The "Strongest Medicine" for Osteoarthritis is Exercise: The Little-Known Mechanism of Joints

"Not Moving Because It Hurts" Is Counterproductive? Why Exercise Is the "Often Overlooked First Choice" for Osteoarthritis

"Stiff knees," "throbbing hips," "struggling with stairs"—are you accepting such chronic joint pain as a consequence of aging?
The Independent highlights that the "common sense" approach to treating and preventing one of the world's most common joint diseases, **osteoarthritis (OA)**, often diverges from the evidence. The conclusion is simple: **the best medicine is not found on a pharmacy shelf but in movement**. However, in reality, exercise therapy is not reaching enough people—this is the crux of the article. The Independent

OA Is Not Just "Wear and Tear": It's Happening to the "Whole" Joint

OA has long been discussed under the "wear model," where "cartilage wears out = consumable." However, the article reinterprets OA as a **"disease of the entire joint."** It involves a gradual process of load and repair, including synovial fluid, bones, ligaments, surrounding muscles, and even the nerves that support movement. The Independent

The "sponge analogy" is symbolically discussed here.
Cartilage has few blood vessels, and nutrients are distributed through "movement." When you walk or bear weight, the expelled fluid returns, circulating nutrients and lubrication—the less you move, the less circulation occurs. The Independent

Why Exercise Works: It Addresses the Root of Pain

The article emphasizes that exercise is not about "toughing it out," but rather,an intervention aligned with joint physiology.

• Muscle weakness can be an early sign of OA. Particularly when muscle strength (supporting power) declines, joints become unstable and the burden increases. Therefore, it makes sense to restore the supporting muscles through resistance exercise. The Independent

• Obesity not only increases load but can also involve inflammatory substances that contribute to cartilage deterioration and progression. Exercise can act on a molecular level, such as reducing inflammation markers. The Independent

• In the first place, there is no definitive medication to halt the progression of the disease itself in OA. This is why exercise, which has low risk and benefits the whole body, should be prioritized, according to the logic presented. The Independent

Furthermore, the article touches on the "wastefulness" in medical settings. In multiple countries' healthcare systems, less than half of OA patientsare referred to exercise or physical therapy, while many treatments not recommended by guidelines are prevalent, and there are not a few cases where patients are referred to surgery before sufficiently trying non-surgical options. The Independent

Hints for a "Prescription for Exercise": Systems Like GLA:D Are Effective

Even if the importance of exercise is understood, "what and how much?" remains challenging. This is where the article introduces programs like **GLA:D (Good Life with osteoArthritis: Denmark)**, which combine neuromuscular training and education. By building up form, balance, strength, and quality of movement in groups (often under the supervision of a physical therapist),pain reduction, improved function, and quality of life improvements have been reported up to 12 months later. The Independent

What is crucial here is not the "exercise menu" itself,

• but a design that can be sustained (attending, having companions, seeing progress)

• Unraveling "fear of pain" through education (understanding the safe range of activity)
  is part of the package. The lack of such "systems" might be part of the reason why exercise therapy is not reaching enough people.
  
  
  

Practical Solutions Starting Today: For Those in Pain, "Start Small and Grow"

To apply the article's claims to daily life, the correct approach is "don't push yourself too hard from the start."

1) Start with Short Sessions of "Joint-Friendly Aerobics"

• Low-impact activities like walking, cycling, and water exercises are generally recommended for self-care in OA. Mayo Clinic

• The idea that "if pain lingers long after exercise, it's a sign of overdoing it" is also introduced (not to stop, but to adjust intensity). Mayo Clinic

2) Build Supporting Muscles: Thighs, Buttocks, Core
According to physical therapists, resistance exercises targeting "supporting muscle groups," such as shallow squats, chair sit-to-stands, and bridges, are important. Fit&Well

3) Understand That "Pain ≠ Damage"
Temporary symptom increase with new exercises is possible, but a guideline is to gradually acclimate and observe for about six weeks. Fit&Well
(Of course, strong swelling or heat, sudden worsening, or post-fall conditions are exceptions. Consult a healthcare provider.)

Reactions on Social Media (Summary of "Trends" in Posts)

When articles like this spread, reactions on social media typically fall into three categories.

• Empathy and Relief Group: "It's not just about medication; moving does make it easier," "I was scared when the doctor said 'exercise,' but this encouraged me."

• Anxiety and Opposition Group: "It's impossible to move when it hurts," "I feel like moving makes it worse. How much is safe?"

• Practice and Sharing Group: "Water walking is amazing," "Chair squats made stairs a bit easier in two weeks," "Pain reduced after correcting form with physical therapy."

Thus, rather than the information that "exercise works,"pain and fear management (how much is okay / whom to consult) tends to become the focal point of discussion. As the article advocates "making exercise the first choice," it becomes apparent that recipients are seeking a "safe path to movement."

Summary: Exercise Is About "Joint Nutrient Circulation" and "Stability," Not "Grit"

OA is not merely simple wear and tear; it involves long-term changes affecting the entire joint. Cartilage receives nutrients through movement, muscles protect joints, and exercise impacts inflammation and metabolism. Before medication or surgery, the focus should be on creating a "form that allows movement"—this is the essence of the article's argument. The Independent

And as the number of OA patients is expected to increase further, the importance of "delivering exercise" will likely grow for the entire health system. healthdata.org