The most common misunderstanding about arthritis is that it is a reason to do less. It is one of the strongest reasons to do more, and the evidence on that is not close.
NICE recommends therapeutic exercise as a core treatment for osteoarthritis for everybody who has it, regardless of age, severity or what a scan shows. Exercise reduces pain and improves function, and it does not accelerate the wear. The instinct to protect a painful joint by using it less produces weaker muscle around it, and a joint supported by weaker muscle hurts more, which is how the cycle tightens.
More information
What a scan does and does not tell you
Degenerative changes are extremely common in people with no pain at all, and they increase with age in everybody. How much a worn joint hurts correlates poorly with how it looks on X-ray, and correlates rather well with strength, activity levels and confidence. All three of those are treatable, which is why a diagnosis of arthritis is not the end of the conversation.
What treatment involves
Assessment of what you can and cannot do now and what you want back. Then a strengthening programme for the muscles around the affected joint, work on movement and function, and pain management strategies. We will also be honest about pacing, because doing too much on a good day and paying for it for three is the most common pattern people fall into.
Where arthritis mainly affects one side of the knee, an offloading brace can make walking and exercise more comfortable for the right person. Our article Do I need a knee brace? explains who it suits and what NICE says about bracing.
Rheumatoid and inflammatory arthritis
These are different conditions requiring medical management by a rheumatologist, and physiotherapy works alongside that rather than instead of it. Hot, swollen joints, morning stiffness lasting more than an hour, or several joints affected symmetrically should be discussed with your GP rather than treated as wear and tear.
When surgery is worth discussing
Where pain and loss of function persist despite good conservative treatment, joint replacement is an excellent operation and we will write to your GP.
Frequently Asked Questions
Will exercise make my arthritis worse?
My X-ray shows severe arthritis. Does that mean nothing can help?
Is rheumatoid arthritis treated the same way?
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