My Arthritis is Bone on Bone…NOW WHAT: 5 Ways to Avoid Surgery

bone on bone

Bone on bone arthritis does not have to be a death sentence to everything you love doing. When you are bone on bone, that typically indicates you have decreased cartilage between your joints and higher levels of bone and joint lining irritation. That bone and joint lining irritation is caused by higher levels of inflammation in your body. It is possible to be bone on bone, but not experience high levels of pain. Let’s take a look.

So your doctor or another medical professional looked at your x-ray and told you that you’re bone on bone….


Most people are left feeling hopeless after being told this about their joints. So you are not alone but I’m so glad you’re here reading this right now.

Surgery is not the only option if your joint is considered bone on bone.

There are actually many other options for your to find pain relief, that your doctor may not be explaining fully.

Here is a decision tree to help you decide if surgery is right for you.

First, you have to understand what the term “bone on bone” means then you will learn 5 ways you can find pain relief!

What does bone on bone mean?

This can be something scary to hear about your joint. But I want you to know something, it isn’t as scary as it sounds ☝🏼

When you are considered to be “bone on bone” it essentially means you have less cartilage between your joint and your bones may be rubbing together.

The important thing to know, according to Dr. Howard Luks, MD,

Believe it or not, the bone on bone arthritis of the knee may not be a “pain generator.” There are no nerve endings in the bone itself. So if two bones are rubbing together and all else is well, they won’t hurt. The cartilage in the knee also does not have nerve endings in it. So thinning cartilage will not hurt in and of itself.

Dr. Howard Luks, MD

So what ends up causing the pain? 

Your joints are surrounding by a tissue called the synovium. The popular analogy being, imagine a balloon is around the bones of your joint. That is the synovium.

When that gets inflamed, you can experience pain. 

Your bones can also become irritated with bone edema which can also be pretty painful. 

What causes these things to become inflamed?

Here are a few of the causes: 

  • 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, once you reduce the inflammation, your bone on bone pain should diminish. 

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

1. Get stronger

I know this is easier said than done when experiencing severe joint pain. But it is still possible! Muscle strength 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. Want to know what did? Quadriceps muscle (thigh muscle) strength! The less strength the participants had in their quads, the worse their knee pain was.

The quadriceps play a vital part in stabilizing the knee so when it becomes unstable from weakness, 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! Find out more about the benefits here.

What’s the best way to get stronger? Start finding ways you can move without flaring up your pain. 

Give this full body, arthritis friendly routine a try! 

2. Fuel your body with the right foods

What you are putting into your body can dramatically impact the way your joints feel. If 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

The number one thing I always recommend is if you are eating any of these foods above on a frequent basis, try to make 2-3 substitutes with anti-inflammatory foods. Here is the best list of anti-inflammatory foods.

Protein is also extremely important, especially if you have arthritis. Find out more on that here.

Instead of focusing on starting a strict diet, focus simply on making a couple of substitutions. This will make you much more successful!  

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 our muscles work. It can also delay our balance reactions, leading to a higher risk for falls. If you have osteoporosis, being a higher risk for falls can be dangerous.

Improving your balance can actually improve your pain levels too. I have almost all of my clients work on balance and they are shocked at how much it helps with pain.

If you are looking for the best ways to improve your balance, despite bone on bone arthritis, check out this post here.

4. Explore supplements

Supplements can be helpful when it comes to finding relief from severe bone on bone pain. But they are just that.. a supplement. They are not an end all be all solution to your pain. They are meant to supplement other things.

For example, I know many people who have had luck with turmeric and fish oil. Both of these can be extremely helpful when it comes to reducing osteoarthritis pain. 

Not all supplements are created equally so it’s so important to make sure you are taking the most quality brands. I love using to find the highest quality supplements. 

Please make sure you talk to your physician prior to starting any new supplement to make sure there will be no interactions with health conditions or other medications you are taking.

5. Be consistent

Consistency is key when it comes to making a change to arthritis pain. Many times, I see people giving up too early, right before they were about to make a big break through.

It is so incredibly 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.

An exercise plan can be the hardest to find because you may be unsure about which exercises are safe and which maybe to avoid. I have created a free 5 day arthritis friendly movement challenge that can help you find ways to stay active and move without flaring up your arthritis pain.

You want to make sure you give yourself at least 3 months of consistent effort to see results. Unfortunately results may not be immediate and you may experience a few obstacles along the way, but you can do this. 

Learn more about the 5 day arthritis friendly movement challenge below!


Bone on bone arthritis pain does not need to be the end of life as you know it. You do not have to give up everything you love. 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.

Try these 5 tips above and start your arthritis adventure. If you would like to fast track your success and make sure you are following the right path, check out the Arthritis Adventure Blueprint below!

arthritis adventure blueprint

The Arthritis Adventure Blueprint

Dr. Alyssa Kuhn’s signature program to help you go from hopeless to hopeful with osteoarthritis. You will learn the secrets to arthritis pain relief that actually work- including exercise, diet, and other ways to control inflammation! Say goodbye to short term pain relief, it’s time to make it last.