5 Things I Wish Everyone with Osteoarthritis Knew as a Physical Therapist

If you have been diagnosed with osteoarthritis, you have probably heard things that made you feel like your future was already decided. That surgery is coming. That exercise will make it worse. That osteoarthritis pain relief is not really possible without an operation.

Most of that is wrong. And believing it can genuinely change the direction of your life, not for the better.

As a physical therapist and osteoarthritis specialist, the statements that bother me most are things like “you have the joints of someone 20 years older,” “just get by until you need surgery,” or “this is the worst joint I have ever seen.” These things make people feel like there is nothing they can do, when that could not be further from the truth.

There is no cure for osteoarthritis. But osteoarthritis pain relief is genuinely achievable, and for many people symptoms can be reduced significantly. The condition does not have to keep advancing. Here are the five most important things to understand.

This is probably the most important thing on this list. When you are in pain, it does not mean your joint is physically changing in that moment. It does not mean you are making things worse.

Pain is your body’s communication system. It protects you and notifies you when something needs attention. A smoke alarm going off does not mean your house is on fire. It might mean something is stuck in the toaster. Your arthritic joint works the same way.

When you feel pain, try asking yourself: what is my body trying to tell me right now?

For example: you go for a walk and feel mild discomfort at 10 minutes. That might be your body saying “I am not sure about this but we can keep going.” At 20 minutes the pain hits a 8 out of 10. That is a clearer signal that today’s walk was too much, and next time you might try 15 minutes instead.

Learning to interpret your pain rather than be ruled by it is one of the most powerful shifts you can make with osteoarthritis. Pushing through significant pain consistently will not make it better. But understanding what your pain is telling you can.

Going into any treatment effort with the assumption that surgery is inevitable is one of the most common reasons it does not work. If you believe nothing will help, you will not put in the consistent effort that actually produces results.

Surgery has a time and a place. It is not a setback if you eventually choose it. But research consistently shows that conservative treatment, meaning exercise, lifestyle changes, and movement retraining, should be attempted seriously before surgery is considered. Many people who try this approach find they do not need surgery after all.

In my years working in home health after joint replacements, I saw many cases where surgery had been done before any real lifestyle work had been tried. That is not the right order.

The behaviors worth committing to for at least three to six months before drawing any conclusions include:

• Strengthening the full body, particularly the muscles surrounding the affected joints
• Finding a reliable outlet for stress, which directly affects pain sensitivity
• Prioritizing sleep as consistently as possible
• Fueling your body with whole foods, quality protein, fruits, and vegetables

The key word is consistently. Not perfectly, and not all at once. Pick one or two to focus on first and build from there.

And if surgery does become the right choice for you at some point, having worked on these behaviors beforehand will genuinely improve your recovery. Either way, they are worth doing.

A lot of people with osteoarthritis are told, directly or indirectly, that their weight is the problem and that pain relief depends on losing a certain amount of it. This is one of the most discouraging and unhelpful things a person can be told.

Weight loss can reduce joint load and it can help. But it is not the only path to feeling better, and for many people it is not even the most accessible starting point.

When you are in constant pain, losing weight is harder. When your mobility is reduced, it is harder still. Treating weight loss as a prerequisite to feeling better keeps people stuck.

Instead, focus on the things that are within reach right now.

• Find three to five gentle movements, whether seated, lying down, or standing, that actually feel good in your body and do them daily.
• Work on stress management. Chronic stress directly increases pain sensitivity, so managing it matters more than most people realize.
• Prioritize sleep. Even small improvements in sleep quality can reduce how much pain you feel during the day.

Each of these changes, once consistent, can reduce pain meaningfully. And when pain goes down, movement becomes easier, motivation increases, and weight loss often follows naturally.

One of the most persistent myths about osteoarthritis is that exercise makes it worse. The opposite is true. It is the lack of the right exercise that tends to make osteoarthritis worse.

The muscles around your joints are what absorb force and protect your cartilage. When those muscles weaken from inactivity, your joint takes more of the load with every movement. Building that muscular support back up is what changes how your joints feel day to day.

That said, not every exercise will feel good for everyone. The goal is not to push through exercises that hurt. It is to find the ones that your body responds positively to and build from there.

If a chair squat does not feel good right now, that does not mean squatting is off-limits forever. It might mean:

• Raising the seat height so the range of motion is smaller
• Using your arms on the chair for assistance
• Starting with a seated leg press variation to build foundational strength first

There is almost always a version of a movement that works for where you are right now. The key is finding it rather than avoiding movement altogether.

Adventurers for Life, my arthritis workout membership, is built specifically for this. It includes an initial assessment so you are placed at the right level from the start, and all workouts are led by me so you know exactly what to do and how to modify it.

Real Results from Adventurers for Life Members

These are real people who decided to stop waiting and start doing the right things for their joints. Here is a look at what became possible for them.

There is no single injection, supplement, brace, or session of physical therapy that will resolve osteoarthritis pain on its own. What produces real, lasting results is consistent daily effort over time.

This is actually good news. It means you have more control over your outcomes than you may have been led to believe. The condition responds to how you move, what you eat, how you sleep, and how you manage stress.

It also means that passive treatments, while sometimes useful in the short term, cannot replace the active work. A brace during a flare, an ice pack after a hard day, or an occasional injection for pain relief can all have a place. But they work best when they are supporting an active program, not substituting for one.

The people who experience the most significant and lasting improvement with osteoarthritis are not the ones who found a quick fix. They are the ones who committed to the right habits and kept showing up.

Osteoarthritis Pain Relief Is More Within Reach Than You Have Been Told

The biggest thing I want you to take away from this is that you are not stuck.

Osteoarthritis does not have to mean the end of the activities you love. It does not mean surgery is coming no matter what. It does not mean exercise will hurt you or that you have to lose a specific amount of weight before things can change.

What it does mean is that you have to take the right kind of action, consistently, and give it enough time to work.

The results people experience when they do that are real. You saw some of them above. The same is possible for you.

Frequently Asked Questions About Osteoarthritis and Osteoarthritis Pain Relief

Dr. Alyssa Kuhn, PT, DPT

Physical Therapist & Osteoarthritis Specialist

Dr. Alyssa Kuhn is a physical therapist and osteoarthritis specialist based in the mountains of Utah. Through Keep the Adventure Alive, she helps people with joint pain reclaim their mobility, reduce pain, and get back to the activities they love. Thousands of people across the world have already rewritten their adventure stories. Now it is your turn.