Osteoarthritis

Osteoarthritis is one of the most common causes of joint pain in adults, particularly in the knees and hips. It often shows up as stiffness and an ache that’s worse after rest or at the end of the day, and that can limit walking, stairs, sleep and the things you enjoy. The good news is that it responds well to the right kind of exercise and education.

Understanding osteoarthritis

Osteoarthritis affects the whole joint: the cartilage, the bone beneath it, the joint lining and the supporting muscles and ligaments. It’s more common with age, previous joint injury, family history and higher body weight, but it’s not an inevitable slide. Pain levels are influenced by many things beyond what shows on a scan, including strength, activity levels, sleep, mood and how much load the joint is coping with.

Symptoms we commonly see

• Joint pain that’s worse with activity and eases with rest, or that aches at night or after a long period of inactivity
• Morning stiffness that usually settles within about half an hour
• Pain with stairs, getting out of a chair, walking on hills or squatting
• Knee swelling or a creaking or grinding sensation
• Hip or groin pain, sometimes referred to the thigh or knee, with reduced movement
• Reduced strength in the muscles around the joint

Our evidence-based approach

International guidelines for hip and knee osteoarthritis consistently recommend exercise, education and weight management as the foundation of care, with other treatments added where needed. Our approach includes:

1. Assessment of your joint, strength, movement and daily demands, and confirming the diagnosis
2. Education about osteoarthritis, so you understand why the joint hurts and why moving it helps
3. Progressive strengthening of the muscles around the hip and knee, tailored to your pain and capacity
4. Aerobic and balance work, to improve fitness and confidence, and reduce falls risk
5. Load and activity pacing, so you can stay active without repeated flare-ups
6. Hands-on treatment where it eases pain and makes exercise easier
7. Supervised strength training in our private gym as you progress, so your program can continue under the same roof
8. Pre- and post-surgery rehab if joint replacement becomes the right option

See our post-surgery recovery page for what rehab after a joint replacement involves.

What to expect: recovery timeline

• First six to twelve weeks: most people notice reduced pain and better function from a consistent strengthening program
• Ongoing: osteoarthritis is a long-term condition, so the aim is to build habits that keep the benefits going
• Flare-ups: can happen, and we help you manage them without losing progress

When to seek help urgently

Seek prompt medical assessment for a joint that becomes suddenly hot, red and swollen, joint pain with fever or feeling unwell, severe pain after a fall or inability to put weight through the leg, or constant severe night pain that doesn’t ease with changes in position.

References

• Kolasinski SL, et al. 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Rheumatol. 2020;72(2):220-233.
• Bannuru RR, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578-1589.