Non-Surgical Treatment Options for Avascular Necrosis: What You Need to Know

Avascular necrosis (osteonecrosis) occurs when bone tissue degenerates due to a lack of blood supply. It can lead to pain and joint damage and affect the bones in the body. It is most commonly seen in the hip, shoulder, and knee joints. 

A disruption or reduction in the blood flow to the bone causes avascular necrosis (AVN). It can be caused by joint or bone trauma, cancer treatments involving radiation, fatty deposits in blood vessels, medications such as corticosteroids, and other medical conditions such as osteoporosis, sickle cell anaemia, diabetes, decompression sickness, HIV, and lupus.

Symptoms of Avascular Necrosis

Symptoms of avascular necrosis include

  • Pain and stiffness in the affected area.
  • Difficulty moving the joint.
  • Visible deformity of the affected bone.

In certain instances, an exposed bone in the jaw may occur accompanied by discomfort, discharge, or both. If the affected region is limited in size, it may not pose a significant issue, and the body’s natural healing mechanisms may be able to reconstruct the damaged portion.

Avascular necrosis treatment usually involves reducing the amount of cholesterol and fat in the blood, medications that open blood vessels, and blood thinners. Surgery or joint replacement may sometimes be necessary to ease pain and improve mobility.

Non-Surgical Treatment Options for Avascular Necrosis

You must know some non-surgical treatment options. Let’s discuss them below:

Rest And Limiting Weight-Bearing Activities

Rest and limiting weight-bearing activities are essential in treating avascular necrosis (AVN) because they reduce the pressure on the affected bone, allowing it to heal. 

Weight-bearing activities, such as running, jumping, and other high-impact activities, can cause further damage to the bone and should be avoided. Instead, swimming, biking, and other low-impact exercises can help maintain fitness and reduce the risk of further damage. 


There are many available medications to treat avascular necrosis. Let’s discuss them below.

  • Pain Relievers

Pain relievers like non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) are commonly used to treat avascular necrosis (osteonecrosis). These medications help reduce the pain associated with avascular necrosis and slow the condition’s progression. 

  • Bisphosphonates

These are the categories of drugs inhibiting bone resorption, breaking down and removing bone tissue. These medications help reduce the risk of bone collapse, a common symptom of AVN. 

  • Blood Thinners

Medications such as anticoagulants, or blood thinners, are commonly used to treat avascular necrosis (AVN). Blood thinners can also help reduce inflammation and pain associated with AVN. Commonly used blood thinners for AVN include Warfarin (Coumadin), aspirin, clopidogrel (Plavix), and heparin.

Physical Therapy and Rehabilitation

One type of physical therapy useful for avascular necrosis is range-of-motion exercises. These exercises involve moving the affected joint through its full range of motion, which can help maintain or improve joint mobility. Strengthening exercises are also helpful, as they can help rebuild muscle strength and support the affected joint.

Assistive Devices

One standard assistive device for avascular necrosis is a cane. Canes can help redistribute weight from the affected bone to other body parts, reducing pain and pressure on the affected area. 

Orthotics, such as braces or shoe inserts, can also help treat avascular necrosis. Braces can help immobilize the affected area, reducing pain and healing the bone. Shoe inserts can help redistribute weight and support the foot and ankle.

For those with avascular necrosis of the hip, mobility aids such as wheelchairs or scooters can be beneficial. These devices allow individuals to move around without weight on the affected joint, reducing pain and improving mobility.

Benefits and Risks of Non-Surgical Treatment Options


  • Pain Relief

Avascular necrosis treatment without surgery options like medication, physical therapy, and lifestyle changes can help alleviate the pain associated with AVN. Medic like painkillers and anti-inflammatory drugs can reduce inflammation and pain, while physical therapy can help improve mobility and strengthen the affected area. Lifestyle changes like weight loss and quitting smoking can also help reduce stress on the affected bone and improve overall health, leading to pain relief. 

  • Improved Mobility

Medical management services like physical therapy, bracing, and activity modification can help improve mobility and reduce pain, allowing patients to move more freely and comfortably.

  • Prevention of Joint Damage

Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen sodium can help to reduce pain associated with avascular necrosis. In contrast, core decompression, injections, and bone grafts can help to improve blood flow to the affected bone and promote healing. 

Osteotomy can also help to reshape the bone and reduce stress on the affected area. These Avascular necrosis treatments can help to reduce the risk of further joint damage and can help to improve the patient’s quality of life.


  • Side Effects Of Medications

Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to help relieve pain associated with avascular necrosis. Still, they can cause gastrointestinal problems, kidney damage, and increased heart attack or stroke risk. 

Medications such as corticosteroids, bisphosphonates, and platelet-rich plasma injections may also treat avascular necrosis. Still, they can also cause side effects, such as an increased risk of infection, bone thinning, and muscle weakness.

  • Limited Efficacy of Treatment

While Avascular necrosis treatment can effectively relieve pain and improve function, it may not always be successful in stopping the progression of the disease. It is because avascular necrosis treatment without surgery does not address the underlying cause of avascular necrosis, which is a lack of blood supply to the bone. As a result, the efficacy of these treatments is limited, and they may not be able to prevent the need for surgery in the future.

  • Prolonged Treatment Timeline

While these non-surgical treatment options can help alleviate symptoms and prevent further damage, they do not cure the condition. As a result, patients may need to undergo these treatments for an extended period or indefinitely. This prolonged timeline can be a burden for patients, both financially and emotionally.


While avascular necrosis can be debilitating, various avascular necrosis treatment options are available to manage symptoms and slow disease progression. Patients have various options, from medication to physical therapy to regenerative medicine, based on their needs and preferences. 

Patients must work closely with their healthcare team to develop a comprehensive treatment plan considering all aspects of their health and lifestyle. With the proper care and management, avascular necrosis patients can continue leading fulfilling and active lives

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