Join our mailing list
If you’d like to hear more about Moving Medicine and receive notifications on updates, please sign up below.
Evidence summary (Updated 2022)
A large body of good quality randomised controlled trial data shows consistent reduction in pain due to osteoarthritis, with benefits reported in strengthening, weight-bearing and aerobic exercise(8,10,11,15–20). This benefit is comparable with other treatment modalities, including many oral and topical analgesics(18). Effect size diminishes with time from structured physical activity intervention with no sustained benefit seen >6 months after a 3 month intervention in 5222 participants reported in a good quality meta-analysis of 54 RCTs suggesting physical activity needs to be sustained to maintain effect(11). A Cochrane review found moderate quality evidence of an absolute reduction in pain by 6% (in 9 studies of 1058 patients).(3)
All exercise types improved pain. Strengthening exercises alone have been shown to have the greatest effect on pain according to systematic reviews(21), although a combination of strengthening, aerobic and flexibility exercises is advised due to this combination still adequately improving pain and having a greater effect on function and general health(19). Goh et al, however found strength exercise had a moderate effect on pain while the greatest effect was seen on aerobic and mind-body exercises(10) and reviews focusing on stationary cycling have also found significant improvement in pain (p<0.0001)(14).
Yoga(5), Tai-chi and aquatic based exercises have been shown to have a significant improvement on pain compared to controls(4). Despite study heterogeneity a study looking at traditional Chinese exercises confirmed this finding and found a significant improvement in pain in intervention groups (p<0.001)(7).
A systematic review looking at the safety of physical activity interventions in those with knee osteoarthritis found that no studies reported an increase in pain in the physical activity group versus controls(22).
Quality of evidence
A – High quality
Strength of recommendation
1 – Strong
Conclusion
Physical activity can be recommended for the treatment of pain to most people with osteoarthritis and is consistently recommended across clinical guidelines.(23)
References
References
If you’d like to hear more about Moving Medicine and receive notifications on updates, please sign up below.