Exercise was just as effective as over-the-counter pain medications for those suffering from knee or hip osteoarthritis (OA), researchers reported in a 2023 review published in the British Journal of Sports Medicine that examined 152 randomized controlled trials.
“Given its excellent safety profile,” the authors note, “exercise should be given more prominence in clinical care, especially in older people with comorbidity or at higher risk of adverse events related to NSAIDs and paracetamol [acetaminophen].”
That message, however, has not been widely embraced by healthcare providers — or by their patients. Writing in BMJ Open, University of Limerick physiotherapist Clodagh Toomey, PhD, cites a large study that found that fewer than half of osteoarthritis patients in Ireland, the United Kingdom, and the United States have been referred to a physical therapist to treat their joint pain.
“Despite OA being among the leading causes of years lived with disability,” Toomey writes, “the decision to seek care can be deterred by negative or dismissive attitudes from healthcare professionals about their nonurgent condition, or the perception that pain is part of aging.”
Many patients misunderstand the origins of OA, which may contribute to treatment avoidance. Osteoarthritis isn’t a product of wear and tear on the joint, she explains. It’s really a “wear and repair” process that can benefit from movement.
The spongelike cartilage that covers the ends of our bones and our joints relies on movement for its nutrient supply. Fluid is squeezed out when this cartilage is compressed during walking or other exercise and reabsorbed when it’s decompressed. By encouraging nutrients and natural lubricants to circulate, exercise promotes joint health.
Toomey sees osteoarthritis as a whole-joint disease because it also affects bones, ligaments, muscles, and nerves. She cites studies that show a link between OA and muscle weakness and argues that resistance training may be key to prevention and treatment. She also points to neuromuscular exercise programs that have been effective at relieving pain from hip and knee osteoarthritis.
And then there’s bicycling. Writing in Outside, Alex Hutchinson touts the results of a 2024 study in Medicine & Science in Sports & Exercise, which found that people who have “any history of cycling” are 9 percent less likely than noncyclists to be diagnosed with osteoarthritis.
“Lifelong cyclists cut their risk of symptomatic knee OA by almost half,” he writes.
Swimming, strength training, and even running have been associated with lower risk for the disease, Hutchinson notes, “despite what every nonrunner and ex-runner you know will continue to insist.”
This article originally appeared as “The Best Medicine for Joint Pain May Be Exercise” in the July/August 2026 issue of Experience Life.
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