It is a therapy that protects a person’s joints and reduces pain.

Stiff knees, aching hips, and the slow progression of chronic joint pain are often accepted as an inevitable part of aging. but while osteoarthritis It is the world’s most common joint disease, with experts saying the way we treat and prevent it is not in line with the evidence.

The best medicine doesn’t come in a pill bottle or an operating theater – it’s movement. Yet across all countries and health systems, very few patients are being directed toward the one therapy proven to protect their joints and reduce their pain: Exercise,

Exercise is one of the most effective treatments for chronic, disabling joint conditions such as osteoarthritis. Yet very few patients actually achieve this.

Research on health systems in Ireland, the UK, Norway and the United States shows the same pattern: less than half of people with osteoarthritis are referred for exercise or physiotherapy by their primary care provider. More than 60% are given treatments that guidelines do not recommend, and nearly 40% are referred to a surgeon before even trying non-surgical options.

To understand why these statistics are so troubling, it helps to understand what exercise does to joints. Osteoarthritis is by far the most common form of arthritis, already affecting more than 595 million people worldwide.

According to a global study in The Lancet, this number could reach one billion by 2050. Longer life expectancies, increasingly sedentary lifestyles and increasing numbers of overweight or obese people are driving this trend.

Yet people who exercise regularly are physically and biologically protecting themselves from developing the disease and suffering its worst effects.

The cartilage covering the ends of our bones is a hard, protective layer that has no blood supply of its own. It depends on speed.

Like a sponge, cartilage compresses when we walk or put weight on the joint, expelling fluid and then drawing fresh nutrients back in. Each step allows nutrients and natural lubricants to circulate and maintain joint health.

That’s why the old idea of ​​osteoarthritis as simple “wear and tear” is misleading. Joints are not car tires that inevitably grind down.

Osteoarthritis is best understood as a long process of wear and repair in which regular movement and exercise are important for healing and overall joint health.

total joint disease

We now know that osteoarthritis is a disease of the entire joint. It affects the joint fluid, underlying bone, ligaments, surrounding muscles, and even the nerves that support movement.

Therapeutic exercise targets all of these elements. Muscle weakness, for example, is one of the early symptoms of osteoarthritis and can be improved with resistance training. There is strong evidence that muscle weakness increases the risk of developing and progressing the disease.

Nerve and muscle control can also be trained through neuromuscular exercise programs such as GLA:D® (Good Life with Osteoarthritis: Denmark) for hip and knee osteoarthritis. Typically delivered in group sessions supervised by a physiotherapist, these programs focus on quality of movement, balance and strength to improve joint stability and rebuild confidence.

Significant improvements in pain, joint function and quality of life have been reported up to 12 months after completing the program.

Exercise is good medicine for the whole body: its benefits have been documented for more than 26 chronic diseases. In osteoarthritis, it not only helps strengthen cartilage and muscles but also helps deal with inflammation, metabolic changes, and hormonal changes that aggravate the disease.

Obesity is a major risk factor for osteoarthritis, and not just because of the extra mechanical load on the joints. High levels of inflammatory molecules in the blood and joint tissue can degrade cartilage and worsen disease.

For osteoarthritis, regular activity can combat it at the molecular level, reducing inflammatory markers, limiting cell damage and even altering gene expression.

Exercise first, surgery later

Currently, there are no medications that modify the course of osteoarthritis. Joint replacement surgery can be life-changing for some people, but it is a major surgery and is not successful for everyone.

Exercise should be the first step and continued during every stage of the disease. It has very few side effects and offers many additional health benefits.

Osteoarthritis is not just a matter of “worn out” joints. It is shaped by muscle strength, inflammation, metabolism and lifestyle.

Regular, targeted exercise addresses several of these factors simultaneously – helping to protect the cartilage, strengthen the entire joint, and improve overall health. Before even considering surgery, movement is one of the most powerful treatments we have.