Stiffness in the knees, hip pain, and persistent joint discomfort are often seen as natural signs of aging. However, osteoarthritis—the most common joint disease worldwide—is frequently not treated according to the latest scientific guidelines. The main issue is not a lack of treatment options, but rather the insufficient use of the most effective one: physical activity.

The Role of Physical Activity in Osteoarthritis Treatment

The most effective way to manage osteoarthritis is not through medication or surgery, but with regular physical exercise. Despite this, in many countries and healthcare systems, patients are rarely prescribed exercise as a primary therapy, even though it is proven to reduce pain and protect the joints. Physical activity is considered one of the most effective treatments for chronic joint diseases, including osteoarthritis, yet only a minority of patients receive this recommendation. Studies in Ireland, the UK, Norway, and the USA show that less than half of people diagnosed with osteoarthritis are referred to exercise programs or physiotherapy, while over 60% undergo treatments not recommended by clinical guidelines. About 40% of patients are referred to a surgeon before fully exploring non-surgical options.

How Exercise Protects the Joints

Osteoarthritis is the most widespread form of arthritis, affecting over 595 million people globally. By 2050, the number of cases could approach one billion, driven by increased life expectancy, sedentary lifestyles, and rising rates of overweight and obesity.

Regular physical activity not only relieves symptoms but also lowers the risk of developing osteoarthritis and reduces its severity. Cartilage, which covers the ends of bones, lacks its own blood supply and relies on movement to stay healthy. When walking or putting weight on a joint, the cartilage compresses, pushing fluid out; when the pressure is released, the fluid returns, bringing nutrients and natural lubricants. Every step helps nourish and maintain the joint.

Osteoarthritis is not simply “wear and tear” of the joint. Joints are not mechanical parts that inevitably degrade over time. The disease is a long-term process of breakdown and repair, where regular movement plays a crucial role in maintaining joint health.

The Comprehensive Impact of Exercise

Osteoarthritis affects not only cartilage but also joint fluid, underlying bone, ligaments, surrounding muscles, and even the nerves that control movement. Targeted exercises can benefit many of these components. Muscle weakness is one of the earliest signs of osteoarthritis, and strength training helps address it. Weak muscles have been shown to increase the risk of developing the disease and accelerate its progression.

Neuromuscular exercise programs, such as GLA:D® (Good Life with osteoArthritis: Denmark), are specifically designed for people with hip and knee osteoarthritis. These programs are typically conducted in groups under the supervision of physiotherapists and focus on improving movement quality, balance, and strength, which contribute to joint stability and confidence in movement. Participants often report significant pain reduction, improved joint function, and a better quality of life, with benefits lasting up to a year after completing the course.

Effects on Overall Health

Physical exercise benefits the entire body and has proven effective in managing more than 26 chronic diseases. In osteoarthritis, its impact goes beyond strengthening muscles and supporting cartilage. Physical activity also influences inflammation, metabolism, and hormonal changes that contribute to disease development.

Inflammation, Obesity, and Joint Damage

Obesity is one of the main risk factors for osteoarthritis, and the reason is not just the extra load on the joints. Excess fat is associated with higher levels of inflammatory molecules in the blood and joint tissues, which can damage cartilage and speed up disease progression. Regular physical activity helps lower inflammatory markers, reduce cell damage, and even affects gene expression to support joint health.

Exercise Before Surgery

Currently, there are no medications that can alter the course of osteoarthritis. Joint replacement surgery can be effective for some patients, but it is a major operation and does not always guarantee the same positive results. Physical exercise should be the first step and remain part of treatment at every stage of the disease, as it carries significantly fewer risks than surgery and provides overall health benefits.

Conclusion

Osteoarthritis is not simply “worn-out” joints. Its development is influenced by muscle strength, inflammation, metabolism, and lifestyle. Regular, structured exercise addresses many of these factors at once, helping to protect cartilage, support the entire joint, and improve overall health. Before considering surgery, movement remains one of the most effective and accessible treatment options.