Exercise, weight loss and osteoarthritis
Weight loss and exercise - both are often recommended to people with osteoarthritis. Losing weight can especially help people with osteoarthritis of the knee. Exercise therapies can relieve pain and improve mobility for people with knee or hip osteoarthritis.
Painful osteoarthritis can make it more difficult to get enough exercise - and that can lead to weight gain. And if you gain more weight, it could make the osteoarthritis worse, especially if it affects your knees. But what results can be expected from losing weight? And what kind of exercise is suitable for people with osteoarthritis?
Most of the people who took part in these studies had knee osteoarthritis. People with hip osteoarthritis only took part in the exercise therapy studies listed here.
How much weight needs to be lost for it to have an effect?
Obesity puts extra strain on the knee joints. That makes joint wear worse and may cause osteoarthritis to develop at a younger age. That's why overweight people with knee osteoarthritis are often advised to lose weight. People with a BMI of 25 are considered overweight, and people with a BMI of 30 or more are classed as "very overweight" (obese).
Experts often advise overweight people with osteoarthritis to lose 10 percent of their body weight in order to improve their health. For example, a woman who is 160 cm tall and weighs 80 kg would have to lose at least 8 kg. But it can be difficult to lose that amount of weight. It takes a lot of motivation and perseverance to successfully lose weight and then maintain the new weight.
But it is possible that even minor weight loss could help people with osteoarthritis. Studies provide weak evidence that overweight people with knee osteoarthritis can improve their mobility and relieve pain if they lose at least 5 percent of their body weight within 5 months - that is to say 4 kg if they weigh 80 kg.
But most participants found it difficult to lose that much weight just by dieting. They were more successful if they combined dieting with exercise therapy. The majority of the participants received support courses on nutrition and dealing with osteoarthritis.
Further research is however needed to be able to say with certainty how much weight loss alone can help with osteoarthritis.
Does exercise therapy help with osteoarthritis of the knee or hip?
Many different types of sports are suitable for people with osteoarthritis, including brisk walking, cycling and swimming.
There are also special exercise therapies depending on the joint affected. These exercises are put together and explained by a physiotherapist, to help increase movement in a joint. Therapeutic exercises can involve muscle strengthening and flexibility or resistance workouts. But they can also include functional or coordination exercises such as specific aerobics exercises.
Studies suggest that aerobics exercises and muscle-strengthening exercises can improve mobility and relieve pain in people with osteoarthritis of the hip.
Aerobics or muscle-strengthening exercises can also help people with osteoarthritis of the knee. Aerobics improved participants' mobility and relieved pain. The participants who did muscle-strengthening exercises also had less pain. There was weak evidence that water aerobics can improve mobility too.
Apart from special exercise therapies for affected joints, it is important that people with osteoarthritis remain active. Losing weight and incorporating exercise into your daily life can help stop your joints from getting worse, and help you live better with osteoarthritis.
Brosseau L, Wells GA, Tugwell P, Egan M, Dubouloz CJ, Casimiro L et al. Ottawa Panel evidence-based clinical practice guidelines for the management of osteoarthritis in adults who are obese or overweight. Phys Ther 2011; 91(6): 843-861.
Christensen R, Bartels EM, Astrup A, Bliddal H. Effect of weight reduction in obese patients diagnosed with knee osteoarthritis: a systematic review and meta-analysis. Ann Rheum Dis 2007; 66(4): 433-439.
Corbett M, Rice S, Slack R, Harden M et al. Acupuncture and other physical treatments for the relief of chronic pain due to osteoarthritis of the knee: a systematic review and network meta-analysis. Centre for Reviews and Dissemination (CRD). 2012.
Fransen M, McConnell S, Hernandez-Molina G, Reichenbach S. Exercise for osteoarthritis of the hip. Cochrane Database Sys Rev 2014; (4): CD007912.
Shamliyan TA, Wang SY, Olson-Kellogg B, Kane RL. Comparative Effectiveness Reviews. In: Physical Therapy Interventions for Knee Pain Secondary to Osteoarthritis. Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); 2012.
IQWiG health information is written with the aim of helping
people understand the advantages and disadvantages of the main treatment options and health
Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.
Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.