A Surprisingly Simple Way To Relieve Knee Arthritis Pain Without Pills Or Surgery

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A randomized, placebo-controlled trial reported that personalized walking retraining was associated with less pain after one year among people with mild to moderate osteoarthritis on the inner side of the knee. The study also found signs consistent with slower cartilage deterioration, but it involved 68 participants and does not establish that the method works for everyone or restores cartilage.

A randomized clinical trial found that people who received personalized training to change their foot angle while walking reported less pain over one year than those who received sham training, according to research published in The Lancet Rheumatology in August 2025. The approach uses gait retraining rather than medication or surgery. The 68 participants were selected in part based on whether a tested foot position reduced loading on the affected knee.

The trial included 68 participants with osteoarthritis in the knee’s medial compartment, the inner portion of the joint. Researchers at the University of Utah, New York University and Stanford University used MRI scans to assess participants, and a sensor-equipped treadmill and motion-capture cameras to analyze their walking mechanics. Participants tried small changes in foot angle: pointing the toes 5 or 10 degrees inward or outward.

Researchers selected the adjustment that reduced loading on each participant’s affected knee. Thirty-four participants received training to use their personalized foot position; another 34 received a sham treatment, going through the training process but being asked to keep their natural foot angle. After one year, the personalized-training group reported significantly less knee pain than the sham group. Average pain improvement was 2.5 points in the intervention group and 1.3 points in the sham group, according to the report. MRI scans also showed signs of slower cartilage degradation, which the report described as encouraging.

Prospective participants were excluded if none of the tested foot positions reduced loading on their knee. The report does not give a numerical size for the cartilage effect or discuss adverse events.

A Mechanical Approach to Knee Pain

Osteoarthritis can make walking, climbing stairs and getting out of a chair increasingly painful as cartilage in a joint wears down. Gait retraining aims to reduce pressure on vulnerable areas of the knee by changing how a person walks. The trial tested a personalized foot-angle adjustment and reported less pain after one year in the intervention group than in the sham group.

The report says there is no established treatment that reliably restores cartilage lost to osteoarthritis. The trial found encouraging signs of slower cartilage deterioration, but it did not report cartilage restoration. The reported pain relief was comparable in magnitude to benefits reported for some commonly used medications; the report does not describe a direct comparison with medication.

The results also show that a generic instruction to turn the toes inward or outward may not suit everyone. Different participants responded to different angles, and some did not qualify because no tested position reduced loading. The method described involved selecting an adjustment for each participant.

How Foot Angle Changes Knee Loading

The knee has an inner, or medial compartment, and an outer, or lateral compartment. During ordinary walking, the inner side typically bears more of the load. Osteoarthritis in that area is common, and repeated stress on an already affected joint may contribute to further damage. The study’s premise was that changing toe direction can shift some of the forces passing through the knee.

Earlier gait-retraining efforts had produced inconsistent results, according to Scott Uhlrich, the University of Utah mechanical engineering professor who co-led the work. The report says prior trials often prescribed the same adjustment to everyone, even though it could reduce loading for some people while having no effect or increasing it for others. This trial used individual measurements to identify a foot position, and excluded people who did not respond to the tested options.

The study compared the tailored intervention with a sham procedure, helping researchers account for factors such as attention from staff, expectations and participation in a structured walking program. The trial was funded by the U.S. Department of Veterans Affairs, according to the report. The supplied source does not provide details about the duration or schedule of the training sessions, beyond noting that the intervention involved a training period.

““We’ve known that for people with osteoarthritis, higher loads in their knee accelerate progression, and that changing the foot angle can reduce knee load.””

— Scott Uhlrich, assistant professor of mechanical engineering at the University of Utah and trial co-leader

Who May Benefit From Retraining

The results do not establish whether gait retraining helps people with advanced osteoarthritis, arthritis in the outer knee compartment, or people whose loading did not improve with the tested foot positions. The group was small, with 68 participants, and the source does not report whether the benefit persists beyond one year or how it compares with other treatments in a direct trial.

The size of the reported cartilage effect, detailed pain measurements and potential harms are also not provided in the source material. It is not clear from the report whether participants could maintain their adjusted walking pattern after training ended, or whether repeated coaching would be needed. The findings should not be taken as proof that changing foot angle independently will reduce pain or slow disease progression.

Further Testing and Clinical Guidance

Further studies would need to test the approach in larger and more varied groups, track outcomes for longer than a year, and report the size of both pain and cartilage changes. Researchers could also compare personalized gait retraining directly with established care and assess how readily people can maintain the new walking pattern in everyday life.

For now, people with knee osteoarthritis should discuss walking changes with a clinician or physical therapist rather than deliberately altering their gait on their own. The trial’s method relied on laboratory measurements to select an adjustment; it did not test a one-size-fits-all instruction. Usual care options, including exercise, physical therapy, weight management and medication, remain relevant, while decisions about treatment depend on an individual’s condition.

Key Questions

What did the knee arthritis trial find?

In a trial of 68 people with mild to moderate osteoarthritis on the inner side of the knee, those given a personalized foot-angle walking adjustment reported less pain after one year than a group given sham training. Researchers also reported signs consistent with slower cartilage deterioration.

Does turning your toes inward or outward work for everyone?

No. Researchers selected different adjustments for different participants, and excluded some people when none of the tested positions reduced knee loading. The results do not support one universal foot angle.

Did the walking method restore damaged cartilage?

No. The report describes encouraging signs of slower deterioration, not cartilage restoration. It does not establish that the method reverses osteoarthritis damage.

Should people try changing their walking pattern on their own?

The trial used laboratory assessments to identify an adjustment, and the same change may not suit everyone. People with knee osteoarthritis should ask a clinician or physical therapist before deliberately changing how they walk.

Source: rss