Arthritis and joint pain

How does exercise help with arthritis and joint pain?

Exercise tends to ease joint pain and help you move better, though the benefit is usually modest. Guidelines strongly recommend it for knee, hip and hand osteoarthritis, and say the vast majority of people can take part and benefit¹. Physical activity is also advised as a normal part of care for inflammatory arthritis².

How much it helps depends on the joint:

• Knee: the pain benefit is moderate straight after a programme and small two to six months later³. Strength training in early knee osteoarthritis tends to improve pain, stiffness, everyday function and quality of life⁵.
• Hand: exercise probably gives a small, short-term cut in pain⁴.
• Hip: the gain in pain and function may be little to none, even though guidelines still recommend exercise⁴.

One suggested reason for the benefit is that stronger muscles around a joint support movement and may ease stiffness and some pain. This is an idea, not a proven explanation⁶.

There's no exact amount or best type of exercise to copy. Choose movement you can get to and are likely to keep doing. Start with a small amount, then build up how often, how hard and how long over time. Some activity is better than none.

Adults living with a long-term condition such as arthritis should aim for the same amounts as other adults where they can: at least 150 minutes of moderate-intensity activity a week, plus muscle-strengthening on at least 2 days. If you can't, any activity you're able to do brings benefits. Exercise doesn't have to hurt to work: soreness isn't needed for progress.

Ask a physio or other health professional for specific advice on what to do. It works better than a general aim to "exercise more"¹.

Can mind-body practices help with chronic pain?

Some can, a little. Tai chi has the strongest case, mainly for knee or hip osteoarthritis. It combines slow, gentle movement with breathing and relaxation, and a US guideline strongly recommends it¹.

Tai chi tends to reduce osteoarthritis pain compared with control treatments, though not clearly more than other active therapies⁷. For knee osteoarthritis, the improvements in pain and function are large enough to matter⁸. Programmes of five weeks or less didn't clearly reduce pain, while programmes of six weeks or more did, so give it at least six weeks before judging⁷. It isn't clear yet whether the pain relief lasts after a programme ends⁷.

Yoga is conditionally recommended for knee osteoarthritis, and its case is weaker than tai chi's¹. In chronic low back pain it may give small improvements, and more people may rate their back pain as better⁹. For back-related function at three months it does about the same as other back exercise⁹.

Mindfulness meditation is linked with a small drop in chronic pain, and with better mood and quality of life. The benefit is small and not certain¹⁰. For low back pain, non-drug therapies generally ease pain by a small to moderate amount, mostly in the short term¹¹.

When to check with a health professional

If you're starting exercise after a long break, it's always a good idea to see your doctor first.

Most of the research is on osteoarthritis, so if you have inflammatory arthritis, check your plans with your doctor or physio. Advice should be fitted to you, so tell them about any other health conditions you have². For an injury or a health condition, see a health professional, such as your doctor or a physio.

Pain during exercise is a signal to stop or ease off. The main downside reported for knee exercise is more knee or low back pain³. If joint pain gets worse with activity or a mind-body practice, ease off, and see a doctor or other health professional if it persists or gets worse.

Joint pain that keeps getting worse, even when resting, or comes with numbness or weakness in the legs or feet, is worth getting checked by a doctor or other health professional. Don't try to diagnose it yourself¹².

Exercise doesn't replace prescribed medicines or treatment. Keep taking them as prescribed, and talk to the doctor before changing or stopping them.

Call your local emergency number for chest pain or pressure (or pain spreading to the arm, neck, jaw or back, especially with sweating or feeling sick), severe breathlessness, fainting or collapse, signs of a stroke, a serious injury, or someone who isn't safe.