Evidence for exercise in osteoarthritis remains mainly inconclusive, questioning its universal promotion
WEDNESDAY, Feb. 25, 2026 (HealthDay News) — Exercise for osteoarthritis has a negligible or short-lasting effect on pain and function, according to a review published online Feb. 18 in RMD Open.
Tim Schleimer, from the Bochum University of Applied Sciences in Germany, and colleagues conducted a systematic review to examine the effects of exercise for osteoarthritis. The analyses included five reviews with 8,631 participants and 28 supplementary trials with 4,360 participants. Exercise was compared to placebo, no intervention, or other interventions for pain and function in osteoarthritis.
The researchers identified small, short-term effects for exercise versus placebo and no treatment (mean difference, −10.8 and −12.4, respectively, on a 0-to-100 scale) for knee osteoarthritis pain; the certainty was very low and effects were smaller in larger or long-term trials. Negligible effects were suggested in hip osteoarthritis and small effects were suggested in hand osteoarthritis (−6.7 and −10.0, respectively), based on moderate evidence. Outcomes were comparable to those seen for education, manual therapy, analgesics, injections, and arthroscopy based on varying certainty evidence. In the longer term, exercise was less effective than knee osteotomy (mean difference, 12.4) and joint replacement (mean difference, 17.1 for knee and 24.2 for hip), based on data from single trials in selected populations.
“Our findings question the universal promotion of exercise therapy as the sole focus in first-line treatment to improve pain and physical function in all patients with osteoarthritis,” the authors write.
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