Therapeutic exercise, information and support, and weight management where appropriate are the core treatments for osteoarthritis. Exercise may feel uncomfortable at first, but regular movement can reduce pain and improve function over time. Manual therapy shouldn’t be relied on alone, and a hot, swollen joint needs prompt medical attention.
What is osteoarthritis?
Osteoarthritis is a long-term joint condition that often affects the knees, hips, hands and spine. It can cause pain, stiffness and reduced movement. Symptoms may vary from day to day, and temporary flare-ups are common.
The UK’s National Institute for Health and Care Excellence (NICE) says osteoarthritis can usually be diagnosed without imaging in people aged 45 or over who have activity-related joint pain and either no morning stiffness or morning stiffness lasting no more than 30 minutes. NICE writes guidance for the UK, but it is widely used as a reference. The Chiropractic Association of South Africa also explains how osteoarthritis differs from osteoporosis and rheumatoid arthritis.
What helps osteoarthritis?
Therapeutic exercise
NICE recommends exercise tailored to your needs, such as local muscle strengthening and general aerobic fitness. Supervised sessions may help some people get started and keep going.
Your joint pain may increase when you first start. This doesn’t necessarily mean you are causing harm. NICE advises that regular, consistent exercise benefits the joints, and that sticking with a plan in the long term helps to reduce pain and improve function and quality of life.
Weight management, if relevant
If you are living with overweight or obesity, NICE says that any weight loss is likely to help, and that losing 10% of your body weight is likely to help more than losing 5%. Your doctor or a dietitian can help you choose a realistic goal.
Information and support
Understanding your condition can make it easier to manage flare-ups and decide what to do next. Ask your health professional to explain your options and agree on a plan you can keep up.
Medicines
Any medication should be discussed with your doctor or pharmacist. NICE advises using medicines alongside non-drug treatments, at the lowest effective dose for the shortest possible time.
Can a chiropractor help with osteoarthritis?
A chiropractor can assess how your joints and muscles are working, explain what they find, and help you plan rehab exercises and a return to activity. They should refer you if your symptoms need medical care or a surgical opinion.
Hands-on treatment has a limited role here. NICE states that there isn’t enough evidence to support manual therapy alone for managing osteoarthritis, so any manual care should be discussed as a possible add-on to exercise. You can read more about what a chiropractor does.
Practical ways to stay active with joint pain
- Find activities you can keep doing: walking, cycling, swimming, water exercise and strength training are common choices.
- Start at a level you can manage: build up gradually instead of doing too much on days when you feel good.
- Have a flare-up plan: reduce the load for a short time if needed, then build back up.
- Consider a walking aid: NICE says walking aids such as sticks can be considered for osteoarthritis in the lower limbs.
When does joint pain need prompt medical attention?
See a doctor promptly or go to an emergency unit if you have:
- A hot, red or swollen joint, particularly if you also have a fever or feel unwell
- Sudden, severe pain or an inability to bear weight, especially after an injury
- A joint that has changed shape suddenly
Also see a health professional if you have long-lasting morning stiffness, if symptoms are rapidly getting worse, or if you are losing weight without trying. These may point to a different diagnosis.
Frequently asked questions
Is exercise bad for arthritic joints?
No. Exercise is one of the core treatments for osteoarthritis, although you may need to adjust the type and amount, and some discomfort may occur early on.
Do I need an X-ray to confirm osteoarthritis?
Not usually. Imaging is generally reserved for atypical features or when another diagnosis is suspected. A health professional can advise you.
Can osteoarthritis be cured?
Osteoarthritis is a long-term condition, and treatment aims to manage symptoms and maintain function. If symptoms have a major effect on your quality of life despite non-surgical care, a doctor can discuss whether surgical assessment is appropriate.
You can read about chiropractic care or get in touch with any questions.
This article is general information and doesn’t replace an individual assessment by a registered healthcare practitioner.