Osteoarthritis: why exercise is the first treatment

How common it is

According to the WHO, about 528 million people had osteoarthritis in 2019, 113% more than in 1990. 73% are over 55 and 60% are women. The knee is the most affected joint, with 365 million people, followed by the hip and the hands.

What raises the risk

Past joint injuries, age, extra weight, genes and being female. The two you can change most are injuries and weight.

World Physiotherapy notes that losing 5 kg, or 5% of body weight, is linked to a 90% lower chance of knee problems six years later.

Why exercise comes first

Exercise suits everyone with osteoarthritis, whatever their age or how severe it is. It reduces pain, improves function and can delay or prevent a joint replacement.

The WHO agrees: exercise and healthy eating, to build strong muscles and keep a healthy weight, can reduce symptoms and the risk of them getting worse.

Myths to forget

• It is not just wear and tear or bone on bone. It is a condition that affects how cartilage repairs itself.
• X-rays do not show how much it hurts. They can show a lot of change with little pain, and the other way round.
• It does not get worse for everyone. Only about a third of people get worse over time.
• Running is generally safe for cartilage. If your knee hurts for more than an hour afterwards, reduce the load, for example two 15-minute runs instead of one 30-minute run, rather than stopping.

How physiotherapy helps

A physiotherapist builds a strength and exercise plan for you, shows you how to adjust it when your joint is sore, and helps you before and after a joint replacement if you need one.