For millions of Indians suffering from persistent knee pain due to osteoarthritis, a simple, accessible solution may be the most effective. Scientists have finally identified which form of exercise provides the most reliable relief for this debilitating condition, which is a leading cause of mobility issues in adults.
The Search for the Best Exercise for Aching Knees
Osteoarthritis, a condition where the protective cartilage at the ends of bones wears down over time, leads to swelling, stiffness, and chronic discomfort. While it can affect any joint, the knee is exceptionally vulnerable. Research indicates that nearly 30% of adults over 45 show signs of knee osteoarthritis on x-rays, with almost half of those experiencing daily pain or movement difficulties. While movement is universally recommended as a cornerstone of managing the condition, medical guidelines have historically been vague on which specific type of exercise works best.
To resolve this uncertainty, a team of researchers undertook a comprehensive analysis, comparing the effectiveness of various exercise regimens used by people with knee osteoarthritis. Their findings, published in the prestigious medical journal The BMJ, deliver a clear verdict.
Aerobic Activity Emerges as the Clear Winner
The scientists conducted an extensive review of 217 randomized clinical trials conducted between 1990 and 2024, involving a total of 15,684 participants. They compared the outcomes of aerobic exercises—such as walking, cycling, and swimming—against other popular methods including flexibility training, strength work, mind-body exercises (like yoga or tai chi), neuromotor programs, and mixed routines.
Using the internationally recognized GRADE system to evaluate results, the team assessed pain reduction, physical function, gait performance, and quality of life at intervals of four, twelve, and twenty-four weeks. Across almost every measure and timeframe, aerobic exercise consistently ranked at the top.
The evidence, rated as moderate-certainty, showed that aerobic activity successfully reduced pain in the short and mid-term, improved physical function both immediately and over the long term, and enhanced both gait performance and quality of life in the early and middle stages of intervention. While other exercises had niche benefits—mind-body workouts aided short-term function, neuromotor exercises helped short-term gait, and strengthening offered mid-term functional gains—none matched the broad, consistent advantages of aerobic movement.
Implications for Treatment and Patient Safety
Importantly, the analysis found that none of the exercise categories caused more adverse events than the control groups, highlighting the overall safety of structured physical activity for knee osteoarthritis. The study authors, acknowledging certain limitations like reliance on indirect comparisons, issued a powerful recommendation.
They advocate that aerobic activity should be used "as a first line intervention for knee osteoarthritis management", particularly when the goals are to boost functional capacity and alleviate pain. For individuals who may find standard aerobic exercise challenging due to other limitations, the researchers add that alternative forms of structured physical activity can still be beneficial.
This landmark study provides much-needed clarity for patients and healthcare providers, pointing toward accessible, low-cost activities like brisk walking, cycling, or swimming as the most scientifically backed strategy for reclaiming mobility and reducing the burden of knee pain.
