Arthritis is managed best initially by a physical medicine and rehabilitation (PM&R) physician who is highly trained in the conservative treatment of joint and muscle problems. Treatment methods used include weight loss, acetaminophen, NSAIDs, corticosteroid injections, viscosupplementation and rehabilitation. Viscosupplementation has recently become more common as it helps to alleviate arthritis pain through injection of a gel-like substance that mimics the natural lubricant created in the joint to allow more “cushion” within the joint. If pain is still persistent regardless of conservative management, a referral from a PM&R physician to an orthopedic surgeon may be necessary to consider total joint arthroplasty.