
Knee osteoarthritis pain is a common problem that can make simple daily tasks painful and really limit your mobility. Luckily research shows that there are several non-surgical treatment options that are effective, safe, and can provide long-lasting relief. Physio treatment for knee osteoarthritis is one of those options, and it is usually the first line of treatment. It focuses on getting you onto the right exercise program, advice on how to stay active and modify activities as needed, and education about how to minimise future problems. It is best combined with weight loss/management when appropriate, and maintaining a healthy diet.
The best treatment for knee osteoarthritis involves a personalised combination of strategies, including targeted exercise, weight management, and pain relief methods. As with most medical conditions, your management program needs to be personalised to suit your specific condition and level of symptoms. A great exercise for one person may flare-up the pain for someone else, and weight loss may be a major factor for some people but only a minor consideration for others.
The goal of physio treatment for knee osteoarthritis is to reduce pain and maximise function, plus it also works to avoid or delay the need for more invasive treatments like surgery. Maintaining a healthy weight and increasing leg strength through targeted exercise has been shown to provide long-term benefits that may delay, or avoid completely, the need for more invasive treatment like knee replacement surgery.
Key Takeaways
- Research shows that the best treatment for knee osteoarthritis is a personalised program combining exercise, weight management, and dietary advice
- A personalised treatment plan is crucial because the best type and intensity of exercise can vary widely between different people
- Physiotherapists are the first-choice treatment providers for managing knee osteoarthritis. They can provide you with effective exercise programs and advice that may delay or avoid the need for more invasive management like surgery or knee replacement.
What Is Knee Osteoarthritis?
Knee osteoarthritis (OA) is a common joint problem that affects many Australians. It happens when the cartilage in your knee wears down over time. This can cause pain, stiffness, and make it hard to move your knee. However, we need to remember that osteoarthritis is a natural part of ageing – we all get it to some degree, usually in big weight-bearing joints like our knees and hips.
Often osteoarthritis does not cause any symptoms or pain, or it can produce low-level discomfort, so just because an x-ray shows that you have osteoarthritis it does not mean that your symptoms will be bad or require invasive treatment. To find out more information read our blog about the Top 5 Myths About Arthritis Treatment.
Symptoms of Knee Osteoarthritis (OA)
The main signs of knee OA are:
- Pain in your knee, especially when you stand or walk a lot
- Stiffness, often worse in the morning
- Swelling around the knee joint
- A grinding feeling when you bend your knee
- Trouble walking, climbing stairs, squatting or kneeling (for example when doing gardening)
How Do You Diagnosis Knee Joint Osteoarthritis?
Diagnosing knee OA is usually fairly simple. Your physio will assess your knee by;
1. Taking a thorough history, including asking about your symptom pattern and any previous injuries
2. Check how well your knee moves
3. Look for swelling or tenderness
4. Check your muscle strength
Do I Need An X-ray To See If I Have Osteoarthritis?
X-rays and MRIs are generally not needed for diagnosing knee osteoarthritis. However, your physio may recommend that you have one if your symptoms are not responding to treatment as expected, or if they feel they need to rule out any other problems that may be contributing to your pain.
What Are The Risk Factors For Knee Arthritis?
Some things that make knee OA more likely are:
- Being over 50 years of age
- Family history of OA
- Being overweight
- Past knee injuries
How Can I Reduce My Risk Of Knee Arthritis?
1. Stay at a healthy weight by following a balanced diet and keeping an active lifestyle
2. Exercise regularly and keep your muscles strong, especially your large leg muscles like your quads, hamstrings and calf
What Are The Most Effective Treatments For Knee Joint Osteoarthritis?
Treating knee osteoarthritis involves several approaches. The most effective options focus on reducing pain, improving joint function, and slowing disease progression. These methods are usually very effective at helping you manage symptoms and maintain an active lifestyle.
Dr Jeffrey Peng MD (https://www.jeffreypengmd.com) is a sports medicine doctor based in California, and he produced the below table summarising the evidence base for knee osteoarthritis treatments. You can see that exercise and weight management are among the top recommendations, with the most solid evidence base to support their use. Simple pain-killers (NSAIDs) like Panadol and Neurofen are often helpful when needed.

Table taken from Dr Jeffrey Peng MD, https://x.com/JeffreyPengMD/status/1782191458466005184
What Is The Best Exercise For Knee Osteoarthritis?
Regular exercise is crucial for managing knee osteoarthritis. It strengthens muscles around the knee, improves flexibility, and reduces pain. Low-impact activities like swimming, cycling, and walking are great options. Aim for 30 minutes of exercise most days of the week.
Strength training is an essential part of managing knee osteoarthritis. Focus on exercises which target the main muscles supporting the knee – the quads, hamstrings and calf muscles. While each person should follow a personalised program that is tailored to their particular needs, some common exercises used by our physios include;
Quads Exercises For Knee OA
- squats
- leg press
- lunges / split squats
- knee extensions
Hamstring Exercises For Knee OA
- hamstring curls
- Deadlift variations
- Hamstring bridges and sliders
Calf Exercise For Knee OA
- Standing calf raises – knee straight and knee bent
- Weighted calf raises
- Seated calf raises with weight
Stretching For Knee Arthritis
While you should focus should be on strength exercises for long-term improvement, stretching can help maintain joint flexibility and range of motion, and may help relieve short-term muscle tightness or aching. Work on your quadriceps, hamstrings, and calf muscles. Hold each stretch for 30 seconds, repeating 2-3 times per muscle group.
Weight Management For Knee Osteoarthritis Management
Maintaining a healthy weight has been shown to be an important part of effective management of knee joint osteoarthritis. Excess weight puts extra stress on your knees. Losing weight can significantly reduce pain and slow disease progression. Even a small weight loss can make a big difference.
Each person’s weight management goals is different. Some people may already be at their ideal weight, so they don’t need to adjust this. But if you are overweight, then manage your weight effectively by setting realistic goals and working with a dietitian. A general program may be to lose 5-10% of your body weight over 3-6 months. This can lead to noticeable improvements in knee pain and function.
Effective long-term weight management can be achieved by combining a healthy diet with regular exercise. Focus on eating more fruit, vegetables, and lean proteins. Cut back on processed foods and sugary drinks. Combining this with increasing general activity, and adding regular longer walks or swimming (a good option if your knees are sore with walking), is effective. Strength training to increase lean muscle mass is very helpful.
Eat An Anti-Inflammatory Diet
While this is beyond the scope of this blog post, some general nutrition advice can be provided. For a more comprehensive dietary plan we highly recommend that you speak to a qualified dietitian.
Include omega-3 fatty acids in your diet. Good sources are fatty fish like salmon, sardines, and mackerel. Aim for 2-3 servings per week. Eat plenty of colourful fruits and vegetables. Berries, leafy greens, and orange vegetables are rich in antioxidants. These compounds may help fight inflammation in the body. You can try adding turmeric or ginger to your meals, as these spices are thought to have anti-inflammatory properties. You can use them in smoothies, soups, or stir-fries.
You should also limit foods that may increase inflammation. These include processed meats, sugary snacks, and refined carbohydrates. Fast-food or takeaways, and highly processed foods, are generally not good to have regularly in your diet.
Will I Need A Knee Replacement?
Knee replacement surgery is only used as a last resort, when other treatments have failed. The vast majority of knee osteoarthritis cases do not any require surgery. However, in more severe cases that have not responded to all other treatments, knee replacement surgery is usually very effective and provides long-term relief. However, to maximise the chance of achieving the best outcome, you need to remember that following surgery it is very important to follow a good rehab program that focuses on rebuilding your strength leg strength.
How Can Physiotherapy Help With Knee Arthritis?
Physiotherapists are first-choice treatment providers for managing knee osteoarthritis. They help to reduce pain, increase flexibility and joint function, and increase strength to allow you to do more activity, sport and exercise. A key part of physio is exercise for knee osteoarthritis. This will include strength training, stretching, and aerobic/cardiovascular activities.
Your physio will create a custom exercise plan for you. They’ll show you how to do each exercise safely and with correct form, and with regular practice you will significantly build muscle strength around your knee. This, combined with effective weight management, can take pressure off the joint and significantly improve your pain and function.
Manual therapy, i.e. hands-on treatment, is another treatment tool that physios use. It may include massage, joint mobilisation, and other hands-on techniques. These can help reduce pain and stiffness, and improve your range of motion.
An important part of physio treatment is education. Your physio will answer all of the questions that you may have about how to best manage your knee now and into the future. They will also give you advice on any modification of daily activities or sport and exercise that will be helpful.
Using heat or cold therapy can also help manage pain. Your physio can guide you on when to use each. Depending on your level of symptoms, they might also discuss using a knee brace for support.
Is Running Bad For Your Knees? Will It Give you Arthritis Or Make It Worse?
It is an old and common myth the running will “wear out your knees and give you arthritis”. In fact, for recreational runners, the opposite has been shown to be true! Runners actually have a reduced incidence of knee OA and knee replacement surgery. The mechanism for this is thought to be that running promotes good leg strength, and consistent loading of the joint cartilage and bone in a positive way, helping to increase joint resilience. Read more about this is our blog post on knee osteoarthritis and running.
Conclusion
Treating knee osteoarthritis requires a tailored approach. Exercise, focusing on strength training for the key muscle groups, and weight management are key. Strengthening your main leg muscles and maintaining a healthy body weight helps support your knee and takes pressure off the joint. However, remember that the exercise program needs to be tailored for your particular needs and situation, so seeing a physio is recommended.
Physiotherapists are the first-line providers of treatment for knee osteoarthritis. After taking a thorough history and examining your knee, they will guide you through a personalised exercise program focussing on strength, mobility and function. Manual therapy (hands-on treatment) can also be used for initial pain relief and to improve mobility and flexibility. They will also advise you about any changes to your activity or lifestyle that can help resolve your pain. Remember, what works for one person may not work for another. Be patient and work with your physio to find the right mix of treatments.
If non-surgical options don’t provide enough relief, you might need to discuss surgical options. However, this is usually not necessary, and is always used as a last resort.
Knee Osteoarthritis – Frequently Asked Questions
Knee osteoarthritis treatment involves a mix of exercise, pain relief, and lifestyle changes. Using simple medications can also be helpful when needed. In some severe cases, surgical options such as a total knee replacement may be considered.
1. What are the 3 most effective treatments for knee osteoarthritis?
The three most effective treatments for knee osteoarthritis are:
A: Exercise and physiotherapy: Strengthening muscles around the knee can reduce pain and improve mobility. Other physiotherapy treatments including hands-on treatment, education and advice are also important.
B: Weight management: Losing excess weight takes pressure off the knee joints.
C: Pain relief medications: Over-the-counter painkillers or prescription drugs can help manage discomfort
What exercises can help with knee osteoarthritis symptoms?
Each case of knee osteoarthritis requires a different mix of exercises. This depends on factors such as how severe the symptoms are, the length of time they have been there, overall fitness and strength levels of the individual, their weight, the activities that the person wants to get back to, and any previous injury or problems. Generally, the focus is on leg strength exercises, and also cardio and general exercises such as cycling, walking or swimming.
How can osteoarthritis of the knee be managed without surgery?
Many cases of knee osteoarthritis can be managed very effectively without surgery. Research shows that the most effective non-surgical treatment usually includes a combination of;
- Doing regular strength exercise, usually a mix of low-impact exercises that are tailored for each person
- Using diet and exercise to achieve and maintain a healthy weight
- Using heat or cold packs can provide temporary relief when needed
- Taking simple pain relief medications as needed, such as Panadol or Neurofen
- In some cases, using a knee brace can be helpful, especially if it lets you increase or maintain your exercise levels to build strength and maintain a healthy weight
Which pain relief options are most effective for managing osteoarthritis in the knee?
Effective pain relief options for knee osteoarthritis include:
- Paracetamol or Neurofen for mild pain
- Non-steroidal anti-inflammatory drugs (NSAIDs) for more severe pain
- Ice or heat can also help in some cases
- Corticosteroid injections can also provide short-term relief for some people.
Are there any recent advancements in the treatment of knee osteoarthritis?
Recent research highlights the importance of maintaining a healthy body weight, and improving the strength in your knee. We need to remember that each case of arthritis is different, and an exercise that is great for one person may be too hard or too easy for another person, so seeing your physio and getting the right exercise program for you is important.
Simple lifestyle choices like staying active with regular walking and other general exercise is also very helpful. Maintaining a healthy diet, and using simple medications like Panadol, or ice if needed, are effective. While these might seem “basic”, there is strong evidence showing that they are effective in many cases.
What lifestyle modifications should I consider to help with knee osteoarthritis?
Key lifestyle modifications for knee osteoarthritis include:
- Maintaining a healthy weight to reduce stress on your knees. This is achieved through a combination of a healthy balanced diet and regular exercise.
- Following a regular exercise program that is tailored for your particular level of symptoms, fitness and strength is important
- Choosing low-impact activities like swimming or cycling for general exercise is often a good option. However, if you are already a runner, research shows that running can still be fine for knee osteoarthritis – see our post on Does Running Cause Knee Osteoarthritis?
- Using a supportive brace, especially during exercise, can be helpful in some cases. In more severe cases, using a walking stick can also be useful.
Physio For Knee Arthritis – Central Performance Sydney / Surry Hills
If you think you may have knee arthritis, or have recently been diagnosed with osteoarthritis, then we can help. Our physios are skilled and experienced in helping clients manage knee osteoarthritis, and helping them stay active and fit into the future. Click below to ask a question or to book a physio appointment online.