Physical therapy

Physical therapy, supervised by a certified physical therapist, can help reduce OA-related pain, usually by strengthening the muscles and tendons that support the joint. A brace can also hold the joint in a neutral position. Typically, the first goal is stretching to improve the range of motion. Then comes strengthening the surrounding muscles, and then a plan for aerobic exercise, such as swimming or bicycling, to increase overall fitness and control weight.

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One of the more dramatic recent discoveries about OA is that deterioration progresses more rapidly in joints where there is "malalignment" of the bones. Someone who is bowlegged, for example, will have a knee joint in which the bones on the inside of the knee are closer together (because there is more cartilage deterioration) than on the outside of the knee. In a person with knock-knee the opposite is true. The bones on the outside of the knee are closer together than those on the inside. Malalignment makes cartilage damage more likely, and erosion of the cartilage brings the bones even closer, producing a vicious cycle of more erosion. In people with malaligned knees, muscle strengthening was shown in one study to actually be harmful. If your legs have become bowlegged or knock-kneed recently from your arthritis, you should consult your doctor before engaging in strenuous muscle-strengthening exercises.