How Physiotherapy Helps Manage Osteoarthritis Pain and Stiffness

Osteoarthritis is a degenerative condition that involves inflammation and wear of the articular cartilage within the joints. While degeneration of the joints is a natural part of the ageing process, osteoarthritis can cause pain, stiffness, and reduced mobility. Physiotherapy is one of the leading treatments used to help manage symptoms of osteoarthritis, improving mobility, strength, and overall function.

Common Areas Affected by Osteoarthritis

Osteoarthritis most commonly affects the:

• Hip
• Knee
• Spine
• Shoulder
• Wrist, hands, and fingers
• Feet and toes

Common Risk Factors

Several factors can increase the likelihood of developing osteoarthritis, including:

• Age: Over 50 years old
• Weight: Higher body mass index (BMI)
• Muscle weakness

Common Signs and Symptoms

The symptoms of osteoarthritis vary depending on the joint affected.

Hip Osteoarthritis

Common symptoms include:

• Groin pain
• Stiffness
• Difficulty walking or limping
• Difficulty getting in and out of a car
• Difficulty climbing stairs

Knee Osteoarthritis

Common symptoms include:

• Pain at the front and/or back of the knee
• Swelling
• Stiffness
• Difficulty walking or limping
• Difficulty descending stairs

Spine Osteoarthritis (Spondylosis)

Common symptoms include:

• Pain in or around the spine
• Difficulty bending backwards
• Difficulty walking
• Morning stiffness

Shoulder Osteoarthritis

Common symptoms include:

• Pain at the front and/or back of the shoulder and sometimes down the arm
• Difficulty lifting the arm
• Stiffness

Wrist and Hand Osteoarthritis

Common symptoms include:

• Pain in the finger joints, base of the thumb, and/or wrist
• Difficulty gripping and holding objects
• Stiffness
• Swelling

Foot and Toe Osteoarthritis

Common symptoms include:

• Pain in the toes, base of the big toe, and/or ankle joint
• Difficulty walking
• Stiffness
• Swelling

Treatment and Management

Many of these symptoms can have a significant impact on daily life. Modifying certain activities is often recommended to help manage symptoms and reduce stress on the joints.

Low-impact activities such as swimming, cycling, and using a cross trainer are often easier on the joints and can provide symptom relief. There are also numerous exercise programmes that your GP or physiotherapist may be able to refer you to, helping you access local activities designed to improve your symptoms and overall health.

While physiotherapy cannot cure osteoarthritis, a combination of exercise prescription, anti-inflammatory medication, and pain relief medication can help manage symptoms and improve quality of life.

Typical Exercises for Lower Limb Arthritis

Squats

Start by sitting on a chair. Place your feet firmly on the floor, shoulder-width apart. Stand up by straightening your legs and then slowly sit back down.

To make the exercise more challenging, try lightly touching the chair with your bottom rather than sitting down completely.

• Repeat 10 repetitions
• Perform 3 times per week

Bridges

Lie on your back with your knees bent to approximately 45 degrees and your palms resting on the floor. Push through your feet and lift your hips towards the ceiling.

This exercise strengthens your gluteal muscles.

• Repeat 10 repetitions
• Perform 3 times per week

Straight Leg Raises

Lie on your back. Bend one knee while keeping the opposite leg straight. Keeping the straight leg extended, lift it a few centimetres from the floor and hold for 3–5 seconds before lowering.

• Repeat 10 repetitions
• Perform 3 times per week

Calf Raises

Stand with your hands resting on a kitchen worktop or wall for support. Raise your heels off the ground while keeping your knees straight. Slowly return to the starting position.

• Repeat 10 repetitions
• Perform 3 times per week

Typical Exercises for Upper Limb Arthritis

Narrow Low Row

Wrap a resistance band around a sturdy object at approximately waist height. Holding one end of the band in each hand, pull your elbows backwards while squeezing your shoulder blades together. Hold for 3–5 seconds before returning to the starting position.

• 3 sets of 10–12 repetitions
• Perform 3 times per week

Shoulder Abduction

Stand on one end of a resistance band while holding the other end in your hand. With your arm by your side, raise it outwards to shoulder height and then slowly lower it back down.

• 3 sets of 10 repetitions
• Perform 3 times per week

Wrist Extensions

Rest your forearm on a table while holding a water bottle or light weight, palm facing down. Lift the weight by moving your wrist upwards and then slowly lower it back down.

• 3 sets of 10 repetitions
• Perform 3 times per week

Additional Advice

Ice Therapy

Applying ice to a swollen joint can help reduce inflammation and provide pain relief.

• Apply ice for up to 20 minutes at a time
• Always use a towel or barrier between the ice and your skin
• Do not apply ice directly to the skin

Heat Therapy

Heat can be helpful when a joint feels stiff and is often particularly beneficial for areas such as the back and hips.

Examples include:

• Hot water bottles
• Wheat bags
• Heat patches
• Warm baths

Heat can be applied for approximately 20 minutes at a time. Ensure heat sources do not come into direct contact with the skin.

Over-the-Counter Medication

Over-the-counter medication can help manage pain and swelling.

Anti-inflammatory medications include:

• Ibuprofen tablets
• Ibuprofen gel
• Anti-inflammatory patches
• Voltarol gel

Pain relief medications such as paracetamol may also help reduce symptoms and can be taken in tablet form or, where appropriate, applied as patches. Always follow the manufacturer’s guidance and consult a healthcare professional if you are unsure whether a medication is suitable for you.

Further Investigations and Referrals

If your physiotherapist feels that further assessment is needed, they may refer you for imaging, such as an X-ray, and seek advice from an orthopaedic consultant.

Orthopaedic consultants may offer additional treatment options, including:

• Corticosteroid injections for pain relief
• Arthrosamid injections to help cushion the joint
• Other joint-preserving interventions

In cases where osteoarthritis is severe and significantly affecting daily life, surgery may be considered. Surgical options may include:

• Partial joint replacement
• Total joint replacement
• Arthroscopy and other joint procedures where appropriate

Physiotherapy can play a valuable role in managing osteoarthritis by reducing pain, improving strength and mobility, and enhancing quality of life. It can also help delay or potentially avoid the need for surgery by equipping individuals with the knowledge and tools required to self-manage their condition.

If you think you may have osteoarthritis or are experiencing persistent joint pain, booking an appointment with a physiotherapist can be the first step towards finding effective symptom relief and improving your long-term joint health. Book an appointment with a physio online.