Fitness
Is Exercise Overrated For Arthritis Pain? Latest Study Challenges Long-Held Beliefs
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Exercise for arthritis pain may be “minimal and short-lived,” claims a new umbrella study, but rheumatologists say the full story changes everything.
A new 2026 review suggests exercise may offer only modest relief for osteoarthritis, but experts say consistency and the right approach can still make a difference. (Image-iStock)
Exercise has long been considered essential for osteoarthritis care. Recently, a new umbrella study suggests that its pain-relief may be short-lived. However, experts argue that consistency and strategy may matter far more than the numbers alone indicate.
When it comes to osteoarthritis care, exercise has been positioned as the first-line recommendation. Doctors not only prescribe it, but clinical guidelines reinforce it as well.
Patients have been encouraged to exercise and move more to preserve mobility, but a February 2026 study published in RMD Open has prompted fresh debate, suggesting exercise may offer only small, temporary improvements in pain and function.
Dr Sandeep Nagar, Consultant – Rheumatology at Yatharth Super Speciality Hospitals, Omega-1, Greater Noida, stresses that the numbers need context. “Expectations should be reframed rather than lowered,” he explains.
“Modern pain management prioritises functional capacity over achieving a ‘zero pain’ score. A 7-15 point reduction on a 100-point scale is considered a clinical success because it often enables patients to do significantly more despite some remaining pain.”
What Is Osteoarthritis, And Why Exercise Matters
Osteoarthritis is one of the most common degenerative joint diseases globally. It involves cartilage breakdown, leading to pain, stiffness, swelling, and limited range of motion. Knees, hips, and hands are most frequently affected, though any joint can be involved.
Since the condition is progressive and incurable, treatment focuses on symptom control and preserving function. Exercise has traditionally been central to that strategy. It enhances circulation, improves joint alignment, strengthens surrounding muscles, and reduces stiffness.
Over time, it can also help patients maintain independence and delay invasive interventions. Yet, the new ‘umbrella review’ raises an important question: Are those benefits as substantial as long believed?
What The Study Says
The February 2026 study, titled “Effectiveness of exercise to ease osteoarthritis symptoms likely minimal and transient,” conducted what researchers describe as an umbrella systematic review, an overarching analysis of existing systematic reviews and randomised clinical trials.
Researchers searched medical databases for relevant studies published up to November 2025. They included:
- Five systematic reviews involving 8631 participants
- Twenty-eight randomised clinical trials involving 4360 participants
In total, nearly 13000 patients were represented. The analysis examined exercise in hip, hand, knee, and ankle osteoarthritis.
It compared exercise against multiple alternatives, including no treatment, placebo, patient education, manual therapy, NSAIDs, corticosteroid injections, hyaluronic acid injections, arthroscopy, osteotomy, and joint replacement. The experiment aimed to determine whether exercise truly stands out as a first-line intervention.
What The Study Found
Compared with placebo or no treatment, exercise reduced pain by between 6 and 12 points on a 100-point scale. For knee osteoarthritis, effects were small and short-lived, with very low certainty of evidence. Larger and longer-term trials showed even smaller benefits.
For hip osteoarthritis, effects were negligible. For hand osteoarthritis, they were small. Exercise did not significantly outperform patient education, NSAIDs, steroid injections, or arthroscopy in improving function. In certain trials, surgical options such as osteotomy and total joint replacement delivered stronger long-term outcomes.
The researchers concluded:
“We found largely inconclusive evidence on exercise for osteoarthritis, suggesting negligible or, at best, short-lasting small effects on pain and function across different types of osteoarthritis compared with placebo or no treatment.”
They added that the findings “question the universal promotion of exercise therapy as the sole focus in first-line treatment.”
How Should Patients Interpret A 6-12 Point Drop?
To many readers, a 6-12 point reduction may sound unimpressive. But Dr Nagar emphasises that clinical impact is not solely about numerical magnitude. “Goals should shift from complete pain relief to improved quality of life and movement,” he says.
“Even modest reductions can increase walking tolerance, improve sleep, and reduce fear of movement. Exercise also raises pain thresholds biologically by activating the body’s endogenous opioid systems.”
Medication Vs Movement: Risk And Cost
One of the review’s notable findings was that exercise alone reduces pain at levels comparable to NSAIDs and corticosteroid injections. Dr Nagar argues this comparison strengthens, rather than weakens, the case for exercise. “Relying on medication over several years carries higher systemic risks and rising long-term costs,” he explains.
“NSAIDs are associated with renal and gastric complications and cardiovascular events. Opioids can lead to dependency and increased pain sensitivity. Exercise, when supervised and individualised, has a superior safety profile.”
He adds that long-term medication costs often escalate. “Chronic opioid users frequently incur nearly double the annual healthcare costs. Structured exercise can potentially save hundreds per year in medication expenses and thousands over a lifetime by reducing the likelihood of surgery.”
However, he cautions that exercise is dose-dependent. “Unlike pills, its benefits require consistent participation.”
Limitations Of The Study
Several limitations may have diluted the exercises’ apparent effectiveness.
All Exercises Were Grouped Together
Strength training, aerobic workouts, stretching, aquatic exercise, and tai chi were analysed collectively. These interventions differ substantially in intensity and physiological impact.
Evidence suggests aerobic and resistance training often outperform stretching alone. By averaging all modalities, stronger effects may have been obscured.
Supervised Vs Unsupervised Was Not Distinguished
Supervised programs generally yield better outcomes than unsupervised routines. Professional oversight improves adherence, progression, and technique. Dr Nagar notes, “The best outcomes occur with tailored, supervised exercise combined with pain education. Active movement consistently outperforms inactivity.”
Short Study Durations
In the umbrella review, many trials lasted approximately 12 weeks. As osteoarthritis is lifelong, long-term adherence could produce cumulative benefits not captured in short trials.
Exercise Dose And Intensity
Research suggests optimal benefits occur at around 150 minutes of moderate intensity exercise weekly. If participants exercised below that threshold, the measured effect may reflect insufficient dosing rather than efficiency. In the study, the dose of exercise was not fully accounted for.
When Does Surgery Become More Effective?
The review also found that exercise is less effective than joint replacement in certain groups, but surgery is not an early solution. Dr Nagar explains that total joint arthroplasty is recommended for symptomatic moderate-to-severe osteoarthritis (stage 3 or 4) that does not respond to comprehensive nonoperative care.
“Persistent pain, significant functional limitation, and clear radiographic joint damage despite exhaustive conservative management justify surgical intervention,” he says. “Exercise remains essential before and after surgery to optimise outcomes.”
Why Exercise Still Matters Beyond Pain
The study focused on pain and function, but exercise delivers systemic benefits that extend far beyond the joint:
- Weight management
- Improved mood
- Cardiovascular protection
- Better sleep
- Reduced diabetes risk
- Lower cancer risk
“These secondary health benefits must be weighed in shared decision-making,” the review authors themselves noted. Exercise may not eliminate osteoarthritis pain entirely, but it strengthens overall resilience.
Should Exercise Remain First-Line Recommendation?
Dr Nagar believes that exercise should remain the first-line recommendation. “Yes,” he says. “Exercise delivers long-term functional and structural benefits that medication cannot. Corticosteroid injections may provide rapid relief, but effects often diminish within six months. Exercise builds strength, improves joint mechanics, and supports cartilage health.”
Unlike medication that masks symptoms, targeted movement addresses biomechanical dysfunction. Repeated injections, he notes, may even contribute to tissue degradation over time.
How To Protect The Joints?
For those concerned about aggravating pain, structured warm-up and cool-down routines are essential. Dr Nagar recommends:
Warm-up (5-10 minutes):
- Light cycling or brisk walking
- Dynamic movements like leg swings, arm circles, or walking lunges
Cool-down (5-10 minutes):
- Gradual slowing to normalise heart rate
- Static stretches, such as hamstring or quadriceps stretches, are held for 10-30 seconds
The February 2026 umbrella review in RMD Open suggests that exercise appears to produce modest, sometimes transient reductions in osteoarthritis pain when analysed broadly.
As Dr Nagar emphasises, “The goal is not zero pain; it is better living.” Exercise may not be a miracle cure or eliminate pain entirely, but when tailored, supervised, and sustained, it remains one of the safest and most empowering tools available to people living with osteoarthritis.
February 24, 2026, 08:00 IST
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Walking is brilliant. It’s accessible, affordable and enjoyable, plus it comes with many health benefits, which is why it forms the backbone of most government exercise guidance.
But it is strength that underpins all movement. If you don’t have the strength to get out of your chair and put one foot in front of the other, what good is being told to walk more?
This was the key takeaway from recent research led by Dr Michael LaMonte and his team at the University at Buffalo, which shows the immense value of building skeletal muscle with strength training. It found that, in more than 5,000 women aged 63 to 99, greater strength levels were strongly linked to a lower risk of death from any cause.
Maintaining muscle should be seen as a savvy investment. Muscle allows you to stand, move and remain independent, all while offering further perks that extend far beyond physical function. It powers our breath, regulates blood sugar levels, emits anti-inflammatory myokines and constantly chats with other bodily systems to keep things running smoothly. In short, muscle is the medical marvel you already own.
Here is how to maintain your body’s largest, and in some ways smartest, organ for decades to come.
Why strength training matters
There is a wealth of research on the merits of aerobic exercise, such as walking, running, swimming and cycling. This is a major reason why it dominates government physical activity guidelines. There is far less research into strength training, and much of the data available centres around young, fit men.
By looking at the impacts of strength training in previously understudied demographics, such as women aged 60 and above, studies like this one from the University at Buffalo could change future exercise recommendations for the better.
“When women go through menopause and lose their body’s own secretion of oestrogen, the loss of skeletal muscle mass increases rapidly,” says Dr LaMonte. “We typically see a change in their body composition, where they start losing muscle and holding fat in the belly area, particularly. That’s not healthy.”
Both men and women also tend to become less active as they grow older, which can contribute to sarcopenia – the age-related loss of strength and muscle. Both menopause and sarcopenia are inflammatory processes, Dr LaMonte says.
Read more: Sitting all day wreaks havoc on your hips and spine – here’s how to stop that from happening
This shift impacts fitness. “Muscle strength is fundamental for getting the body from point A to point B, especially when you’re working against gravity.” But it also throws off chemical signalling between skeletal muscle and other systems in the body, such as the heart.
“Fat tissue tends to secrete chemicals called cytokines that are pro-inflammatory,” Dr LaMonte explains. “There’s quite a bit of evidence to show that, when skeletal muscle contracts, it secretes counterbalancing cytokines that are anti-inflammatory.
“This was discovered by a scientist named Bente Pedersen in the 2000s. She published a compelling series of papers showing that these cytokines, which she called myokines, had regulatory functions outside the muscle itself.”
Exactly how skeletal muscle interacts with other crucial systems in our body is unclear, Dr LaMonte says. But it is constantly in deep discussions with them, and it is looking to help out where it can. For this reason, if you can keep your muscles strong and healthy, they can be a powerful force for good.
Read more: Expert warns why this daily habit is shortening your life – even if you exercise
3 simple ways to gauge your strength
Dr LaMonte’s research used a series of simple tests to assess the strength levels of 5,472 women aged 63 and above:
- Grip strength: a dynamometer was used to assess grip strength, with people asked to hold their upper arm at their side, elbow bent at a right angle, then squeeze the machine as hard as possible. This is an indication of upper-body strength.
- Sit-to-stand: people were timed to see how quickly they could stand up from a chair, then sit back down again five times with their arms across their chest. This is an indication of lower body strength.
- Gait speed: a timer was used to see how long it took subjects to walk 2.5m.
Women with greater grip strength – a good signifier of overall strength levels – and faster sit-to-stand times had a “significantly lower death risk over an eight-year follow-up”, the study discovered.
“Gait speed is another one of the most potent predictors of mortality,” Dr LaMonte adds.
“I’d like to see the health care profession embrace functional health as much as they do the things they can prescribe drugs for – because you can’t prescribe a drug for this. It’s a behaviour, and I think that’s why it probably doesn’t get the same kind of attention. Nobody makes money from this, but people do die from it.”
Dr LaMonte also suggests another bonus test anyone can use as a sign they need to work on their strength levels:
- The pickle jar test – this is a proxy for any everyday task. If you notice it starts to feel more difficult, this is a good indication that your fitness has decreased, and it would be beneficial to gain strength and muscle through exercise.
“When you can’t open the pickle jar any more, don’t just assume they’re making the jars harder to open,” Dr LaMonte says. “That’s a good indicator that you might be at a phase of life where your strength levels have changed unknowingly.
“The same applies when you go to pick up a grandchild or climb the stairs, and you find you’re huffing and puffing – it could simply be that you’re getting more out of shape, or in the worst case scenario, it could be indicative of disease.
“Be mindful of your body. It’s going to tell you where you’re at, and we don’t want an injury to be that indicator.”
Read more: Four things you can do to reduce inflammation and cut heart disease risk, according to the experts
How to start strength training at any age
The human body is a representation of the life it has lived, informed by genetics and altered by myriad interventions along the way. A robust life, filled with challenging physical tasks, often builds a robust body. As a result, someone who has always been active will likely find it easier to remain more active as they age.
“I wouldn’t want to convey a message that age becomes a constraint for people doing what they enjoy,” says Dr LaMonte. “I know people in their late, late years who still enjoy going to gyms and lifting weights. It’s effective for their strength goals, and the social aspect keeps them healthy in other ways.”
However, if you are new to strength training and exercise generally, you need to start more conservatively. As with any new skill, there is an obligatory learning curve that allows your mind and body to adapt to the fresh stimulus without being overwhelmed.
“You can use simple bodyweight exercises like press-ups against a wall or sit-to-stands – US adults in their 70s and 80s spend around nine-and-a-half hours each day sitting down, so you could break this up by doing a few sit-to-stands every hour, or each time there is an advert if you are watching television,” Dr LaMonte says.
“Resistance bands are another good option, or even using soup cans or books as a form of resistance provides stimulus to skeletal muscles.”
The common denominator behind these exercises is the act of overcoming resistance. That resistance needs to be slightly challenging, relative to your individual strength levels, to trigger an increase in muscle and strength levels. By consistently doing a task that requires you to be stronger, you are telling your body you want it to adapt to handle it better. If the task feels easy, the body has no reason to make any changes.
“If someone finds that lifting a soup can or book [for example, pressing it overhead 10 times] challenges them, that’s probably the level they should be working at, and they should not be trying to do more,” says Dr LaMonte. As you grow stronger, you can then gradually progress to slightly heavier items to continue to increase your strength levels.
“Older adults in particular should consult with their health care provider about the safety of beginning muscle-strengthening exercises,” Dr LaMonte adds.
In short, building and maintaining strength is important at any age. And if you do fall below this study’s 63-99 demographic, any strength and muscle you can develop now will likely serve you well for the rest of your life.
“We want to live as long as we can healthily, and I think resistance exercises are a part of that,” Dr LaMonte concludes. “When we can no longer get out of the chair and move around, we are in trouble.”
Read more: After 50, you need to train smarter – the eight rules for strength training in midlife, according to experts
Read more: The science-backed two-minute daily workouts for improving heart health
Exercise is part of a healthy lifestyle and its benefits are well known and have been for a long time. What is only recently proven by doctors is just how much exercise makes a difference for one’s longevity.
By now, most people understand that exercise is part of a healthy lifestyle; its benefits are well known and have been for a long time. What is only recently proven by doctors is just how much exercise makes a difference for one’s longevity.
For most people who sit at desks or behind the wheel all day, the problem is often finding time to work out. The good news, according to Dr. Julie Chen, an internal medicine and lifestyle medicine doctor at Kaiser Permanente in Gaithersburg, is that a daily exercise routine can be broken down into brief segments.
“The general recommendation is for 150 minutes of moderate activity per week,” Dr. Chen said. “So that is roughly about 30 minutes a day, five days a week. But the important point is it does not have to all be done at once. You can break it up into shorter segments of exercise and still get the same great benefits.”
And those benefits can be tremendous. Chen said that studies have shown going from no exercise a day to only 15 minutes of total exercise a day can “can actually decrease their risk of death, death from all causes, by about 14%.”
“Any movement is actually better than being sedentary,” she said.
Movement can be divided up into short segments throughout the day instead of in one long, strenuous workout and it can still offer the same reductions in the risk of certain diseases.
Now, you might understand there are benefits of exercising for short periods of time, several times per day; but you might be wondering how you can get in the gym several times a day.
Chen advocates for what she calls “exercise snacks” — “small bursts of physical activity that you can get in, two to three minutes at a time throughout the day.”
For example, taking the stairs or doing squats while putting groceries away, walking around the office on a phone call or planking while your dinner is in the microwave. Chen said try to do whatever it takes to get a few minutes of movement in a few times a day.
Chen is also a big fan of fitness apps, including the ones that come built into our smartphones and watches: “Studies have shown that that is really motivating that you can actually track your progress in your app. You can see your trends.”
“Consistency is a really big goal of this effort, and so if you look at your trends over time, that’s going to be a really rewarding aspect of trying to improve your health,” she added.
Beginning an exercise regimen doesn’t need to be complicated or time-consuming. You don’t need to splurge on workout clothes or a gym membership; you just need a few minutes, several times a day, to start reaping the benefits.
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Forget boring home workouts, on-demand HITT classes and cold winter runs.
The latest wellness trend bouncing around TikTok involves a workout you might not even realize you’re doing, and that’s the point. It’s called rebounding. This low-impact exercise involves jumping on a mini fitness trampoline — called a rebounder — to get your heart pumping and support lymphatic drainage.
On Amazon, this best-selling model is currently on sale for just $129. It measures in at just 40 inches, making it ideal for small spaces while still offering room for an adult to jump, squat and jog in place. Users swear it gives them a seriously effective full-body workout, and many remark that it’s “so much fun” to use.
Clinical trials also back the benefits: a 12-week rebounding program for overweight women showed significant improvements in body composition as well as a decrease in diastolic blood pressure.
Ready to jump on the rebounding trend, too? You’d better hop on this Amazon deal fast.
This sleek rebounder by BCAN is sturdy and easy to set up, thanks to pre-assembled bungees and simpel video tutorial.
Reviewers say it’s completely changed their workouts, with one remarking they “feel like a little kid again.” Others have also noted it’s much easier on their joints than higher-impact exercises.
“It absorbs impact well and allows for a nice, smooth rebound that is gentle on the joints, making it perfect for a low-impact cardio workout,” one person explained. “Whether I’m doing high-intensity intervals or simply bouncing for fun, the movement feels fluid and responsive.
The BCAN model features an upgraded handlebar for added stability. It’s 8mm premium bungee — with a durable woven outer layer and a 350-strand natural latex core — delivers smooth, quiet bounces, so you can enjoy your workout without disturbing others.
This article was written by Miska Salemann, New York Post Commerce Writer/Reporter. As a health-forward member of Gen Z, Miska seeks out experts to weigh in on the benefits, safety and designs of both trending and tried-and-true fitness equipment, workout clothing, dietary supplements and more. Taking matters into her own hands, Miska intrepidly tests wellness products, ranging from Bryan Johnson’s Blueprint Longevity Mix to the viral Oura Ring to Jennifer Aniston’s favorite workout platform – often with her adorable toddler by her side. Before joining The Post, Miska covered lifestyle and consumer topics for the U.S. Sun and The Cannon Beach Gazette.
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