I too have severe osteoarthritis in my right knee-grade 4. I’m on a low dose blood thinner as well so I too can only take Tylenol. I find taking at night only mainly to relax and sleep works best. Also sleeping with a pillow between my legs helps as well. I also have been taking a supplement of Magnesium Glycinate with a multivitamin. I did get some relief from a Cortisone shot as well. My knee pain has gone from an 8 or 9 to a 3 or 4 most days. I don’t know exactly why but I’m grateful. I have a knee replacement in my future but I’m holding off as long as possible. Good luck-hope you find some relief soon.