Short answer. Yes. Regular exercise eases knee arthritis pain about as much as anti inflammatory tablets, with none of the side effects, and it works for most people.
Evidence grade. Good evidence it helps.
What it is
Exercise for knee arthritis means a planned programme, not just being active. It usually has three parts. Strength work for the thigh and hip muscles, such as sit to stand, step ups and leg raises. Aerobic exercise that gets you a little out of breath, such as walking, cycling or swimming. And work on balance and movement of the knee. A physiotherapist sets the programme to suit your knee and your fitness, and you do most of it at home.
What the research shows
A Cochrane review pooled 54 trials with more than 3,500 people with knee arthritis. Exercise lowered pain by about 12 points on a 100 point scale straight after the programme, and improved how well people could move around by about 10 points. The size of the benefit is similar to that from anti inflammatory tablets. Pain relief lasted for at least two to six months after the formal programme ended, and no trial reported a serious side effect. The main side effect was a temporary increase in knee or back pain while getting started.1
People who did their programme one to one with a physiotherapist tended to do better than people in a class or working alone at home. The trials used many different types of exercise, and no single type stood out, so the best programme is the one you will keep doing.
Risks and effort
Group programmes such as GLA:D are run through physiotherapy practices in many countries. The effort is the main demand. Three sessions a week for at least 12 weeks is needed to see the benefit, and it has to be kept up. Some ache during and after exercise is normal and settles within a day. Exercise does not wear the joint out faster.
What usually works instead
Nothing works instead. Exercise is the first line treatment in every major guideline. Weight loss where it applies, simple pain relief and a knee brace can be added. Injections and arthroscopy do not replace exercise. Knee replacement is for arthritis that still limits life after these have been tried. See Osteoarthritis of the Knee.
Questions people ask
My knee hurts when I exercise. Am I doing damage?
Usually not. Pain of up to about 5 out of 10 during exercise that settles by the next morning is acceptable and does not damage the joint. Pain that is worse the next day means the load was too high, so ease back and build up more slowly.
Is walking enough?
Walking is good aerobic exercise but on its own it does little for the thigh muscles. Adding strength work two or three times a week gives the pain relief seen in the trials.
What about swimming or cycling?
Both are good choices when walking hurts, because they load the knee less. Water based exercise has a little less evidence than land based exercise but helps many people.
I am waiting for a knee replacement. Is there any point exercising now?
Yes. People who are stronger before surgery recover faster afterwards, and some people improve enough to put the operation off.
References
- Fransen M, McConnell S, Harmer AR, Van der Esch M, Simic M, Bennell KL. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2015;1(1):CD004376. https://doi.org/10.1002/14651858.CD004376.pub3
Last reviewed 18 October 2026. Next review due October 2028.