Musculoskeletal Conditions
Here's what many people don't realise: physiotherapy isn't just a nice-to-have option—it's now considered a core treatment for arthritis, sitting alongside weight management and patient education as a first-line approach. The National Institute for Health and Care Excellence (NICE) explicitly recommends therapeutic exercise before reaching for stronger medications.
Physiotherapy for Arthritis: Your Complete Guide to Managing Joint Pain
The Short Answer
Physiotherapy is a recommended first-line treatment for arthritis under current UK clinical guidelines. Research shows that structured exercise programmes can reduce arthritic pain and significantly improve quality of life—without the side effects of long-term medication. A physiotherapist designs personalised exercises to strengthen the muscles supporting your affected joints, improve mobility, and help you get back to the activities you enjoy.
If you're living with stiff, aching joints, you're certainly not alone. Arthritis affects millions of people across the UK, and the discomfort it causes can make everyday activities—from climbing stairs to opening jars—feel like a challenge.
At CK Physio, we've helped countless patients across West London manage their arthritic pain and reclaim their quality of life. This guide shares what we've learned—and what the evidence tells us—about how physiotherapy can help you move better and feel better.
Understanding Arthritis: It's Not Just 'Wear and Tear'
You may have heard arthritis described as simple "wear and tear"—something inevitable that you just have to live with. This outdated view can leave you feeling helpless about your condition.
Modern medical understanding paints a more accurate—and more hopeful—picture. Arthritis is now recognised as a complex, active condition of the entire joint, including cartilage, bone, ligaments, and surrounding muscles. More importantly, it's a condition where symptoms can often be managed effectively with the right approach.
The Two Most Common Types
Osteoarthritis (OA)
The most common form, typically developing after age 45. It occurs when the protective cartilage in your joints gradually breaks down, causing pain, stiffness, and sometimes swelling. It most often affects weight-bearing joints—knees, hips, and spine—though hands and feet can also be affected.
Typical signs: Joint pain during or after movement, morning stiffness lasting less than 30 minutes, reduced range of motion.
Rheumatoid Arthritis (RA)
An autoimmune condition where your immune system mistakenly attacks the healthy lining of your joints. It often starts in smaller joints—fingers and toes—before potentially spreading to larger joints. Symptoms can vary in severity over time, with periods of remission and flare-ups.
Typical signs: Morning stiffness lasting more than an hour, fatigue, swelling in multiple joints, symmetrical symptoms (both hands, both knees).
Both types can benefit significantly from physiotherapy, though the approach may differ based on your specific condition and symptoms. If you're experiencing joint pain, our conditions page provides more detail on what we treat.
Why Physiotherapy Works: The Evidence
The evidence for physiotherapy in managing arthritis isn't just encouraging—it's compelling enough that NICE made it a cornerstone of their 2022 guidelines (NG226) on osteoarthritis management.
What the Guidelines Say
"The core treatments for osteoarthritis are therapeutic exercise and weight management (if appropriate), along with information and support."
— NICE Guideline NG226, October 2022
This isn't simply because physiotherapy is a gentler option than medication. The evidence shows it has a clinically important benefit for people with arthritis, combined with general health benefits and a superior safety profile compared with other common treatments such as painkillers.
What the Research Shows
- Pain reduction: Structured exercise programmes show effect sizes of 0.35–0.72 for reducing pain—comparable to, or better than, many medications.
- Improved function: Supervised exercise programmes can produce significant improvements in physical function and quality of life.
- Long-term benefits: Unlike medications that only work whilst you take them, the strength and mobility gains from physiotherapy can last well beyond your treatment period.
- Reduced medication reliance: Research suggests early physiotherapy intervention can reduce future reliance on stronger pain medications.
Your Joints Are Designed to Move: Addressing Common Fears
We understand that when your joints hurt, the last thing you might want to do is exercise. Many people worry that movement will increase their pain or damage their joints further.
Here's what we want you to know: Your joints are designed to move, and inactivity actually weakens the muscles that support them. When muscles weaken, your joints have to work harder, which can make symptoms worse over time.
Versus Arthritis, the UK's leading arthritis charity, specifically addresses this concern: appropriate exercise doesn't worsen joint damage. Instead, it can strengthen the muscles around affected joints, improve flexibility and range of motion, boost overall fitness, stimulate natural pain-relieving hormones, and help maintain a healthy weight to reduce stress on joints.
Other Concerns We Hear
"I'm too old for physiotherapy."
Physiotherapy can benefit people of all ages. We regularly work with patients in their 70s, 80s, and beyond. Treatment is always adapted to your individual abilities and comfort levels.
"It's just normal ageing—nothing can be done."
Whilst arthritis is more common as we age, that doesn't mean you simply have to accept the pain. Symptoms can be managed, function can be improved, and quality of life can be significantly enhanced.
"The exercises will be too painful."
Your physiotherapist will start gently and progress at a pace that's right for you. Some mild discomfort during exercise can be normal, but treatment shouldn't cause severe pain. We adjust everything based on your feedback.
What Physiotherapy Treatment Involves
At CK Physio, we take a holistic approach to managing arthritic pain. This means we don't just focus on the affected joint—we consider your whole body, your lifestyle, and your personal goals.
Your Initial Assessment
Your first appointment (typically 45 minutes) involves a comprehensive assessment:
- We'll discuss your symptoms, medical history, and how your condition affects your daily life
- A physical examination assessing your strength, range of motion, and joint function
- Understanding your goals—what activities do you want to get back to?
- Creating a personalised treatment plan tailored specifically to you
Treatment Approaches We Use
Therapeutic Exercise
The cornerstone of arthritis management. We design personalised programmes including strengthening exercises for the muscles supporting your joints, stretching to improve flexibility, aerobic activity for general fitness, and balance work to reduce fall risk.
Manual Therapy
Hands-on techniques including soft tissue massage and joint mobilisation. NICE recommends this alongside exercise (not as a standalone treatment) for hip and knee osteoarthritis. It can help reduce stiffness, improve joint movement, and provide pain relief.
Education and Self-Management
We'll teach you about your condition and equip you with strategies to manage symptoms independently. This includes joint protection techniques, pacing activities, understanding when to rest and when to move, and exercises you can do at home.
Heat and Cold Therapy
Simple but effective pain relief methods. Heat can ease stiff joints before exercise, whilst cold can reduce inflammation after activity. We'll advise on when and how to use each approach.
Note: We focus on evidence-based treatments. Some modalities like TENS may be used for temporary pain relief, but therapeutic exercise remains the foundation of effective arthritis management.
Types of Exercises That Help
The best exercise programme for arthritis includes a mix of different types of activity. Your physiotherapist will design a programme specifically for you, but here's what it typically includes:
Strengthening Exercises
Building strength in the muscles around your affected joints provides better support and can significantly reduce pain. For knee arthritis, this often means working on your quadriceps (front thigh muscles). For hip arthritis, strengthening the gluteal muscles is important. We recommend strength work at least 2 days per week, with progressive loading as you get stronger.
Stretching and Flexibility
Gentle stretching helps maintain and improve your range of motion. It's particularly helpful for that morning stiffness many people experience. Daily stretching, even just for a few minutes, can make a real difference to how your joints feel throughout the day.
Aerobic Activity
Low-impact activities like walking, swimming, or cycling improve cardiovascular health and help with weight management—both important for reducing joint stress. The goal is typically 150 minutes of moderate activity per week, broken into manageable chunks.
Balance Training
Particularly important for older adults, balance exercises help prevent falls. Simple activities like standing on one leg (with support nearby) or heel-to-toe walking can improve stability. We recommend balance work at least 2 days per week.
Aquatic Therapy: A Gentler Option
If land-based exercise feels too challenging, aquatic therapy (exercises in warm water) can be an excellent alternative. The water supports your body weight whilst providing resistance, and the warmth helps ease joint stiffness. Some physiotherapists have access to hydrotherapy pools for this purpose.
Special Considerations for Older Adults
If you're in your later years and wondering whether physiotherapy can help you, the answer is a resounding yes. We understand that you may have concerns about your age or ability to exercise, but treatment is always adapted to suit you.
For our older patients, we often focus on exercises that can be done seated or with support, gentle movements that don't require getting up and down from the floor, balance training to reduce fall risk, activities that support independence and daily living, and gradual progression at a comfortable pace.
For those who find it difficult to travel, we also offer home visits in selected West London postcodes. This means you can receive expert physiotherapy care in the comfort of your own home. Learn more about our physiotherapy for older adults.
NHS vs Private Physiotherapy: Making the Right Choice
You have options when it comes to accessing physiotherapy for arthritis. Here's an honest comparison to help you decide:
| NHS Physiotherapy | Private Physiotherapy | |
|---|---|---|
| Cost | Free at point of use | Initial assessment from £70; follow-up sessions from £55 |
| Waiting time | 6–8 weeks average; can be longer in some areas | Usually within days |
| Session length | Typically 15–20 minutes | Initial: 45 minutes; follow-up: 30 minutes |
| Referral needed? | Many areas now offer self-referral | No referral required |
| Flexibility | Appointments during clinic hours | Early morning, evening, and Saturday appointments available |
If you have private health insurance through BUPA, AXA, Aviva, or other major insurers, your physiotherapy may be covered. CK Physio is registered with most major insurance companies. View our full treatment fees for more details.
Frequently Asked Questions
Can physiotherapy help arthritis?
Yes, physiotherapy is recommended as a first-line treatment for arthritis by NICE guidelines. Research shows that structured exercise programmes can reduce arthritic pain and significantly improve quality of life. A physiotherapist designs personalised exercises to strengthen muscles around affected joints, improve mobility, and reduce stiffness—without medication side effects.
Will exercise make my arthritis worse?
No, appropriate exercise does not worsen joint damage. Your joints are designed to move, and research consistently shows that inactivity weakens the muscles that support your joints, potentially making symptoms worse. A physiotherapist will guide you through exercises tailored to your condition and pain levels, starting gently and progressing safely.
How many physiotherapy sessions will I need for arthritis?
The number of sessions varies depending on your individual condition, symptoms, and goals. Some people notice improvements within a few sessions, whilst others benefit from ongoing treatment. Your physiotherapist will discuss a personalised treatment plan during your initial assessment and adjust it as you progress.
What is the difference between osteoarthritis and rheumatoid arthritis?
Osteoarthritis is the most common form, caused by gradual wear on joint cartilage over time. It typically affects weight-bearing joints like knees and hips. Rheumatoid arthritis is an autoimmune condition where the immune system attacks the joint lining, often affecting smaller joints like fingers and toes first. Both can benefit significantly from physiotherapy.
Do I need a referral to see a physiotherapist for arthritis?
No referral is required for private physiotherapy. You can book directly with a clinic like CK Physio. For NHS physiotherapy, many areas now offer self-referral—check with your local service. Some people prefer private treatment to avoid waiting times and receive more personalised care.
Am I too old for physiotherapy?
Absolutely not. Physiotherapy can benefit people of all ages, including those in their 80s and beyond. Treatment is always adapted to your individual needs, abilities and comfort levels. Many older adults find physiotherapy helps them maintain independence and continue enjoying daily activities with less pain.
Getting Started: Your Next Steps
If arthritic pain is affecting your quality of life, you don't have to simply accept it. The evidence is clear: physiotherapy can make a real difference.
What to Bring to Your First Appointment
- Comfortable, loose-fitting clothing that allows access to your affected joints
- A list of any medications you're taking
- Any relevant X-rays or scan results (if you have them)
- Your insurance authorisation code (if using private medical insurance)
- A note of any questions you'd like to ask
Ready to Take the First Step?
Book your initial assessment at CK Physio and start your journey towards less pain and better mobility.
Book Your AppointmentOr call us on 020 8566 4113
References & Further Reading
- National Institute for Health and Care Excellence (2022). Osteoarthritis in over 16s: diagnosis and management [NG226]. www.nice.org.uk/guidance/ng226
- Versus Arthritis. Physiotherapy: Benefits and how it can help. www.versusarthritis.org/about-arthritis/treatments/therapies/physiotherapy
- Versus Arthritis. Exercising with arthritis. www.versusarthritis.org/about-arthritis/exercising-with-arthritis/
- The Chartered Society of Physiotherapy. What is physiotherapy? www.csp.org.uk/public-patient/what-physiotherapy
- NHS. Osteoarthritis. www.nhs.uk/conditions/osteoarthritis/
Medical Disclaimer: This article provides general information about physiotherapy for arthritis and should not be considered a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your GP or other qualified health provider with any questions you may have about a medical condition. If you're experiencing severe or worsening symptoms, please consult a healthcare professional.
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