Tag Archive for: knee arthritis

Why Your Knee Still Hurts – And What Actually Helps It Heal

March 9, 2026/in Movement/by Carrie Jose

Advice From a Knee Pain Specialist in Portsmouth, NH

Knee pain has an annoying way of sneaking into everyday life. At first, it might just feel a little stiff when you stand up from a chair. Then you start noticing it when walking down stairs or getting in and out of the car. Before long, you realize you’re avoiding things you used to enjoy – long walks, hiking, exercise classes, or even playing with your kids or grandkids.

For many adults over 40 in the Seacoast area, knee pain becomes something they simply learn to live with. And when they finally decide to seek help, they are often given a familiar set of options: rest, pain medication, cortisone injections, or eventually surgery.

Sometimes the advice is even worse.

A woman I recently spoke with was told: “Just look it up online – there are exercises you can do on your own for this.”

Yes – I was horrified.

But here’s what many people in and around Portsmouth don’t realize: most knee pain is far more treatable than people think, and in many cases it can improve naturally. That means you may not need medication, injections, or invasive procedures.

But first, you have to understand what is actually causing your pain.

Most Knee Pain Isn’t What You Think

When people experience persistent knee pain, the first instinct is often to look for structural damage. X-rays and MRIs frequently reveal things like arthritis, meniscus tears, or cartilage degeneration.

Those findings can sound alarming.

But research has consistently shown something surprising – many people with these exact findings have no knee pain at all.

In fact, studies have found that more than half of adults over 50 show signs of meniscus tears or arthritis on imaging even when their knees feel perfectly fine.

This tells us something important.

What shows up on imaging is not always the true cause of pain.

In many cases – nearly 80 percent – knee pain is actually mechanical. This means it is related to how the body moves and distributes force through the joints rather than damage to the structures themselves.

Small issues in movement patterns, muscle strength, flexibility, or joint mobility can place excessive stress on the knee. Over time, that stress leads to irritation, inflammation, and pain.

The encouraging part is that mechanical knee pain is highly treatable once it is identified.

Why Quick Fixes Often Fall Short

Because knee pain can be frustrating and limiting, many people look for fast relief.

Cortisone injections are one of the most common treatments recommended for knee pain. They work by reducing inflammation in the joint, which can temporarily decrease pain.

But cortisone injections come with an important limitation – they do not address the root cause of the problem.

Instead, they simply quiet the symptoms.

This can create a situation where the underlying issue continues to worsen while the pain is temporarily masked. Some people then end up receiving repeated injections over time and eventually undergo total knee replacement due to progressive joint damage.

Research has also shown that repeated cortisone injections may accelerate joint deterioration and contribute to cartilage breakdown over time.

Even more important, cortisone suppresses the body’s natural inflammatory response, which plays a critical role in tissue repair and healing.

In other words, cortisone shots may reduce symptoms in the short term, but they can interfere with your body’s ability to truly recover.

What Actually Helps Knee Pain Heal

The good news is that the body is remarkably capable of healing and adapting when given the right environment.

Instead of masking pain, the goal should be to restore proper movement and support the tissues around the knee so they can function the way they were designed to.

Strengthening the Muscles That Support the Knee

Your knee does not operate in isolation. The muscles of your hips, glutes, and core play a major role in controlling how force moves through your leg.

When these muscles are weak or poorly coordinated, the knee often ends up absorbing more stress than it should.

Strengthening these supporting muscles can significantly reduce pressure on the knee joint and improve stability during walking, climbing stairs, and exercise.

Improving Mobility and Flexibility

Mobility is equally important for healthy knees.

Tight muscles and stiff joints can change the way your body moves. When the hips, hamstrings, or quadriceps lack flexibility, the knee often compensates by taking on additional strain.

Improving mobility throughout the lower body helps distribute forces more evenly and allows the knee to move more efficiently.

Continuing to Move

One of the biggest misconceptions about knee pain is that rest is the best solution.

In reality, too much rest often makes knee pain worse.

Movement helps circulate nutrients through the joint, lubricate cartilage, and maintain strength in surrounding muscles. Low-impact activities such as walking, cycling, swimming, and Pilates can help support joint health without overloading the knee.

Treatments That Support Natural Healing

In some cases, additional treatments can stimulate the body’s natural healing response.

Technologies such as regenerative shockwave therapy and electromagnetic transduction therapy (EMTT) are designed to increase blood flow, stimulate cellular repair, and reduce inflammation without medications or injections.

These treatments work with the body’s natural healing processes rather than suppressing them.

A Different Way to Think About Knee Pain

One of the most important mindset shifts people can make is moving away from the idea that knee pain is simply the result of “wear and tear” that must inevitably worsen with age.

Our bodies are far more adaptable than that.

With the right combination of movement, strength, mobility, and professional guidance, many people can reduce pain, restore function, and return to the activities they love without injections, medications, or surgery.

The knee is a remarkably resilient joint when it is supported properly.

And for many people, the path back to healthy knees begins with restoring the way the body moves.

Dr. Carrie Jose is a Physical Therapy Specialist and Mechanical Knee Pain expert and owner of CJ Physical Therapy & Pilates. She helps active adults across the Seacoast stay mobile, avoid unnecessary surgery, and get back to the activities they love.

For a free copy of her Guide to Knee Pain or information about an upcoming Knee Pain Masterclass, visit cjphysicaltherapy.com or call 603-380-7902.

Before You Consider Knee Surgery: Read This

March 6, 2026/in Movement/by Carrie Jose

Before You Consider Knee Surgery – Read This

Arthroscopic knee surgery is one of the most commonly performed orthopedic procedures in the United States, and total knee replacement isn’t far behind. Both procedures are frequently recommended for people suffering from knee pain, especially when imaging shows arthritis, meniscus tears, or other degenerative changes inside the joint.

But here’s what many people don’t realize – the presence of those findings doesn’t automatically mean surgery is necessary. In fact, research over the past two decades has repeatedly shown that many knee surgeries are performed on people who could have improved with conservative treatment like physical therapy and movement-based care.

For people dealing with chronic knee pain in Portsmouth, NH and throughout the Seacoast, understanding your options before committing to surgery is critical.

The Truth About Arthroscopic Knee Surgery

Let’s start with arthroscopic knee surgery.

Arthroscopy is considered minimally invasive. A small camera is inserted into the joint and the surgeon may trim damaged meniscus tissue or “clean up” arthritic debris. Because the incisions are small and recovery is relatively quick, it’s often presented as a simple solution for knee pain.

But research tells a more complicated story.

A landmark study published in the New England Journal of Medicine by Dr. JB Moseley and colleagues compared arthroscopic surgery to placebo surgery in patients with advanced knee arthritis. Some patients received the full procedure – while others only received small incisions without any surgical repair.

The results were surprising. Patients who received the placebo surgery improved just as much as those who had the real operation.

Since that study, numerous others have confirmed similar findings, suggesting that for many cases of degenerative knee pain and arthritis, arthroscopic surgery provides little additional benefit over conservative care like targeted physical therapy, strengthening, and mobility work.

That doesn’t mean arthroscopic surgery never helps. It simply means it’s often used in situations where other treatments could be just as effective.

In some cases, undergoing surgery when it isn’t truly necessary can even accelerate problems inside the knee joint – increasing your likelihood of needing a total knee replacement later on. Ironically, many people choose arthroscopic surgery in hopes of avoiding that major procedure down the road.

When Is Total Knee Replacement Necessary?

Which brings us to total knee replacement surgery – another procedure that has become increasingly common and, in many cases, more avoidable than you might think.

Unlike arthroscopy, knee replacement is a major operation. The damaged joint surfaces are removed and replaced with artificial components designed to restore function and reduce pain.

When performed on the right candidate, knee replacement can be very successful. About 90 percent of patients experience significant improvement, and many implants last 20 years or longer.

However, that doesn’t mean everyone with knee arthritis or chronic knee pain needs one.

Why MRI and X-Ray Findings Can Be Misleading

One of the biggest misconceptions about knee pain is that arthritis on an X-ray automatically explains the symptoms.

What’s not a misconception, however, is that joint degeneration is incredibly common as we age.

Studies show that only about 15 percent of people with evidence of knee osteoarthritis actually experience symptoms. The other 85 percent walk around completely pain free despite having the same findings on imaging.

MRI studies reveal similar patterns.

In one well-known study published in 2012, researchers performed MRI scans on more than 500 people who had no knee pain at all. Seventy-two percent showed signs of arthritis and roughly one quarter had meniscus tears.

In other words – structural changes inside the knee are far more normal than most people realize.

This is why basing a treatment decision solely on imaging can be misleading.

Sometimes Knee Pain Isn’t Actually Coming From the Knee

Over my two decades of treating patients with knee pain, the biggest problems I’ve seen after surgery rarely had anything to do with the procedure itself.

Instead, the issue was an incorrect diagnosis before surgery.

Sometimes the knee wasn’t actually the primary source of pain.

Knee pain can originate from the hip, ankle, or even the lower back. Research has shown that a surprising percentage of people with isolated knee pain actually respond to treatment directed at their spine.

That means someone could have arthritis in their knee and still have their symptoms driven by a problem elsewhere.

If that underlying cause isn’t identified first – surgery may be unnecessary, and it certainly won’t solve your problem.

3 Things to Consider Before Knee Surgery

Before considering any type of knee surgery – whether arthroscopic or a full replacement – there are several important things to evaluate.

1. The severity of your pain

If your discomfort is manageable and you can still participate in most of the activities you enjoy, rushing into surgery may not make sense.

Even successful knee replacements involve risks such as infection, blood clots, or complications related to anesthesia. Full recovery can take six to twelve months.

2. Whether your spine could be involved

If your knee pain fluctuates, appears suddenly, or occurs alongside back discomfort, it is worth having your spine evaluated by someone trained in diagnosing mechanical pain patterns.

In many cases, addressing the spinal issue resolves the knee pain without any treatment directed at the knee itself.

3. How stiff your knee actually is

With truly advanced arthritis, stiffness tends to be constant and progressive.

But if your knee mobility improves with movement, stretching, or specific exercises, the limitation may be mechanical rather than structural.

When that happens, restoring the right movement patterns can dramatically improve symptoms without surgery.

The Bottom Line: Surgery Should Be a Last Resort

To be clear – knee surgery is not always avoidable. For some patients, particularly those with severe arthritis and significant functional limitations, knee replacement can be life changing.

But surgery should almost always be considered a last resort, not the first step.

Before going down that road, it’s essential to make sure your knee pain has been accurately diagnosed and that you have explored all appropriate conservative treatment options.

Arthroscopic surgery and knee replacement may be among the most commonly performed orthopedic procedures in the country, but that does not mean they are always the right solution.

In many cases, the right diagnosis and treatment approach can restore knee function and eliminate pain without ever needing surgery.

Knee Pain Treatment in Portsmouth, NH

Dr. Carrie Jose is a Physical Therapy Specialist and Mechanical Knee Pain expert. She is the owner of CJ Physical Therapy & Pilates in Portsmouth, NH, where she helps people across the Seacoast of New Hampshire overcome chronic knee pain and avoid unnecessary surgery through specialized movement-based treatment.

She also hosts educational workshops and classes for people struggling with knee arthritis, meniscus injuries, and persistent knee pain.

To get a free copy of her Guide to Knee Pain or learn about the next Knee Pain Masterclass in Portsmouth, visit cjphysicaltherapy.com or call 603-380-7902.

When exercise hurts your back instead of helps

Six Ways to Help Manage Knee Arthritis and Stay Active

March 1, 2026/in Knee Pain/by Carrie Jose

Knee Arthritis Treatment in Portsmouth, NH: 6 Ways to Stay Active Without Injections or Surgery

Knee arthritis is one of the most common forms of osteoarthritis, affecting more than 80% of osteoarthritis cases and nearly 19% of Americans over age 45. Here in Portsmouth, NH and across the Seacoast region, we see it every day – active adults who want to keep walking, hiking, golfing, skiing, and staying independent without being limited by chronic knee pain.

For many people, a diagnosis of knee osteoarthritis leads to chronic, debilitating knee pain that stops them from doing their favorite activities. Sometimes it is due to the limiting belief that once you have arthritis, you have “bad knees” for life. Other times it is because you have been told you have “bone-on-bone” in your knee and should scale back activity so you do not make it worse.

This line of thinking is flawed and often leads to unnecessary injections, procedures, and surgery. Being active is one of the best things you can do to manage knee arthritis and protect your joints long term.

But what if movement and activity hurt?

Here are six expert-backed strategies we use at our Portsmouth, NH physical therapy clinic to help people manage knee osteoarthritis naturally and stay active without relying on injections or surgery.

1. Strengthen Your Hips and Core

If your hips and core are weak, your knees take the hit.

Your thigh bone (femur) connects your knee to your pelvis. Your core strength controls your pelvis. If your pelvis is not stable, your femur struggles to stay in proper alignment, which increases stress through your knee joint.

At our Portsmouth physical therapy clinic, we prioritize hip and core strengthening for patients with knee arthritis because improving these areas often significantly reduces knee pain. If you have arthritis in your knees, minimizing unnecessary joint stress is critical. Strong hips and a stable core help prevent flare-ups and keep you active longer.

2. Keep Your Knees Mobile

Mobility before stability is a principle we emphasize with every joint, but especially the knee.

Your knee needs to bend fully so you can squat and pick things up, and it needs to straighten fully to provide stability when walking. When either of these motions is limited, surrounding muscles and ligaments absorb more stress, which can aggravate arthritis symptoms.

Many people in the Seacoast area are told that stiffness is simply part of arthritis and something they must accept. But even a 10 percent improvement in knee mobility can create meaningful functional gains, reduce daily discomfort, and help you avoid more invasive treatments.

Limited motion is often treatable – even with arthritis.

3. Do Not Stop Your Activities

When people hear they have arthritis, especially if they have been told it is “bone-on-bone,” they often think slowing down will protect their knees. In reality, inactivity can make symptoms worse.

Research consistently shows that severe joint pain among adults with arthritis is worse with inactivity. Movement improves blood flow, maintains joint nutrition, and preserves muscle strength.

Interestingly, only about 15 percent of patients with evidence of knee osteoarthritis on X-ray report symptoms. That means many people are walking, biking, hiking around Portsmouth, and enjoying their favorite activities despite what imaging shows.

The key is smart activity, not no activity. Continuing to move is one of the most powerful ways to prevent arthritis from progressing and to maintain independence as you age. If pain is limiting you, working with a knee pain specialist in Portsmouth, NH can help you modify activities safely and effectively.

4. Optimize Your Footwear and Walking Mechanics

Your feet have a direct impact on your knees. If you wear unsupportive shoes or walk with poor mechanics, your knees absorb more stress than they should.

Over time, this increased strain can worsen arthritis symptoms. Supportive footwear that promotes proper alignment and cushioning can reduce unnecessary joint loading.

Walking is one of the best low-impact activities for knee arthritis. If you experience knee pain while walking around Portsmouth or on local trails, a professional gait assessment can identify weaknesses or imbalances contributing to your discomfort and help you choose footwear that supports your specific needs.

5. Choose Natural, Joint-Friendly Pain Relief Options

Your knees work hard every day. If you have arthritis, finding relief without relying on medications, injections, or surgery can be life changing.

Natural pain relief strategies can help reduce inflammation and improve mobility. Heat therapy and targeted stretching reduce stiffness by increasing circulation and relaxing surrounding muscles. Massage and foam rolling improve blood flow and ease muscle tension around the knee.

Regenerative treatments such as shockwave therapy, EMTT, and dry needling are becoming popular alternatives to cortisone injections. These approaches stimulate your body’s natural healing response rather than masking pain or contributing to long-term joint breakdown.

When used appropriately, these strategies can help you manage knee arthritis while staying active and avoiding unnecessary procedures.

6. Manage Inflammation with Diet and Hydration

Chronic inflammation can worsen arthritis symptoms, but nutrition plays a significant role in joint health.

Anti-inflammatory foods such as fatty fish, leafy greens, berries, and turmeric support joint function. Omega-3 fatty acids from fish oil may reduce inflammation at a cellular level. Supplements like collagen and glucosamine-chondroitin may support cartilage health and joint lubrication for some individuals.

Hydration is equally important. Water helps maintain joint cushioning and reduces friction within the joint.

Simple dietary changes combined with appropriate supplementation can complement your physical therapy program and support long-term knee health.

Final Thoughts on Knee Arthritis Treatment in Portsmouth, NH

Even if you have been told you have “bone-on-bone” or advanced arthritis, you can still improve your knee health.

The best thing you can do for your knees is to keep moving. The right strength program, improved mobility, supportive footwear, smart activity modification, and natural pain relief strategies can make a significant difference.

If you live in Portsmouth, NH or the surrounding Seacoast area and knee arthritis is limiting your ability to stay active, consider speaking with a physical therapy specialist who understands how to treat arthritis without defaulting to injections or surgery.

Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH and writes for Seacoast Media Group. If you are local to Portsmouth, NH and looking for help with knee arthritis treatment, request a FREE Discovery Visit with one of her specialists to learn how to stay active and protect your knees naturally.

Seven Smarter Ways to Manage Arthritis Pain Without Drugs or Surgery

February 9, 2026/in Home Page, Movement/by Carrie Jose

Seven Smarter Ways to Manage Arthritis Pain – Without Drugs or Surgery (Portsmouth & Seacoast, NH)

Arthritis is one of the most common causes of chronic joint pain and mobility limitations, affecting nearly 60 million adults in the United States. Many people in Portsmouth, NH and throughout the Seacoast live with persistent stiffness, swelling, and joint pain that can interfere with daily activities, exercise, and quality of life.

After an arthritis diagnosis, it’s common to feel like medication, injections, or even surgery are inevitable. While those options can be appropriate in certain cases, research and clinical experience show that many people can successfully manage arthritis pain using non-invasive, natural, and movement-based strategies that address inflammation, joint mechanics, and overall joint health.

Below are seven effective, evidence-informed approaches that help people in Portsmouth and the surrounding Seacoast region move better, feel better, and stay active — without relying solely on drugs or surgery.

1. Reduce Inflammation Through Nutrition

Inflammation is a major driver of arthritis pain and stiffness. When chronic inflammation persists inside a joint, it can irritate cartilage, surrounding tissues, and even underlying bone — leading to increased discomfort and reduced mobility.

Adopting an anti-inflammatory eating pattern can support joint health and help reduce symptom flare-ups. Foods rich in omega-3 fatty acids — such as salmon, sardines, and walnuts — are known to support joint lubrication and reduce inflammatory responses. Fruits and vegetables provide antioxidants that protect joint tissue, while spices like turmeric and ginger contain natural compounds that help regulate inflammation. Healthy fats like olive oil also contribute to better joint function.

Highly processed foods, excess sugar, refined carbohydrates, and fried foods tend to promote inflammation and may worsen arthritis symptoms over time.

2. Keep Joints Moving With the Right Kind of Exercise

Many people with arthritis in Portsmouth and Seacoast NH avoid movement out of fear that it will increase pain. However, inactivity often leads to more stiffness, muscle weakness, and decreased joint tolerance — ultimately making symptoms worse.

Gentle, consistent movement improves circulation, nourishes joint tissues, and helps reduce inflammatory buildup. Low-impact activities like walking, cycling, and swimming are excellent options. Pilates and yoga improve mobility, balance, and joint control, while strength training helps surrounding muscles absorb stress that would otherwise burden the joints.

When joints are supported by strong, well-coordinated muscles, everyday movements — like climbing stairs, getting out of a chair, or walking — become easier and less painful.

3. Manage Weight to Reduce Joint Stress

Body weight plays a significant role in joint health, especially in weight-bearing joints like the knees, hips, and lower back. Extra weight increases the force placed through joints with every step.

Studies show that losing even a small amount of weight can meaningfully reduce joint stress and arthritis pain. For the knees specifically, each pound of weight loss can reduce pressure by approximately four pounds during daily activities.

Regular walking is one of the simplest and most effective ways to support both weight management and joint health. Even small increases in daily movement can make a meaningful difference.

4. Understand How Hormonal Changes Affect Joint Health (Especially for Women)

Many women in Portsmouth and across New Hampshire notice worsening joint pain during perimenopause and menopause — and this is not just “getting older.” Declining estrogen levels can significantly impact joint health by increasing inflammation, reducing cartilage resilience, and affecting bone density.

As estrogen levels drop, joints may feel stiffer, more sensitive, and slower to recover from activity or minor injuries. This means arthritis management for midlife women often requires a more comprehensive approach that prioritizes movement, strength, and recovery — not just pain suppression.

5. Use Hands-On Therapies to Support Pain Relief and Mobility

Complementary therapies such as acupuncture and massage are widely used in Portsmouth and the Seacoast area to help manage arthritis pain and stiffness.

Acupuncture can influence pain pathways and improve circulation, while therapeutic massage reduces muscle tension, increases blood flow, and restores movement around stiff joints. Some people also benefit from cupping or heat-based therapies when combined with an active rehabilitation plan.

These non-invasive therapies are often most effective when paired with movement-based care such as physical therapy or corrective exercise.

6. Improve Joint Mechanics — Not Just Symptoms

One of the most overlooked causes of arthritis pain is poor joint mechanics. When joints don’t move properly, certain areas bear excessive stress, which can accelerate wear and increase pain over time.

Targeted mobility exercises, corrective movement, and joint retraining can help distribute forces more evenly across the joint. Many people in Portsmouth find that when their movement improves, their pain decreases — even when arthritis is still present.

This approach shifts the focus from masking symptoms to restoring function, which is often the missing piece for those who feel stuck despite trying multiple treatments.

7. Explore Non-Invasive Regenerative Technologies (Available in Seacoast NH)

One of the most exciting developments in arthritis care is the growth of non-invasive regenerative therapies available in and around Portsmouth, NH. Unlike injections or surgery, these treatments aim to stimulate the body’s natural healing processes.

Shockwave therapy uses targeted acoustic energy to improve blood flow, reduce chronic inflammation, and support tissue repair.

Extracorporeal magnetotransduction therapy (EMTT) uses high-energy electromagnetic fields to enhance cellular activity and reduce pain.

These therapies can help reduce pain, improve mobility, and speed recovery with little to no downtime. Unlike cortisone injections — which may weaken tissue over time — regenerative approaches focus on improving joint health at a cellular level.

Final Thoughts

Living with arthritis in Portsmouth or anywhere along the Seacoast does not mean accepting chronic pain or declining mobility. With the right combination of nutrition, movement, weight management, hands-on care, hormonal awareness, and modern non-invasive therapies, many people can stay active, independent, and pain-free for years to come.

Your body has an incredible ability to adapt and heal when given the right support. By taking proactive steps today, you can experience better movement, less pain, and a higher quality of life tomorrow.

Dr. Carrie Jose, Physical Therapy Specialist and Regenerative Therapy Expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH and writes for Seacoast Media Group. To get in touch or request a free discovery visit with a physical therapy specialist visit cjphysicaltherapy.com or call 603-380-7902.

Top 5 Arthritis Myths That Keep People in Pain

May 20, 2025/in Movement/by Carrie Jose

If you or someone you love is living with arthritis — then you already know how frustrating it can be. Daily tasks become harder, favorite activities fall by the wayside, and you may start to wonder: “Will things ever get better?”

Even worse, many people living with arthritis fall victim to misguided advice.

Let’s look at five of the most common myths about arthritis management — and shed some light on what you can actually do instead:

Myth #1: “There’s nothing you can do — it’s just part of getting older.”

This is one of the biggest and most damaging myths of all.

While it’s true that arthritis becomes more common as you get older — and it’s considered a normal part of aging — it doesn’t mean you have to live with chronic pain or disability. In fact, many people with visible (even advanced) arthritis on X-rays and MRIs are living active, healthy lives with minimal to no pain at all.

Research supports this. A 2015 study published in Arthritis & Rheumatology found that more than 30% of adults over 60 had radiographic evidence of knee osteoarthritis — but only a portion of them had symptoms. In other words, just because your joints show signs of “wear and tear” doesn’t mean you’re doomed to pain.

The real issue is how you move — and how you use your joints. Strategic exercise, strength training, and natural therapies can drastically improve your mobility and reduce pain — regardless of your age or what your imaging says.

Doing nothing, on the other hand, is one of the worst things you can do.

Myth #2: “You should rest and avoid activity to protect your joints.”

If your joints hurt, don’t move them — right? That might make sense if you have an injury that requires an initial rest and healing phase. But that’s not the case with arthritis. When you avoid movement in an arthritic joint, you actually worsen your symptoms.

Too much rest leads to stiff joints, weakened muscles, and poor circulation — all of which contribute to more pain and less function over time. Movement helps lubricate joints, strengthen muscles, and prevent further degeneration.

I’m not sure why this myth is still so common — especially when just about every major orthopedic organization (including the CDC and the Arthritis Foundation) agrees that regular, low-impact physical activity is one of the best things you can do for arthritis.

The key is doing the right kind of movement. So if you’re struggling, work with an expert who can help you figure out the proper, targeted activity your body needs. But whatever you do — don’t fall for this myth.

Myth #3: “If your joint is bone-on-bone, surgery is the only option.”

Hearing the phrase “bone-on-bone” from your doctor can feel like a death sentence for your joint. And the typical recommendation? Joint replacement surgery.

But what if I told you that “bone-on-bone” isn’t always the actual reason for your pain — and that you’ve got options beyond a major procedure like surgery?

The first thing to understand is that what shows up on your imaging (like X-rays and MRIs) doesn’t always match up with your symptoms. A 2018 study in BMJ Open found that nearly half of people with severe osteoarthritis on imaging had little to no pain. And many people with significant joint pain showed only mild arthritic changes on their images.

Translation? “Bone-on-bone” isn’t necessarily the root cause of your problem. I’ve seen many people with this diagnosis successfully avoid major surgery and keep their original parts far longer than they thought possible.

When faced with this kind of diagnosis, the best thing you can do is pause — and explore your options. Surgery will always be there if you need it. But don’t rush into it or assume it’s your only option.

Myth #4: “Cortisone shots and medications are the best way to manage arthritis.”

Cortisone shots may provide short-term pain relief for arthritis — but they don’t actually fix anything. Worse, repeated cortisone injections have been shown to damage cartilage and accelerate joint degeneration over time.

One study published in JAMA (2017) showed that patients receiving cortisone injections for knee arthritis had worse cartilage loss at two-year follow-up than those who received a saline placebo — despite experiencing no significant difference in pain relief.

NSAIDs (like Advil) and prescription pain medications can also help dull pain, but they come with side effects — and, just like cortisone, do nothing to address the root cause of your symptoms.

If you’re relying on medication or repeated cortisone shots just to get through the day — or to delay surgery — it’s time to explore options that promote natural healing instead of just masking symptoms.

Shockwave Therapy and EMTT are two non-invasive regenerative therapies that do exactly that. These cutting-edge technologies enhance your body’s natural healing processes by targeting inflammation and tissue damage at the cellular level. And while more research is still needed, promising clinical evidence suggests these therapies may actually help reverse — or significantly delay — the progression of arthritis.

Do your own research — and be open to natural, forward-thinking treatment options that support your long-term joint health.

Myth #5: “Arthritis means you’ll never get back to the activities you love.”

This is one of the most heartbreaking myths — and it’s simply not true.

I’ve worked with countless clients who believed their days of hiking, gardening, traveling, or playing with grandkids were behind them — only to regain full function and freedom after following a personalized treatment plan.

And while surgery sometimes is the best option — especially if you’ve waited until your arthritis has become advanced — there’s a lot you can do to improve your outcome. Working with a specialist to build strength and prescribe targeted movement can make recovery faster and easier.

Plus, emerging research shows that using regenerative therapies like Shockwave and EMTT both before and after surgery may help accelerate healing and improve long-term outcomes.

Managing arthritis is absolutely possible when you take a natural, proactive, and personalized approach. You just need the right plan — and the right team to guide you.

Final Thoughts:

Arthritis is real — but don’t let myths and outdated advice keep you stuck. If you’re not sure where to start — or feel like you’ve already tried everything — speak with someone who specializes in mechanical pain and natural joint care. Often, the most effective solutions are the ones no one has told you about yet.

Dr. Carrie Jose, Physical Therapy Specialist, and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH, and writes for Seacoast Media Group. If local to Portsmouth, NH, and looking for help – request a FREE Discovery Visit with one of her Specialists by CLICKING HERE.

Four Non-Invasive Ways to Get Rid of Arthritic Knee Pain

May 13, 2025/in Movement/by Carrie Jose

Knee arthritis is one of the most common and debilitating causes of joint pain for adults over 50. As the protective cartilage in the knee joint gradually wears down, many people experience stiffness, swelling, and chronic pain that can make everyday activities—like walking the dog, climbing stairs, or getting out of the car—feel frustrating and exhausting.

For years, conventional treatments such as traditional physical therapy, cortisone injections, and pain medications have been the go-to options for knee arthritis relief. While these approaches may provide temporary symptom relief, they often fail to address the underlying mechanical and inflammatory causes of knee pain. For many people, the results are short-lived—or nonexistent.

The good news? There are effective, non-invasive, and drug-free solutions available that focus on improving joint function, reducing inflammation, and supporting your body’s natural healing process—especially for those who want to avoid injections or surgery.

Here are four non-invasive ways to relieve arthritic knee pain naturally, used successfully by many adults in Portsmouth and throughout the Seacoast of New Hampshire.

1. Corrective, Therapeutic Movement Strategies for Knee Arthritis

Movement is one of the most accessible—and powerful—tools for managing arthritic knee pain. While it may seem counterintuitive to move a painful knee, not all knee pain is caused by arthritis alone.

In many cases, pain is driven by joint stiffness, poor mechanics, and long-standing compensatory movement patternsthat place excess stress on the knee. When the joint doesn’t move well, surrounding tissues are forced to work harder, increasing irritation and discomfort.

By identifying and correcting faulty movement patterns with specifically prescribed therapeutic exercises, it’s often possible to significantly reduce pain—even in arthritic knees. These targeted strategies focus on improving knee mobility, restoring proper alignment, and optimizing how forces move through the joint.

Working with a specialist trained in mechanical pain assessment is key. Once the right movements are identified, they can be used long-term to help manage symptoms—without ongoing costs, medications, or injections.

2. Weight Management to Reduce Knee Joint Stress

Excess body weight places a significant load on the knee joints during everyday activities like walking, standing, and climbing stairs. In fact, research from Wake Forest University led by Dr. Stephen Messier found that for every pound of weight lost, there is a four-pound reduction in knee joint stress during daily movement.

That means losing just 10 pounds can reduce pressure on your knees by 40 pounds with every step.

Healthy, sustainable weight management—through smart nutrition and regular movement—can dramatically reduce knee pain and improve function. Beyond your knees, weight loss also decreases strain on the hips, ankles, and lower back, supporting overall joint health and long-term mobility.

3. Adopt an Anti-Inflammatory Lifestyle

While knee arthritis is often described as “wear and tear,” chronic inflammation plays a major role in pain, stiffness, and joint degeneration.

Reducing inflammation through lifestyle changes—especially nutrition—can lead to noticeable improvements in how your knees feel. An anti-inflammatory diet emphasizes whole, unprocessed foods rich in antioxidants and healthy fats, including:

Fatty fish like salmon, sardines, and mackerel
Dark leafy greens such as spinach and kale
Berries, walnuts, chia seeds, and flaxseed
Extra virgin olive oil
Anti-inflammatory spices like turmeric and ginger

At the same time, limiting refined sugars, processed grains, and fried foods is essential, as these are known to promote inflammation.

Beyond diet, other daily habits that help reduce inflammation include getting 7–8 hours of quality sleep, managing stress through walking or breathing exercises, and staying well-hydrated. These foundational changes not only support knee arthritis relief—but overall health and energy as well.

4. Explore Non-Invasive Regenerative Therapy for Knee Arthritis

One of the most exciting advances in non-surgical knee arthritis treatment is the use of non-invasive regenerative therapies, including Shockwave Therapy and EMTT (Extracorporeal Magnetotransduction Therapy).

These cutting-edge technologies work with your body’s natural healing mechanisms rather than masking pain.

Shockwave Therapy uses mechanical sound waves to improve blood flow, break down damaged tissue, and stimulate dormant healing cells within the knee joint.
EMTT uses high-frequency electromagnetic energy to reduce inflammation at the cellular level, boost mitochondrial activity, and accelerate tissue repair—making it especially effective for chronic joint inflammation and bone marrow lesions commonly seen with knee arthritis.

Recent research supports the combined use of these therapies. A 2021 clinical study published in Orthopedic Reviewsfound that using Shockwave Therapy and EMTT together led to greater improvements in pain relief and functional mobility than either treatment alone, with longer-lasting results.

For individuals who have already tried traditional physical therapy or cortisone injections without success, this non-invasive combination offers a powerful, drug-free alternative—without surgery.

Take Control of Your Knee Arthritis Pain—Naturally

If you’re living with knee arthritis and feel like you’ve exhausted your options, don’t lose hope. Pills, injections, and surgery are not your only choices.

By combining corrective movement strategies, healthy weight management, anti-inflammatory lifestyle changes, and advanced non-invasive regenerative therapies, many people are able to reduce knee pain and regain confidence in their movement—naturally and safely.

The key is addressing the root cause of your pain and choosing solutions that support long-term joint health, not just short-term relief.

About the Author

Dr. Carrie Jose, Doctor of Physical Therapy and Mechanical Pain Expert, is the owner of CJ Physical Therapy & Pilates in Portsmouth, New Hampshire. She specializes in helping adults over 40 overcome chronic knee, hip, and back pain—without relying on medication, injections, or surgery.

Knee Surgery Gone Wrong? It’s More Common Than You Think.

October 24, 2022/in Knee Pain, Movement/by Carrie Jose

Arthroscopic knee surgery is one of the most common surgeries performed. Despite research telling us that it’s not nearly as effective as most people are led to believe.

Science tells us that people who do undergo arthroscopic knee surgery are likely to have knee arthritis that advances rapidly. This results in a total knee replacement that you could avoid.

Arthroscopic knee surgery is a minimally invasive procedure that’s commonly done to help “clean out” your knee joint. It’s done if you’ve got degenerative arthritis, or to clip out pieces of a torn meniscus that might be irritating your knee.

Sounds pretty simple and harmless – right?

Well… it is until it isn’t.

The big problem is that arthroscopic knee surgery is not necessary for most cases of knee pain.

If there is a complication – which there are many even with “minimally invasive” procedures – you could end up being worse off than when you went in.

Plus – if you never even needed the surgery to begin with – you just put your knee through unnecessary trauma that you’ve got to now heal from. This further delays you from addressing the root cause of your knee pain.

The truth is that most people can get full relief of their knee pain as well as full restoration of knee function without any type of surgery or procedure. This is true for 70% of all knee pain cases.

An early research study from 2002 by JB Moseley and colleagues, and published in the New England Journal of Medicine, revealed that placebo surgery for advanced knee arthritis was just as effective as actual arthroscopic surgery.

Since then, numerous studies have proven similar results. This means that even if you have a torn meniscus or degenerative arthritis in your knee – you can still get better naturally and with conservative treatment.

So why then – despite all this research – are surgeons still performing arthroscopic knee surgery more than ever?

In some cases it’s just what the surgeon knows, and they haven’t kept up with the research. Other times, it’s due to poor conservative management of knee pain. If you’ve gotten physical therapy and it wasn’t effective, people believe that the physical therapy “didn’t work”.

But more often than not, you just haven’t found the right physical therapist yet – someone who understands how to diagnose knee pain properly and get you the customized approach that is required to avoid surgery.

And then there’s the elephant in the room…

It’s very common for knee pain to be coming from somewhere other than your knee. Knee pain can come from your ankle, hip, or back. One study showed that 40% of the time – knee pain is caused by your back – even when you don’t have any back pain.

MRI’s add even more confusion to this. It’s entirely possible to have degenerative changes, a torn meniscus, or advanced arthritis in your knee – and still have your knee pain stemming from a source other than your knee.

Over the course of my 20 year career, I’ve seen many knee surgeries go wrong.

Most of the time, it has nothing to do with the procedure itself. It has everything to do with an incorrect diagnosis going in. Say your knee pain can be resolved conservatively. Then you put it through unnecessary trauma (surgery). There’s a good chance you’re going to have more problems afterwards. You get knee surgery when your knee problem isn’t even coming from your knee. Then you’re definitely going to have problems afterwards.

The moral of this story is to make absolutely certain that:

1) Your knee problem is really a knee problem and

2) You’ve fully exhausted all (quality) conservative therapy options before going under the knife.

Remember that 70% of all knee pain cases do not need surgery.

Science has proven this. Don’t resort to knee surgery unless you’re 100% sure you really need it. Because it can go wrong and when it does – it’s much harder to come back from then if you had avoided it to begin with.

Want help with your pain now? CLICK HERE to talk to one of my specialists for free – you can tell them all about your knee pain and we’ll let you know if we can help. 🙂

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her Knee Pain Free Report CLICK HERE or to get in touch, email her at [email protected].

Three Tips to Protect Your Knees From Arthritis

October 17, 2022/in Knee Pain, Movement/by Carrie Jose

Knee arthritis is one of the most common forms of osteoarthritis.

Knee arthritis accounts for more than 80% of all osteoarthritis and impacts at least 19% of Americans over the age of 45.

For many, a diagnosis of knee osteoarthritis leads to chronic, debilitating knee pain that stops them from doing all of their favorite activities. Sometimes it’s simply due to the limiting belief that once you have arthritis – you’ve got “bad knees” for life.

Other times it’s because you’ve been told you have “bone on bone” in your knee and there’s nothing you can do – except to scale back on activity so that you don’t make it worse. This line of thinking is flawed and often leads people to unnecessary procedures and surgery. One of the best things you can do to protect your knees from the debilitating effects of arthritis is to keep moving.

Here are three tips to help you protect your knees from arthritis as you age – so that you can keep doing all of your favorite activities and avoid any major procedures or surgery:

1. Strengthen Your Hips and Core

Your knee joint is situated just below your hips and core. And research has shown that when you have poor control of your upper leg muscles – you get more stress through your knee joint.

The strength of your upper leg muscles is very much dependent on your hip and core strength. Your thigh bone – or femur – connects your knee and your pelvis – and your core strength controls your pelvis.

If your pelvis isn’t stable – your femur is going to have a difficult time staying in alignment – which will ultimately have an impact on your knee joint. If you’ve got arthritis in your knees, it’s critical you minimize any added stress to your knee joints.

Strengthening your core and having good hip strength is going to help prevent and minimize the symptoms of arthritis and keep you doing activities you love longer.

2. Keep Your Knees Mobile

Mobility before stability is my mantra.

And I say this for just about every joint in your body. But it’s especially true for your knees. There are joints whose primary function is stability – and there are those whose major function is mobility.

Your knee needs to be mobile.

Its major purpose is to bend all the way so you can squat and pick things up – and it needs to straighten all the way to give you stability when you need it. When either of these motions are lacking – your ligaments and surrounding muscles will suffer.

A lot of folks just “accept” that their knees are stiff – especially if you’ve been told you have arthritis in your knees. The limiting belief is that stiffness is par for the course. But the truth is that if you keep your knees mobile as you age – you can not only maintain the mobility you have but improve what is lacking.

If your knees are stiff – start moving them. The thing to understand about arthritis is that it’s a normal part of aging. Debilitating mobility is not. Even a 10% improvement in your knee mobility – which can happen even if you’ve got arthritis – will result in huge improvements in your knee function.

It can be the difference between a natural solution to knee pain vs undergoing a major surgery like knee replacement.

3. Don’t Stop Your Activities

When people find out they have arthritis – and especially if they’re in pain – they often think that slowing down or stopping activity will help protect their knees.

This couldn’t be farther from the truth.

Study after study – including one from the Center for Disease Control – shows that severe joint pain among adults with arthritis is worse with inactivity. When you remain active, you keep blood flowing, your knee joints mobile, and your muscles strong. These are very important factors in managing your arthritis. Sometimes, the knee pain you feel when you’re doing certain activities has nothing to do with your arthritis. Statistics show that only 15% of patients with evidence of knee osteoarthritis on X-ray even had symptoms.

That means that the other 85% is walking, biking, and running around enjoying their most favorite activities – despite the fact their X-ray showed arthritis too. The point here is to keep doing your activities – whether you’ve got arthritis already or not – it’s one of the best ways to prevent and protect your knee joints as you age.

So – to review…

If you want to optimize your knee health as you age – which you still can even if you’ve been told you have “advanced arthritis” – prioritize your core strength, the mobility of your knees, and stay active.

Focusing on these three things can have a significant impact on how arthritis affects you – and can help you avoid major (often unnecessary) surgery in your future.

Is knee pain keeping you from doing your favorite activities? Are you considering a major procedure or surgery but not sure if you need it?

Join us on Tuesday Oct. 25th from 6-7pm for our Free Masterclass for Knee Pain Sufferers.

We hope to see you there!

Can’t make it live? All participants will receive a complimentary replay of the class 🙂

Arthroscopic Knee Surgery – Does it Even Work?

April 21, 2021/in Arthritis and Joint Pain, Knee Pain, Knee Pain, Movement/by Carrie Jose

While researching for my latest article in the Portsmouth Herald, I came across an interesting study titled: “Arthroscopy for degenerative knees – a difficult habit to break.”

The title of this study is telling.

Arthroscopic knee surgery is still one of the most common surgeries performed, despite research telling us that it’s not nearly as effective as most people are led to believe.

Furthermore, studies now indicate that people who get arthroscopic knee surgery are likely to have knee arthritis that advances more rapidly – resulting in a total knee replacement that could have been avoided.

Arthroscopic knee surgery is a minimally invasive procedure that’s commonly done to help “clean out” your knee joint if you’ve got degenerative arthritis, or to clip out pieces of a torn meniscus that might be irritating your knee.

Sounds pretty simple and harmless – right?

But over the years, research has shown that this procedure is really not necessary in most cases.

Most people can get pain relief and restore function in their knees without ever getting surgery.

One of the earliest studies from 2002 by JB Mosely and colleagues, and published in the New England Journal of Medicine, revealed that placebo surgery for advanced knee arthritis was just as effective as actual arthroscopic surgery. Since then, numerous studies have shown similar results. Even if you have a torn meniscus or degenerative arthritis in your knee – you can still get better naturally and with conservative treatment like physical therapy.

Despite all this research, surgeons are still performing these procedures more than ever.

In some cases it’s just what the surgeon knows, and they haven’t kept up with the research. Other times, it’s due to poor conservative management and not giving therapy enough time to work.

In our office, we often see people after they’ve tried regular physical therapy first. Since we have a more specialized approach, and we’re able to spend more time with our clients, we tend to get better results and can help clients avoid surgery all together.

But not all physical therapy clinics are afforded that luxury. In those cases, people are led to believe that the physical therapy “didn’t work,” and they get scheduled for surgery.

But what’s the big deal really?

If outcomes are the same regardless of whether you get surgery or not – why not just get it? It’s quicker, and far more convenient than going to weekly therapy appointments…

But despite the term “minimally invasive,” it’s still surgery.

You will have bleeding, swelling, and recovery time. There is trauma that is caused to the soft tissue in and around your knee that has to heal. There’s also the risk of infection, which comes with a whole set of different complications.

And then of course there’s the elephant in the room that nobody likes to talk about…

I’ve seen many of these arthroscopic surgeries performed that had clients feeling WORSE than before surgery. Because it turns out the procedure wasn’t even necessary. Luckily, we’re still able to rehabilitate them. But it’s completely demoralizing and discouraging for our clients.

In general, despite how small the procedure may seem, you want to avoid surgery whenever possible.

Although small, the risks that can happen with surgery simply aren’t worth it – especially when you can get the same results from natural, conservative treatment.

For some, arthroscopic knee surgery really is necessary. But for most, it can be avoided.

If you’re currently suffering from knee pain and want to learn more about what you can do to avoid surgery and heal your knee pain naturally and on your own – DOWNLOAD our Free Guide: 7 Ways to Get rid of Knee Pain Naturally.