The word arthritis is used to describe pain, swelling and stiffness in a joint or joints. The most common type is osteoarthritis (OA), which affects 10 million people in the UK and is the most common cause of chronic joint pain. This is diagnosed clinically by a medical profession based on your history, risk-factors, and symptoms. This may involve imaging such as X-rays or MRIs, but these are not required to make a diagnosis, nor are they always indicative of your symptoms.
Below we will discuss what OA is, the treatment options, and provide some useful links to help you understand your condition.
Common symptoms of OA include:
Joint stiffness
Pain
Swelling
Muscle weakness
The most common joints affected by OA are in the lower limb. As of 2025 in the UK:
Knee arthritis affects 5.4 million people
Hip arthritis affects 3.2 million people
Arthritis can affect any joint, but other common areas includes the hands and fingers, shoulders, and spine.
What is osteoarthritis?
Factors influencing osteoarthritis:
Age: usually over 45
Gender: more prevalent in women (60%) than men
Weight: higher body weight is correlated to increased risk
Health Inequalities: People living in more deprived areas have higher incidence of OA
Hereditary: Some ethnicities are disproportionately impacted by OA and MSK conditions. Family histories of arthritis are also correlated with diagnosis.
Joint abnormalities / anatomical differences
Previous injury or surgery
Treatment of osteoarthritis
Contrary to common belief, there are many effective treatment options for OA. First-line management is the initial treatment that a patient should receive after receiving a diagnosis. This is often the least invasive, most evidence-based form of treatment, which should continues as a foundational part of ones ongoing care. For osteoarthritis, there are three key first-line management strategies:
Education - It is important to understand the nature of osteoarthritis, including what to expect, the benefits of movement, signs of overdoing things, and to have a good understanding of what treatment options are available and how things like diet, sleep, weather or previous experiences contribute.
Exercise - Movement is very important in managing osteoarthritis, but it can be challenging to find the right exercises for you. A combination of resistance (strength) training and aerobic exercise is best. Strengthening muscles and loading soft tissues can improve joint health and significantly improve pain and functional levels.
Weight control - Increased body weight places significant additional load on the knee joint, and weight loss is well correlated with reduced osteoarthritis symptoms and improved quality of life.
Second-line treatment is another step down the management pathway, and is considered an adjunct or additional option. This means it may not be suitable for everybody, but could be beneficial to the right person. You should continue using first-line management strategies while exploring these options. This could include:
Walking aids or braces
pharmacological management such as non-steroidal anti-inflammatory drugs, infrequent or short-term paracetamol or weak opioids, and intra-articular corticosteroid injections. Medication and injections should be discussed and prescribed by your consultant or GP.
Third-line manage is the most invasive option, and should only be considered if symptoms persist despite trying other first and second line options. In such cases surgical joint replacement is often utilised. This is a decision made between you and your orthopaedic surgeon who will explain the risks, expectations, and timelines associated.
Osteoarthritis and physiotherapy
Research shows that physiotherapy can be highly effective in the management of osteoarthritis. Our specialist physiotherapists will comprehensively assess you to provide advice and implement an individualised treatment plan. Our aim is to help you manage your condition independently with exercise, education and self-management strategies, with the aim of avoiding or delaying surgical or invasive treatments.
Exercise and osteoarthritis
Exercise can improve symptoms of osteoarthritis and overall health and fitness to help maintain a healthy weight. This can also help with other health conditions such as heart disease and diabetes. A graded exercise programme can be delivered by your physiotherapist in your session or within the ESCAPE-pain programme. The Nuffield Health Joint Pain Programme is a free programme designed to provide supervised exercise and gym access for patients who self-refer to their local Nuffield Health centre.
Enabling Self-management and Coping with Arthritic Pain using Exercise
The ESCAPE-pain programme is designed for people with chronic joint pain from osteoarthritis. It integrates educational self-management and coping strategies with an exercise regimen individualised for each participant. It helps you understand your condition and gives you the tools to manage and cope with pain better. Your physiotherapist will discuss a referral to this class with you, if it is appropriate.
For more information about ESCAPE-pain, visit their website where you can start a web-based version of the programme and find lots of useful information and advice on arthritis.
