- There is currently no cure for osteoarthritis, and low-impact exercise is a popular treatment for managing disease symptoms.
- A new study challenges the effectiveness of exercise in easing osteoarthritis symptoms.
- Scientists believe their findings help remind doctors that there are other treatment options available for symptom relief and that ongoing exercise therapy may be needed.
Recent studies estimate that in 2020, about 595 million people around the world were living with osteoarthritis — a type of arthritis that occurs when the cartilage between the body’s joints wears down, causing pain, stiffness, inflammation, and an inhibited range of motion.
Osteoarthritis can occur in any joints in the body, including the toes, fingers, knees, hips, and spine. Because of the pain and limited motion range associated with osteoarthritis, although the condition is located in the joints, it can have a major negative impact on surrounding areas of the body, including pain and discomfort, pinched nerves, soft tissue inflammation, and weakened muscles and tendons.
There is currently no cure for osteoarthritis. Treatment generally includes oral medications,
“Osteoarthritis is a leading cause of chronic joint pain and contributes to high healthcare use,” Tim Schleimer, BSc, MSc, PhD student in the Department of Nursery, Midwifery and Therapy Sciences at the Bochum University of Applied Sciences in Germany, told Medical News Today.
Schleimer is the first author of a new study published in the journal RMD Open that challenges the effectiveness of exercise in easing osteoarthritis symptoms.
Scientists believe their findings help remind doctors that for people with osteoarthritis who can’t or prefer not to exercise, there are other treatment options available for symptom relief. And while the symptom benefits of exercise may be small, physical activity itself still offers positive impacts to a person’s overall health.
“[Osteoarthritis’] societal and economic impact is large and growing, with prevalence projected to reach
1 billion people by 2050 . In the absence of approved disease-modifying therapies, management remains symptom-focused. Effective strategies to ease symptoms are therefore both a clinical and public health priority.”
— Tim Schleimer, BSc, MSc
For this study, researchers analyzed data from five previous reviews and 28 clinical control trials published up to November 2025 that studied the effects of exercise therapy on adults with osteoarthritis of the knee, hip, hand, shoulder, or ankle joint and that also reported one of the main study outcomes as self-reported pain and/or physical function.
“Exercise is universally recommended as first-line treatment for osteoarthritis and therefore the single most important conservative treatment,” Schleimer said. “However, its surrounding evidence is fragmented. Most trials evaluated one joint at a single time point, compared with a single alternative, and used different outcome scales or metrics.”
“As a result, clinicians have lacked a clear overview of: the magnitude of benefit on a common, interpretable scale; how durable those benefits are; whether effects differ by joint; how exercise compares with other treatment approaches,” he continued.
“Our goal was to synthesize the available data across joints, time points, and comparators, and express the effects on a metric that is clinically interpretable,” he said.
At the study’s conclusion, researchers found that exercise was associated with only small, short-lived effects on pain for knee osteoarthritis, little to no difference for hip osteoarthritis, and small outcomes for hand osteoarthritis, compared with no treatment.
“These findings call for a more realistic perspective: the symptom relief provided by exercise appears to be small and likely does not last long, suggesting that ongoing exercise may be necessary to at least maintain these modest benefits.”
— Tim Schleimer, BSc, MSc
Similar outcomes with other therapies
Scientists also discovered that exercise therapy triggered similar outcomes to other therapy options — patient education, manual therapy, keyhole knee surgery, and use of painkillers, steroids, or injections.
“These findings — which mainly pertain to knee osteoarthritis — indicate that treatment options other than exercise may provide similar symptom relief, which may question its strong promotion as the universal first-line standard,” Schleimer said.
“For patients who are unable to engage in exercise — for example, due to comorbidities, time constraints, or access barriers — alternative conservative treatments may offer comparable benefits. However, when considering potential harms, costs, and broader Health benefits, exercise may still be preferable before progressing to pharmacological or surgical interventions,” he explained.
Exercise not only treatment for osteoarthritis“The benefits of exercise for pain and function are likely small, but it may be a low cost, low risk treatment that can be practiced over the longer term and may also have positive effects on overall health. However, for those who simply do not like or are unable to exercise, it is not the only treatment that may improve symptoms.”
— Tim Schleimer, BSc, MSc
MNT spoke with Nora Tossounian, MD, internal medicine physician at Hackensack University Medical Center in New Jersey, about this study, who commented that her first reaction to its findings was one of caution, not dismissal.
“Exercise has been a vital part of a doctor’s recommendation for patients with arthritis, especially due to added cardiovascular benefits,” Tossounian said.
Exercise is ‘not useless’“This study doesn’t mean exercise is useless, but it rightly questions a one-size-fits-all approach. It’s a critical reminder that the treatment plan needs to be more nuanced, including setting realistic expectations with patients and integrating exercise as one part of a broader, personalized treatment plan rather than promoting it as a universal first-line fix for pain.”
— Nora Tossounian, MD
Tossounian also commented that osteoarthritis is a leading cause of disability that severely diminishes quality of life, and since there is no cure, managing symptoms is the primary goal.
“Continued research is vital to determine exercise’s role in the multimodality approach to treating this condition due to the immense personal and societal burden of untreated or undertreated disease,” she continued.
“More studies (especially prospective ones) need to be conducted to further elaborate the conclusions reached in this study. With more personalized medicine, hopefully, each and every patient who suffers from arthritis can achieve their goals through a customized approach,” she added.
MNT also spoke with Bert Mandelbaum, MD, sports medicine specialist, orthopedic surgeon, and co-director of the Regenerative Orthobiologic Center at Cedars-Sinai Orthopaedics in Los Angeles, CA, who disagreed with the study’s findings.
“How could you ever say exercise does not help osteoarthritis?,” Mandelbaum commented. “Exercise is the most important thing for people with osteoarthritis because it keeps us functional, it keeps our muscles strong, it keeps our heart strong, it keeps our lipoproteins down, our cholesterol down.”
“If you take all the studies of 99-year-old people who are at the very lowest level of healthspan and dysfunction, and you say does exercise help a person in a wheelchair, (it’s) hard to decipher that it would. I’m not sure that you could show that and I think that’s what they’re getting to here. But if you take 100 40-year-olds with osteoarthritis, exercise is a critical part of their lifestyle and function, and significant improvement in what their longevity will be — it’s associated (with) everything,” he told MNT.
Mandelbaum suggested that researchers design a study that examines longevity in terms of different types of exercise.
“Is it resistance exercise?,” he continued. “Is it endurance exercise? Is it high intensity exercise? Each of which have been proven in the literature to have different effects on the function of a joint. So if I were reviewing that article, I would ask them to please stratify what you are calling exercise. It’s like saying one medicine at seven different doses has the same effect.”
For readers who may have or have loved ones with osteoarthritis, we asked Tossounian what’s the best way to treat and manage symptoms of the disease.
She said the focus shouldn’t be on abandoning activity, but on creating a comprehensive management plan, with key strategies including:
- Weight management to reduce stress on joints — every pound of weight lost translates into several pounds less force on the joints.
- Low-impact activities like swimming, stationary bike, or walking to maintain mobility without aggravating pain.
- Physical therapy for targeted strengthening and movement coaching.
- Medical treatments when needed, ranging from medications and injections to joint replacement surgery for severe cases.
“Benefits of exercise versus these other treatments depends upon the severity of arthritis and how much the level of pain affects the patient’s ability to conduct activities of daily living,” Tossounian said.
