A surprisingly simple way to relieve knee arthritis pain without pills or surgery
A surprisingly simple change in how you walk could help relieve knee arthritis pain and even slow joint damage. In a year-long clinical trial, researchers found that adjusting the angle of a person's foot while walking reduced osteoarthritis pain by an amount comparable to medication, without requiring drugs or surgery. Even more promising, MRI scans revealed that participants who adopted the personalized walking…
Key points
- A one-year clinical trial found that personalized gait retraining reduced knee arthritis pain more than a placebo and showed signs of slower cartilage deterioration.
- Participants who received the training reported an average pain improvement of 2.5 points on a 10-point scale, compared with 1.3 points in the sham group.
- Researchers say the approach is not yet ready for routine clinical use and requires professional assessment to determine each person's correct foot angle.
A clinical trial published in The Lancet Rheumatology suggests that a small, personalized change to foot angle during walking can ease knee arthritis pain without pills or surgery. The trial, published in August 2025, was co-led by Scott Uhlrich, an assistant professor of mechanical engineering at the University of Utah, with collaborators at Stanford University and New York University.
After one year, participants who learned to walk with a personalized foot position reported significantly less knee pain than those who received a placebo treatment. They also showed encouraging signs of slower deterioration of knee cartilage. The pain relief was comparable in magnitude to benefits reported for some commonly used medications.
How the trial worked
The researchers focused on people with mild to moderate osteoarthritis affecting the inner part of the knee. Participants underwent MRI scans and walked on a specialized treadmill with sensors and motion capture cameras. They tested small changes in foot position, turning their toes inward or outward by either 5 or 10 degrees, and the scientists identified which adjustment reduced pressure on the affected knee most effectively for each person.
After the initial assessments, 68 participants were randomly divided into two groups of 34. One group received personalized instructions designed to minimize stress on the inner knee, while the other received a sham treatment and was instructed to maintain their natural foot angle. Both groups attended six weekly training sessions using biofeedback, then practiced their walking technique for at least 20 minutes each day.
The reported decrease in pain over the placebo group was somewhere between what you'd expect from an over-the-counter medication, like ibuprofen, and a narcotic, like OxyContin.
— Scott Uhlrich
Results and limitations
One year after starting the program, participants in the intervention group reported an average pain improvement of 2.5 points on a scale from zero to 10, compared with 1.3 points in the sham group. In an exploratory analysis, about 91% of participants receiving personalized retraining experienced a clinically meaningful reduction in pain, compared with 66% in the comparison group. One MRI measurement suggested cartilage in the inner knee deteriorated more slowly among participants who changed their walking pattern, while a second measurement showed no significant difference.
The treatment appeared generally well tolerated, with no severe adverse events reported. However, two participants in the intervention group and one in the sham group withdrew because of increased knee pain. The study included only 68 participants, all with mild to moderate osteoarthritis affecting the inner knee, so the findings may not apply to people with advanced arthritis or other patterns of joint damage.
Making treatment more accessible
One major obstacle remains: delivering personalized gait retraining outside a specialized research laboratory. The original trial relied on sophisticated motion capture equipment, pressure-sensitive treadmill measurements, MRI scans, and repeated in-person visits. Uhlrich said he and others have developed technology that could personalize and deliver the intervention in a clinical setting using mobile sensors, like smartphone video and a smart shoe.
A separate randomized trial published in Clinical Biomechanics in April 2026 by researchers at the University of Bath investigated different types of biofeedback training in 50 people with knee osteoarthritis. All three groups, including the control group, experienced improvements in activity-related knee pain and physical function, but only the group receiving feedback about its walking pattern achieved a lasting reduction in a key measure of knee loading. That group's knee loading measure fell by 7.6%, with the improvement maintained at a follow-up assessment one month later.
