Overview
- An umbrella review in RMD Open pooling five systematic reviews and 28 randomized trials covering nearly 13,000 patients found exercise yields negligible or short‑lived improvements in osteoarthritis pain and function.
- The analysis reported effects comparable to no treatment in many comparisons and often similar to outcomes from patient education, manual therapy, common pain medicines, injections and arthroscopy.
- Single longer‑term trials suggested exercise was less effective than osteotomy or joint replacement for some patients with knee or hip osteoarthritis.
- The authors recommended shared decision‑making that weighs modest symptom relief against exercise’s broader health benefits, safety profile and low cost, along with alternative options.
- Arthritis UK and other experts criticised the review for pooling diverse exercise types, short trial durations and study quality issues, and current NICE/NHS guidance continues to recommend therapeutic exercise.