The first line of treatment for osteoarthritis (OA) involves a number of steps you can take on your own under the guidance and supervision of a healthcare professional. These include patient education, developing a self-management plan, therapeutic exercise, physical activity and weight management, if appropriate (HQO, Quality Standard: Osteoarthritis, 2018).
An important first step is to become educated about osteoarthritis and what you can do to manage symptoms on your own. This is referred to as “self-management”. You can learn ways to cope with arthritis symptoms and make lifestyle changes that may reduce pain and improve function and mood.
Lifestyle changes such as increasing physical activity/exercise and reducing excess weight can have the greatest effect on OA. Developing relaxation and coping skills can help you maintain balance in your life, giving you a greater feeling of control over your arthritis and a more positive outlook. For more information, visit the Arthritis Society’s free online arthritis self-management learning resources.
A common misconception is that a painful joint requires rest. On the contrary, not enough movement can cause muscle weakness and worsening joint pain and stiffness. Light or moderate physical activity protects joints by strengthening the muscles around them, increasing blood flow to the joint and helping promote normal joint regeneration. Physical activity can also improve mood and lessen pain.
Physical activity is any movement that increases heart rate through activation of your muscles, while exercise is considered a structured, planned, repetitive and purposeful activity with the goal of improving or maintaining a component of physical fitness (source: Canadian Society for Exercise Physiology). An increase in physical activity, even in small increments, can help relieve arthritis symptoms and improve your daily function.
Physical activity strengthens the muscles and connective tissues around your joints, helping support joints that have been damaged by arthritis. Physical activity includes all those activities that you do as a part of everyday life – such as vacuuming the house, walking to work, even gardening. These kinds of activities can be very beneficial for your joints, and can help you maintain and improve your mobility.
Canadian 24-hour Movement Guidelines
The Canadian 24-hour Movement Guidelines are an evidence based set of general recommendations detailing appropriate levels of activity for people of different ages.
Exercise is physical activity that involves heavier, repetitive exertion, and is designed to improve or maintain physical fitness. Lifting weights, walking on a treadmill, taking a yoga class – these are the kinds of planned motions that we do specifically to improve our strength, endurance or flexibility. Being physically active can reduce pain and fatigue, improve mobility and overall fitness, and improve your state of mind by allowing you to actively participate in your own treatment. Participating in a properly designed exercise program is a great way to help alleviate the discomfort caused by arthritis.
Targeted exercise for your joints may have added benefit. A qualified therapist, such as a physiotherapist, can work with you to develop a progressive exercise program that is tailored to you.
There is conflicting evidence about the possibility of harm from high-impact exercise, such as running, soccer or tennis, so you will need to be your own judge about what activities your body can tolerate and consult with your doctor. You should be prepared to modify or swap out an activity if it worsens your joint symptoms. Joint rest is recommended when you are experiencing a flare of joint pain and/or your joint is swollen and hot. At these times, it is important to keep doing range of motion exercises.
What types of exercise are recommended for OA?
Tai Chi & Yoga
Activities like Tai Chi and Yoga that combine muscle strengthening, flexibility, and balance exercises can be beneficial in the management of OA. These exercises can also be meditative, promoting relaxation and increasing your capacity to cope.
Tai Chi: This ancient Chinese martial art is a combination of movements performed in a slow, focused manner. Though it has many variations and styles, Tai Chi is a low-impact exercise and is reminiscent of both yoga and meditation. Tai Chi could improve pain and physical function in some people as well as alleviate depression and contribute to health-related quality of life. Visit our Tai Chi to Help Arthritis video and practice along with Dr. Paul Lam.
Yoga: Numerous studies have shown the benefits of yoga for stress and anxiety. The practice of controlled breathing, simple meditation and stretching can improve a person’s state of mind and help them better manage pain. Regular yoga under the guidance of a certified instructor can also boost one’s general health and increase energy levels. (NOTE: In some cases, people living with arthritis should avoid strenuous yoga routines, such as Bikram and power yoga.) Our 20-Minute Warm-Up for the Joints video is a great place to start.
Many low-impact exercise options can benefit people living with arthritis. For example, water therapy and swimming can help with pain and mobility. The resistance of the water can help strengthen your muscles while the buoyancy helps take some of the weight off painful joints. Consult your health-care provider to determine suitable exercises for you and your particular condition. For more information about arthritis, physical activity and exercise, visit our flourish articles on Exercise & Motion.
How much exercise is recommended for people with OA?
Any increase in your physical activity or exercise may help if you are not active. The right frequency, intensity, type and duration varies from person to person. A gradual increase in exercise is recommended, with an eventual target for adults of 150 minutes of moderate-to-vigorous intensity exercise per week, in sessions of 10 minutes or more (if tolerated). If you are not currently active, you are advised to start with light activities, such as walking, and attempt to increase your speed and/or distance over time.
Protect your joints
While it’s important to keep your joints moving, it’s also important to avoid situations that put excessive stress or strain on your joints, as that can increase your risk of injury and make your joints deteriorate faster. Avoiding joint stress will also lead to less pain and help your joints work better, longer.
Techniques to protect your joints include:
Effective weight management
Just as there is no single definition of a healthy body, there is no single definition of a healthy weight – it’s unique for each individual based on body composition, age, sex, lifestyle and other conditions. The best way to determine an appropriate weight for you is to consult with a healthcare professional.
Carrying excess weight increases the risk of developing OA in your load-bearing joints (knees, hips, ankles, spine, feet), and increases the rate at which these conditions progress. Excess weight has also been linked to OA of the hand, indicating that there is also a metabolic link to the disease, so achieving and maintaining a healthy weight is critical. To learn more about the effect of excess weight on osteoarthritis, visit our flourish article “Can Decreasing Weight Decrease Pain?”
The good news is that, if you are overweight, losing even ten per cent of your body weight can help reduce strain on your knees and reduce pain. In fact, depending on the existing level of joint damage, losing weight may not only make you feel better, but could also delay or prevent the need for surgery.
There are a number of ways to achieve weight loss including healthy eating, exercise, and cognitive behavioural strategies. If you are having difficulty controlling your weight, you are advised to discuss these options with your healthcare provider.
There is no conclusive evidence to suggest that what you eat can make arthritis either better or worse. However, being overweight can put excess strain on your joints. To work normally, your body needs food to supply energy, vitamins and minerals. Healthy eating will help you manage your weight and give you the energy to complete your daily activities, as well as promote a strong immune system and bone and tissue health.
Three ways to improve your nutrition include:
Supplements are consumable products designed to be added to (not replace) your diet, to help you get the proper nutrition your body needs. It is always important to consult your doctor if you decide to take supplements as they may interact with medications or may contain ingredients not listed on the label.
Other supplements are often advertised for OA (e.g. avocado-soybean unsaponifiables), but there is not enough research to offer any recommendation regarding their use.
Heat and cold
Taking a hot shower and using warm packs are great ways to help reduce pain and stiffness. Always use a protective barrier, such as a towel, between the warm pack and your skin.
Heat is ideal for:
- Relieving pain
- Relieving muscle spasms and tightness
- Enhancing range of motion
IMPORTANT: Do not use heat on an already inflamed joint, as it can make symptoms worse.
Using a commercial cold pack or a homemade one (from ice cubes, a damp face cloth or a bag of frozen vegetables) can be helpful to provide short-term relief from inflammation. Always use a protective barrier, such as a towel, between the cold pack and your skin.
Cold is ideal for:
- Decreasing pain
- Constricting blood flow to an inflamed joint
For more information about using heat or cold, visit the Strategies and Techniques section of our Managing Chronic Pain Learning Guide.
Relaxation and coping skills
Developing relaxation and coping skills can help you maintain balance in your life, giving you a greater feeling of control over your arthritis and a more positive outlook. Relaxing the muscles around a sore joint reduces pain. There are many ways to relax. Try meditation or deep breathing exercises. Listen to music or relaxation tapes. Imagine or visualize a pleasant and restful acivity, such as lying on a beach.
For more information about relaxation and coping skills, visit the Strategies and Techniques for Managing Chronic Pain section of our Managing Chronic Pain online guide.
This osteoarthritis resource was reviewed in February 2021 with expert advice from:
Dr. Sarah E. Ward, MD, FRCSC
Orthopaedic Surgeon, Division of Orthopaedic Surgery
St. Michael’s Hospital
Assistant Professor, Department of Surgery
University of Toronto
Members of the Canadian Arthritis Patient Alliance Steering Committee, including:
- Linda Wilhelm
- Janet Gunderson
- Therese Lane
- Louise Crane
This resource was made possible through unrestricted educational grants from: