Study Identifies Most Effective Exercise for Knee Arthritis Pain Relief

Movement, not medication, may be the most powerful tool against knee pain. A major analysis published in The BMJ finds that aerobic exercise, such as walking, cycling, and swimming, offers the most effective relief for people with knee osteoarthritis.

Osteoarthritis occurs when the cartilage cushioning the joints gradually wears down, leading to pain, stiffness, and reduced mobility. The knees are especially affected, with nearly 30% of adults over 45 showing signs of the condition. While exercise has long been recommended, uncertainty has remained over which types provide the greatest benefit.

To answer this, researchers analyzed 217 clinical trials conducted over three decades, involving more than 15,000 participants. The study compared multiple exercise approaches, including strengthening, flexibility, neuromotor training, and mind-body techniques. Across nearly all key outcomes—pain reduction, physical function, walking ability, and quality of life—aerobic exercise consistently ranked highest.

The benefits were evident across different timeframes. Aerobic activity reduced pain in both short- and mid-term follow-ups and improved physical function even over the long term. Participants also experienced better mobility and overall quality of life, reinforcing its role as a foundational treatment.

Other forms of exercise still played a supportive role. Strength training and mixed exercise programs improved function over time, while neuromotor and mind-body exercises showed short-term benefits in balance and movement. However, researchers emphasize these should complement—not replace—aerobic activity.

While some limitations exist, including variations in study quality and limited long-term data in certain areas, the overall message is clear: consistent aerobic movement should be the first-line strategy for managing knee osteoarthritis.

For those unable to perform traditional aerobic exercises, alternative physical activities can still offer meaningful relief. But for most people, simple, regular movement may be the key to reducing pain and reclaiming mobility.

REFERENCE: Lei Yan, Dijun Li, Dan Xing, Zijuan Fan, Guangyuan Du, Jingwei Jiu, Xiaoke Li, Janne Estill, Qi Wang, Ahmed Atef Belal, Chen Tian, Jiao Jiao Li, Songyan Li, Haifeng Liu, Xuanbo Liu, Yijia Ren, Yiqi Yang, Jinxiu Chen, Yihe Hu, Long Ge, Bin Wang. Comparative efficacy and safety of exercise modalities in knee osteoarthritis: systematic review and network meta-analysis. BMJ, 2025; 391: e085242 DOI: 10.1136/bmj-2025-085242