What your doctor may not be telling you

Learn the risks of knee OA treatments like glucosamine, SAMe, and hyaluronic injections

Knee OA treatments like NSAIDs, supplements, hyaluronic acid injections, and arthroscopies are widely recommended by doctors and health advice sites like Healthline, WebMD, Mayo Clinic and Johns Hopkins.

But a closer look at the scientific research shows that these conventional pharmacological and surgical options for knee OA may be less effective and may have more side effects than commonly recognised.

Read on to get a fuller picture of what the research shows about these conventional medical treatments.

We also discuss the best natural, non-invasive alternatives recommended by experts, and why you might want to consider trying them first.

Pharmacological and surgical options

Painkillers

NSAIDs (non-steroidal anti-inflammatory drugs)

The most commonly recommended first-line treatment for knee OA is over-the-counter pain pills, especially NSAIDs (non-steroidal anti-inflammatory drugs) – a widely-used category of drugs including aspirin, naproxen (Aleve), and ibuprofen (Advil).

...Long-term NSAID users experience a ten- to thirty-fold higher risk of developing peptic ulcers than the general population.

NSAIDs relieve pain by suppressing an enzyme called cyclooxygenase, which prevents the synthesis of prostaglandins – a group of chemicals which plays a key role in the immune system’s inflammatory and pain responses.

Prostaglandins also affect other bodily processes, including blood clotting and the maintenance of the protective mucous lining in the digestive tract. As a result, long-term NSAID use can lead to a range of side effects, including gastrointestinal (GI) issues, renal (kidney) toxicity, and impairment to blood platelet functioning.[1]

These side effects are well known, but they are often not taken seriously enough. In particular, doctors and patients alike tend to underestimate the scope and severity of potential GI complications. [2] [3]

Long-term NSAID users experience a ten- to thirty-fold higher risk of developing peptic ulcers than the general population. [4]

They have a “three- to ten-fold higher risk of gastrointestinal injury and death”, with at least 16,500 NSAID-related deaths occurring in the US every year among arthritis patients alone. [5] [6] Long-term NSAID users also experience a one-in-five rate of mortality from gastrointestinal bleeding or perforation, as compared to 1 in 13 in the general population. [7]

Three additional pieces of data make NSAID-related GI problems especially concerning.

First, these risks are present even if you are not taking a high dose: a nationwide study of NSAID-related hospitalizations and fatalities found that up to one-third of NSAID-related deaths can be attributed to low-dose users. [8]

Second, these GI complications cannot be prevented with the use of common gastro-protective drugs like antacids and H2-blockers (e.g. Tums, Pepto-Bismol, Zantac, Famotidine). [9]

Third and perhaps most alarming, there are usually no prior warning signs that you may be about to suffer a serious GI incident. In over 80% of cases, patients with serious NSAID-related GI complications had no prior GI symptoms. [10]

COX-2 inhibitors

A special class of NSAIDs known as COX-2 inhibitors may be a safer alternative for those with greater GI-related risks. While traditional NSAIDs inhibit two forms of cyclooxygenase (COX-1 and COX-2), COX-2 inhibitors suppress only COX-2, leaving COX-1 activity relatively unimpaired, and thus reducing the severity of GI-related side effects arising from cyclooxygenase suppression. [11]

...COX-2 inhibitors can increase the risk of heart attacks and strokes

However, more research is needed to assess their safety for long-term use. [12] In particular, COX-2 inhibitors can increase the risk of heart attacks and strokes, because they interfere with the body’s production of the blood-thinner and vasodilator prostacyclin, which leads to an increased likelihood of blood clots. [13] [14]

Several COX-2 inhibitors have been withdrawn from the market for this reason, including popular Merck drug Vioxx (rofecoxib), which had annual sales of $2.5 billion until it was withdrawn in 2004, after a study unexpectedly showed that it doubled the risk of heart attack in patients who took the drug for more than 18 months. [15] (Merck has since pleaded guilty to a criminal misdemeanour charge with a $321.6 million criminal fine. [16] It has also paid millions more to settle lawsuits brought against it in relation to the injuries and deaths of tens of thousands of Vioxx users. [17] )

The only COX-2 inhibitor currently available in the US is Celebrex (celecoxib), and it is available by prescription only, so that your doctor can assess your suitability and risk levels first.

Corticosteroid injections

Like NSAIDs, corticosteroids (also called glucocorticoids) also help to reduce inflammation and relieve pain. They do this by preventing the synthesis of arachidonic acid. This suppresses even more inflammation pathways within the immune system than NSAIDs do, thus producing an even more powerful anti-inflammatory and analgesic response.

To treat knee OA, steroids like prednisone or triamcinolone are injected directly into the knee joint, usually alongside a local anaesthetic. Clinical studies show that pain relief from the injection lasts from one to four weeks, though some people report beneficial effects for as long as a few months. [18]

...Steroid injections can cause serious and irreversible long-term side effects

However, as is common with steroid use, patients often experience diminishing returns – that is, the first injection is often the most effective, with each subsequent treatment becoming less and less effective after that.

Steroid injections can cause serious and irreversible long-term side effects. The most concerning of these for OA patients is cartilage degeneration, which could result in permanent damage to the knee joint. [19]

A large, high-quality two-year study found “significantly greater cartilage volume loss” in knee OA patients who received corticosteroid injections, [20] compared to those in the placebo group who received only saline injections. The steroid group also experienced 67% more complications and side effects– while reporting “no significant difference in knee pain”. [21]

Other risks of steroid knee injections include joint infection, nerve damage, and damage to nearby tendons and bones. [22] This is in addition to the usual, widely-recognised risks of corticosteroid use, which include cardiometabolic effects like osteoporosis, high blood pressure, high cholesterol, and high blood sugar, which can lead over time to heart problems, diabetes, weight gain; and the effects related to the steroids’ suppression of the immune system, such as greater susceptibility to infection. [23] [24] Lesser-known adverse effects also include steroid-induced glaucoma and cataracts (caused by steroidal interference with the levels of fluids in the eye, leading to increases in eye pressure), sleep and mood disorders, and cognitive instability. [25] [26]

As such, doctors and experts commonly advise patients to carefully weigh the short-term pain-relief benefits against the longer-term health risks before making corticosteroid injections a regular part of their knee OA treatment plan.

Opioids

For more severe pain, doctors may also prescribe opioids like tramadol, which is available in both pill and injection form. Opioids work by binding to receptors in nerve cells in the brain and body, and blocking pain signals from passing through. [27] Unfortunately, in addition to muffling pain, opioids also cause your entire system to slow down, causing side effects such as slow breathing, shortness of breath, constipation, drowsiness, and low blood pressure. These occur when the opioids bind to receptors in a part of the brain called the locus ceruleus, preventing the release of noradrenaline– the chemical responsible for stimulating wakefulness, breathing, blood pressure, and general alertness. [28]

...opioids also cause your entire system to slow down, causing side effects such as slow breathing, shortness of breath, constipation, drowsiness, and low blood pressure

As such, it’s recommended that those using tramadol be monitored for potentially life-endangering breathing problems, especially when taking the drug for the first time, or when their dosage is increased. (Call your doctor or emergency services immediately if you notice symptoms like slowed breathing or shortness of breath while on tramadol.) A final, important downside of opioids like tramadol is that they can become addictive and may cause physical or mental dependency over time. [29]

The risks of tramadol increase if you are taking other medications that may potentially interact with the drug, or if there is a history of chemical dependency in your family, so be sure to inform your doctor if these apply to you. [30]

Conclusion

Painkillers are a useful option for anyone living with knee OA, as they can provide immediate relief, especially during flare-ups. However, they are much less ideal as a long-term solution, as the risk of significant side effects increases when they are used for extended periods of time.

Supplements

Glucosamine and chondroitin

Glucosamine and chondroitin are both compounds found naturally in human and animal cartilage. Dietary supplements contain versions of these compounds which are either synthesised in the lab, or derived from animals such as shellfish.

Supplement manufacturers advertise that consumption of these compounds may help to rebuild cartilage. This is an extremely bold claim, since the medical consensus for decades has been that cartilage does not regrow or regenerate in adults. [31]

...no convincing evidence that glucosamine and chondroitin provided major benefit.

In fact, the use of glucosamine and chondroitin is discouraged by the Arthritis Foundation, the American College of Rheumatology (ACR), and the Osteoarthritis Research Society International (OARSI), which “strongly recommends against all glucosamine and chondroitin formulations” on the grounds of insufficient evidence and the presence of bias in research studies. [32] [33] Major data reviews, including a 2022 meta-analysis covering over eight studies and over 4000 patients, also drew the same conclusion: “no convincing evidence that glucosamine and chondroitin provided major benefit.” [34]

There is even evidence to suggest that these supplements may do more harm than good – such as a landmark 2016 study on glucosamine and chondroitin, which had to be shut down because patients’ OA symptoms were worsening instead of improving as expected. [35]

Nevertheless, many remain convinced that these supplements may help with osteoarthritis: a recent Harvard Health review reported that global sales of glucosamine and chondroitin are predicted to reach $3.5 billion a year by 2025. [36]

SAMe

SAMe (pronounced “sam-ee”) is short for S-adenosyl-L-methionine. It also occurs naturally in the human body, and is involved in multiple biochemical pathways and processes. It can be thought of as a “helper chemical” that supports the formation, activation, and breakdown of many other key compounds in the body, including proteins, hormones, neurotransmitters, and chemicals that help to regulate inflammation and cellular function.

...excess SAMe breaks down in the body into methylthioadenosine and adenine – highly toxic substances known to cause a wide range of health problems including gout, kidney disease and liver disease

SAMe supplements are lab-synthesised, and manufacturers claim that they can help to treat a wide range of conditions including depression, schizophrenia, liver disease, osteoarthritis, and even cancer. SAMe is also marketed online as a liver health supplement for pets such as dogs and cats.

The evidence on SAMe’s effectiveness is extremely inconclusive, with the author of a recent Communications Biology study stating flatly that “the health benefits that manufacturers claim are questionable to say the very least”. [37]

An international group of biologists has also issued a warning against SAMe after unexpectedly discovering that excess SAMe breaks down in the body into methylthioadenosine and adenine – highly toxic substances known to cause a wide range of health problems including gout, kidney disease and liver disease. [38]

The study’s lead scientist thus strongly advised people to “steer clear of SAMe”, at least until more research has been done to determine whether a safe, non-toxic supplementation dosage exists. [39]

Conclusion

Despite these warnings and recommendations, many consumers remain unaware of the potential risks of consuming these compounds for knee OA. This may be because they are classified as supplements in many countries including the United States and Australia, and thus tend to be much more loosely regulated than prescription drugs. As such, consumers would be wise to do their own due diligence before taking up these treatment options.

Viscosupplementation

Viscosupplementation, also known as hyaluronic acid injections, appears at first glance to be one of the more promising options for treating knee OA.

The treatment usually consists of a series of 3-6 injections administered into the knee joint, and costs an average of $1,128 per round of treatment in the US. [40]

...studies consistently and conclusively reveal that, in practice, viscosupplementation does not work any better than placebo.

The idea behind viscosupplementation is that the injected hyaluronic acid-based solution will function like additional synovial fluid – the viscous, egg white-like substance that helps to cushion and lubricate your joints. The additional cushioning and lubrication will thus, in theory, help to prevent further wear and tear on the cartilage.

Because of its popularity, viscosupplementation Is one of the best-studied knee OA treatment options. Unfortunately, these studies consistently and conclusively reveal that, in practice, viscosupplementation does not work any better than placebo.

Wide-reaching systematic studies, including a recent July 2022 review of 50 years’ worth of international patient data, have shown that viscosupplementation is essentially no better than placebo when it comes to either reducing patients’ pain or increasing their function. [41]

Similar results have been available for over a decade, with a similar large systematic 2012 study coming to the very same conclusions. [42] The American Academy of Orthopedic Surgeons has also repeatedly issued clinical guidelines advising against the use of hyaluronic acid injections as a knee OA treatment. [43]

Despite this, many doctors continue to push their patients towards viscosupplementation, with Medicare patients in the US alone continuing to spend over $300 million a year on the treatment. [44]

Many of the top-ranked health advice articles on the web also continue to recommend viscosupplementation. And although some do admit that it “may not work for everyone”, most say there are few downsides to trying it, and list only mild side effects such as swelling and inflammation.

However, strong evidence suggests that viscosupplementation is not a procedure to be undertaken lightly: an analysis of 15 large clinical trials with a total of 6462 participants showed that viscosupplementation was associated with a “statistically significant higher risk of serious adverse events than placebo.” [45] In particular, there appears to be a significant risk of joint infection: “In 2018, more than a quarter of Medicare expenditures for viscosupplementation were incurred for treating subsequent joint infections.[46]

Surgeries

The three most commonly recommended knee OA surgery options are arthroscopy, osteotomy, and arthroplasty (knee replacement).

Arthroscopy

Knee arthroscopy is a keyhole surgery, in which a few small incisions are made in the knee area. [47]

The doctor inserts a small camera and light (the arthroscope) through the incisions and into the joint, allowing for visibility. Jets of fluid are then sprayed into the joint to help wash away or suck out debris and other particulate matter, such as cartilage fragments (a procedure known as lavage). The doctor may also use surgical tools like cutters, shavers and burs to cut, trim, or scrape away damaged or improperly shaped tissue or bone (a procedure known as debridement).

We already know that arthroscopy for osteoarthritis doesn’t help.” “No room for doubt.

According to proponents of the procedure, arthroscopic lavage and debridement can help knee OA patients’ joints to function more smoothly. However, it is widely and unequivocally acknowledged by medical experts from Harvard Health to the Arthritis Foundation and the British Medical Journal that “most OA patients do not benefit from the surgery”. [48] “We already know that arthroscopy for osteoarthritis doesn’t help.[49] “No room for doubt.” [50]

These conclusions are based on multiple systematic reviews, including large, high-quality randomized controlled trials in which arthroscopy was compared against sham surgery or against a control group using more conservative management strategies, such as physical therapy. [51] [52]

Researchers followed up with patients at various intervals after their surgeries, with the final follow-up at two years. They found that arthroscopic lavage and debridement conferred “no additional benefit” to patients, and that patients who underwent these procedures fared “no better than placebo.” [53] [54]

Studies have also revealed significant risks from arthroscopy, including nerve and artery damage, blood clots, and infection, which might lead to a condition known as pyogenic or septic arthritis – arthritis caused by infection. [55] [56] Some research even suggests that arthroscopy may “cause arthritis to advance more rapidly than it would have, which could lead to the need for knee replacement”. [57]

Other downsides of arthroscopy include the high cost (about $5,000-10,000 in the United States) and the recovery time, which ranges from several weeks to several months, with patients often needing to use crutches and avoid basic activities like driving for the first few weeks after surgery. [58] Many patients will face additional costs as well, as they may need to undergo physiotherapy to ensure a smooth recovery. [59]

Despite this, many doctors and mainstream health advice articles unfortunately continue to make outdated recommendations in favour of arthroscopy. About a million knee arthroscopies are still performed each year in the United States – costing patients and taxpayers over $3 billion. [60]

Osteotomy

Knee osteotomy involves cutting away parts of either the tibia (shinbone) or the femur (thighbone) to relieve imbalances in the knee joint. [61]

It is suitable for people whose knee OA is caused by structural misalignments which put extra pressure or friction on some parts of the knee, leading to cartilage degeneration over time. [62]

Patients face the same types of risks as in arthroplasty, but magnified, since osteotomy is a much more invasive intervention.

Osteotomy may also be suitable for people with unilateral knee OA – that is, pain and damage on only one side of the knee. In these instances, the goal of the surgery is to shift the patient’s weight away from the damaged side of the joint, and onto the healthier side. [63]

During surgery, cuts to the bone are made using an oscillating saw. The surgeon will then secure the bones in place by inserting plates and screws, which can be made of either metal or a bioabsorbable material which degrades and is reabsorbed into the body over time. [64] [65]

Osteotomy is a major surgical procedure which must be performed under general or spinal anaesthesia. Patients face the same types of risks as in arthroplasty, but magnified, since osteotomy is a much more invasive intervention. They also face the additional risks of general or spinal anaesthesia, and the possibility that the osteotomy may simply fail to heal. [66] [67]

Recovery from an osteotomy is also an arduous process, taking an average of 9-12 months. Patients will need 24-hour help to function in the first week, and will need to use crutches or a walker and/or a brace or cast for weeks or months after that. Narcotics, blood thinners, and TED (thrombo-embolic deterrent) compression hose are also needed in the months after the surgery, to help relieve pain and inflammation, and to prevent potentially life-threatening blood clots. [68]

Arthroplasty (knee replacement)

An arthroplasty is a partial or total replacement of the knee joint by artificial parts made of metal and plastic. It is usually the last knee OA treatment people choose to undergo, as it is the most drastic and invasive option available.

During an arthroplasty, surgeons cut away both damaged cartilage and parts of the femur (thighbone) and tibia (shinbone) which are adjacent to the knee joint. These are then replaced by the artificial implants, which are attached to the remaining bone structure using cement. [69]

one in every 100-200 patients dies within 90 days of the surgery, and even more suffer serious complications...

A new attachment option known as “press-fit” is also available. In this option, the implants are made from a porous material, which allows the remaining bone to grow into and bond with the implant over time in a process known as “biological fixation”. [70] Press-fit knee implants are thought to last longer and have better stability than traditional cemented implants. Younger patients who are active, fit, and have no other comorbidities are often good candidates for this procedure. Conversely, it may not be suitable for older patients or those with other health conditions, such as osteoporosis (low bone density). [71]

Needless to say, as a major surgery, knee arthroplasty comes with considerable risks: one in every 100-200 patients dies within 90 days of the surgery, and even more suffer serious complications like “infections, blood clots or knee stiffness severe enough to require another medical procedure under anesthesia”. [72] [73]

Despite this, many doctors and surgeons continue to present knee arthroscopy as a “simple routine procedure, with nearly 100% of patients suffering no serious side effects at all”. [74] Patient surveys however tell a very different story– that up to a third of patients regret getting a knee replacement, and about a third also continue to experience chronic pain after the surgery. [75]

Some experts believe that doctors are over-recommending knee arthroplasty because the procedure – which costs an average of $31,000 in the US and generates over $9 billion a year – is “crucial to the financial health of hospitals and doctors’ practices. [76] [77]

A final point to consider is that knee replacements do not last forever. This is because implants can become infected or loosen and detach over time. [78] The plastic components within implants are also subject to wear and tear, and degrade over time within the body, creating debris that can cause inflammation, pain and damage in the joint. [79] A Lancet study found that over 10% of knee replacements failed after 20 years of use, requiring patients to undergo another costly round of “revision surgery” (averaging about $49,360 for total knee replacements). [80] [81]

Conclusion

From this survey we can conclude that, unfortunately, many of the most frequently recommended pharmacological and surgical interventions for knee OA may not be as effective as advertised. Many may also have much more serious side effects than commonly realised.

This is not to say that knee OA patients should never consider pharmacological or surgical interventions. However, given the high costs, lack of robust effectiveness data, and risk of significant side effects, many top knee OA experts and institutions strongly recommend more conservative and non-invasive treatment options first. [82]

Natural, non-invasive options

The more natural, non-invasive treatment options for knee OA fall into the following two categories:

Lifestyle changes

One of the most unanimous top recommendations for knee OA is weight loss for people who are overweight. This will reduce pressure on load-bearing joints and thus reduce strain and wear on the bones and cartilage.

A second commonly recommended lifestyle change is to replace high-impact with low-impact activities. For instance, you might replace running with swimming in your weekly fitness routine. Other low-impact fitness activities that are gentler on the knees include walking, biking, elliptical training, water aerobics, yoga, and tai chi. You may also reduce the impact of everyday activities like walking by using assistive devices such as a cane or walker.

A third lifestyle change is to rest or take breaks more frequently when doing activities that cause strain or wear on the knee joint, such as standing for long periods, or long-distance driving.

These healthy lifestyle choices present no risk of side effects, though it may take time and patience for the results to materialise in the form of actual relief from knee OA symptoms and pain. Some of the advice, like taking breaks more frequently or driving less, may also not be feasible for everyone.

Physiotherapy and exercise

Physiotherapist-guided exercise differs from exercising for general fitness or weight loss. It is specifically intended to strengthen and stretch specific muscle groups affecting the knee, with the goal of reducing load on the knee joint and improving its overall functioning.

Strengthening exercises often focus on the quadriceps and other thigh muscles, which can help absorb the impact of walking and other activities that put pressure on the knees. [83] Meanwhile, stretching and other range-of-motion exercises help to reduce tightness and improve mobility, and thus help to relieve key knee OA symptoms like joint stiffness and pain. [84]

...the benefits are lost after six months if the patient discontinues them.

Your physiotherapist will customise these exercises to form a program that suits your needs and abilities. They will also help to ensure that your form is correct so that you are activating the right muscle groups, instead of falling into counterproductive compensation patterns. (This occurs when surrounding muscles are unconsciously recruited to help compensate for a weaker muscle, so that the latter is not actually undergoing proper strengthening and conditioning while performing the exercises.)

Physiotherapy can cost between $90 and $150 per visit, with patients usually requiring several sessions spread across a period of weeks or months. The patient’s level of discipline and commitment to the process is the key factor in treatment success, as the bulk of the work is accomplished not during the physiotherapist visit itself, but in the consistent daily exercise sessions between consultations. Moreover, the patient must commit to doing the exercises consistently to maintain the results, as “the benefits are lost after six months” if the patient discontinues them. [85]

As with lifestyle changes, it may take time for results to materialise. However, if performed consistently and correctly, physiotherapist-guided exercise can be a highly effective treatment for knee OA, with no risk of negative side effects.

Heat therapy

Heat therapy (also known as thermotherapy) is an age-old arthritis remedy used in both clinical and at-home settings, with the first documented use of heat for arthritis going back at least to Ancient Greece. [86]

Heat therapy relieves pain, reduces tension, and loosens tight and stiff joints, muscles and tissue, while also supporting healing by boosting circulation to the treated area. Its efficacy is also backed by scientific research, with an international review of multiple heat therapy studies finding that improved joint function was reported in “nearly all cases”. [87]

Despite its simplicity, properly executed heat therapy can be surprisingly powerful as a knee OA treatment. In fact, results from a randomized controlled study published in 2016 suggest that it may even be as effective as exercise.

In the study, one group of patients with knee OA was treated with 20 minutes of localized heat therapy twice a day, five days a week. A second group was put through a physiotherapist-guided treatment plan consisting of a series of seven exercises to be conducted for ten minutes twice a day, five days a week. A third group received both the heat therapy and the exercise interventions, while a fourth group received no interventions and served as the control.

After four weeks, all three intervention groups (but not the control group) showed significant improvements, with both reduction in pain levels and improved joint functioning as measured by VAS and WOMAC scores. [88] [89]

...The main downside of heat therapy is the inefficiency and inconvenience of the traditional home-based treatment methods recommended by most health advice articles

Interestingly, there was no statistically significant difference between the heat-only group, the exercise-only group, and the heat-plus-exercise group. This suggests that at-home heat therapy may be a powerful alternative for knee OA patients who are unable to access physiotherapy or make time for consistent daily exercise. Heat therapy is also a natural, gentle treatment that is free of side effects.

The main downside of heat therapy is the inefficiency and inconvenience of the traditional home-based treatment methods recommended by most health advice articles. Items like hot water bottles and microwaveable bead or gel packs often do not stay warm for more than a few minutes, and do not remain at a consistent temperature.

This is a problem, as heat therapy needs to be of sufficient temperature and duration (at least fifteen minutes) in order for the heat to penetrate the surface levels of your skin and effectively reach the deeper tissues in the knee joint. [90] Patients also complain of the inconvenience of having to hold the heat pack in the same spot for the full treatment duration, and the hassle of heat packs slipping out of place when secured with bandages or tape. These inconveniences can be off-putting, making it less likely that patients will be consistent and successful in their use of heat therapy.

Our knee OA product, the HeatPulse Knee Massager, was created to help solve these problems, so you can enjoy consistently effective, hassle-free heat therapy, every time. Learn more about the HeatPulse below.

About the HeatPulse

HeatPulse
Knee Massager

by

Long-lasting comfort with heat and vibration therapy

$169

Doctor- and physiotherapist-recommended heat therapy device for knee osteoarthritis.

Boosted with effective pain-relieving vibrative massage.

Hundreds of customers say it’s brought life-changing relief from knee OA pain.

How it works

Effective, long-lasting
heat therapy

Enjoy lasting warmth with HeatLast™ infrared graphene technology

Stays warm for over an hour, no more microwaving or reheating

Stays at a consistent temperature throughout

Choose from 5 settings between 40-60°C (104-140°F)

Automated 30-minute sessions for sufficient treatment duration

Boosted with
vibration therapy

Provides strong, steady pulses of 120Hz vibrative massage

Helps improve circulation in the treated area to boost recovery

Gently disrupts pain signals for highly effective natural pain relief

Choose from 3 massage speeds, from 0 (no massage) to 3 (highest)

The perfect complement to heat therapy

Simple and convenient

Ready to use in seconds:

No bandages or tape to get heat packs to stay in the right spot

Hands-free operation – use it while working, resting or watching TV

Fully cordless, unlike electric heating pads or electric blankets

Reusable and rechargeable, unlike disposable heating packs

Control pod detaches for fuss-free USB-C charging

Customizable comfort

Fully adjustable 360° Silkro™ sleeve for a comfortable fit

Breathable, moisture-wicking polyester mesh lining

Comes with an extension strap for larger knees

Also works on other joints, like the shoulder and elbow

What the experts are saying

“...a fantastic way for patients to relieve pain, reduce stiffness and improve blood flow to an injured knee and potentially accelerate their recovery from injury.”

Will Harlow

Clinic Director and Lead Physiotherapist
HT Physio

Hear from our customers

Our promise to you

Although hundreds of people have found relief with the HeatPulse, we understand that everybody is different, and that what works for some might not work for everyone.

So we’ve made it risk-free to try the HeatPulse, with our policy.

You’ll have 30 full days to test the HeatPulse. If it doesn’t suit you for any reason, we’ll take it back and give you a full refund– no questions asked.

We also provide friendly and dedicated customer support, so if you need any help with your HeatPulse, just reach out to our team at support@hydragun.com, or by submitting a support ticket. We aim to reply to all messages within one business day.

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