Osteoarthritis: what it is and how we help

Osteoarthritis at a glance

Osteoarthritis is the most common form of arthritis in the UK, affecting around ten million people. The cartilage and bone in a joint change over time, causing pain and stiffness, most often in the knees, hips, hands and lower back. It is not simply wear and tear: joints respond to how they are loaded, which is why the right exercise reduces pain for most people.

Symptoms of osteoarthritis

• Joint pain that is worse with activity and eases with rest
• Morning stiffness lasting under 30 minutes
• Reduced range of movement and a grinding or creaking feeling
• Bony swelling, especially at the finger joints
• Flares after a busy day, cold weather or a change in routine

What causes osteoarthritis?

Age, genetics, previous joint injury, excess body weight, weak muscles around the joint and repetitive load all contribute. It is more common in women, especially after the menopause.

How is osteoarthritis treated?

NICE guidance (NG226) recommends exercise, including strengthening, for everyone with osteoarthritis, weight loss where relevant, and information to help you manage it. Pain relief is discussed with your GP. Joint replacement is considered when pain and function remain poor despite these measures. For a fuller guide, including knees, hips and hands, see osteoarthritis treatment.

Arthritis in the knee: symptoms and pain relief

The knee is the joint most often affected by osteoarthritis. Typical symptoms of arthritis in the knee are pain on stairs, when getting up from a chair or after walking, stiffness after sitting that eases as you move, a creaking or grinding feeling, occasional swelling and a sense of the knee giving way.

For knee arthritis pain relief, NICE recommends strengthening the thigh and hip muscles, staying active and losing weight if you are overweight. Anti-inflammatory gels rubbed onto the knee are usually tried first for pain, and a pharmacist or GP can advise on tablets. A walking stick held in the opposite hand, cushioned shoes and pacing your day also help. Our knee pain exercises are a safe place to start.

Osteoarthritis treatment in Chiswick, London

• Physiotherapy: a tailored strengthening and mobility programme for the affected joints. Initial assessment and treatment £99, follow-ups from £70.
• Red light therapy: NovoTHOR and THOR laser; trials of photobiomodulation report reduced pain in knee and hand osteoarthritis. NovoTHOR £70, THOR laser £80.
• Acupuncture: some people find it eases pain, although NICE does not recommend it for osteoarthritis. Traditional acupuncture £80.
• Ayurveda: diet and lifestyle guidance; see our Vata diet plan, which includes an osteoarthritis-friendly week of meals. Consultations from £65.
• Tai chi: gentle, weight-bearing movement with good evidence for knee osteoarthritis pain and balance. Group classes £15 every Wednesday at 9:30am and Friday at 1:30pm, one-to-one sessions £50.

For more detail, read our guides to acupuncture for knee pain and red light therapy for joint pain.

Physiotherapy at Omnia is recognised by AXA Health, Aviva, WPA and Vitality, and you can see every price on our fees page.

What does the evidence say?

Exercise is as effective as many painkillers for osteoarthritis pain, with benefits that build over eight to twelve weeks. Tai chi has trial evidence for knee osteoarthritis. Losing even five percent of body weight can noticeably reduce knee pain.

What are the early signs of osteoarthritis?

Early signs are often an ache in the joint after activity, brief stiffness after sitting or first thing in the morning, and a creaking or grinding feeling. In the hands, small bony swellings may appear at the finger joints. Symptoms usually come and go at first, with flares after a busy day.

Can osteoarthritis be reversed?

The changes seen on X-ray cannot be reversed, but symptoms often improve a great deal. X-ray findings match pain poorly: many people with marked changes have little pain, and the reverse. Strengthening, weight loss where relevant and staying active reduce pain and improve function for most people, and osteoarthritis does not inevitably get worse.

Is walking good for osteoarthritis?

Yes. Walking is one of the best activities for knee and hip osteoarthritis. Start with a distance that is comfortable, build up gradually and wear cushioned, supportive shoes. Some aching during or after walking is acceptable if it settles within a day. Cycling and swimming are useful alternatives on flare days.

What to expect at Omnia

Your first appointment covers which joints are affected, your daily activity and goals, and any previous treatment. Your physiotherapist assesses strength, movement and walking, then builds a progressive programme you can do at home or with guided Pixformance training (£50 a session). Red light therapy, tai chi and Ayurvedic diet guidance can be added for comfort and wellbeing, and we review progress every few weeks.

What you can do at home

• Stay active every day; pace activity rather than avoiding it
• Strengthen the muscles around the joint two or three times a week
• Use heat for stiffness and cold for flares
• Choose supportive, cushioned footwear for knee and hip arthritis

If your hip is the main problem, our hip pain page explains how arthritis is told apart from bursitis and other causes.

See our guides to the 4 stages of osteoarthritis and what arthritis feels like.

Also read about knee pain and joint pain. Osteoarthritis care is available at Omnia Lifestyle, 8 to 9 Bedford Corner, The Avenue, Chiswick W4 1LZ, close to Turnham Green station, on bus routes 94, E3 and 272. Limited parking is available on request when booking. Book online or call 020 4515 0000.