of this happens at one office, at 5009 Roswell Road NE, Suite 201 in Buckhead; AMI has no other locations. Because joint pain rarely travels alone, your plan may connect with other care provided here by the same physicians.

• Medical weight loss and GLP-1 care: /services/weight-loss-atlanta-ga, /services/semaglutide-program, /services/tirzepatide-program
• Obesity as a driver of joint load: /services/obesity-treatment
• Hormone-related symptoms evaluated alongside your joint care, not as a treatment for arthritis: /services/bioidentical-hormone-replacement-therapy, /services/menopause-treatment
• Broader anti-aging and healthspan care: /services/anti-aging-treatments
• The therapies discussed above, in more detail: /services/stem-cells-exosomes-therapy, /services/acoustic-sound-wave-therapy
• Meet the physicians: /about/dr-leslye-pace, /about/dr-elbridge-bills, /about/dr-jeff-semel