Does Exercise Really Work for Osteoarthritis? New Research Questions Standard Treatment – But the Answer Is More Complicated

Tech finds footing as Nvidia-Meta chip deal lifts sentiment ahead of Fed minutes.

The quick scan: Markets climbed for the third consecutive session with modest gains as beaten-down technology stocks showed signs of life, supported by Nvidia's expanded AI chip deal with Meta and Bill Ackman's increased Amazon stake.

S&P 500: +0.56% to 6,881.31 – The index advanced 38 points as utilities +2.8% and real estate +1.5% led gains, though nine of 11 sectors still finished in negative territory for the session, highlighting the narrow leadership driving markets higher
Dow Jones: +0.26% to 49,662.66 – The blue-chip index gained 129 points in a choppy session with 15 components positive, 14 negative, and one unchanged, as defensive positioning continued
NASDAQ: +0.78% to 22,753.63 – Tech-heavy index outperformed on Nvidia +1.6% (Meta announced millions of chips for datacenters) and Amazon +2% (Pershing Square grew stake 65%), showing early signs tech selling may be exhausting itself.

What's driving it: Meta Platforms' announcement that it will use millions of Nvidia chips in its datacenter buildout provided a tangible validation of AI infrastructure spending, easing some fears that capex wouldn't translate to actual orders. Similarly, Bill Ackman's Pershing Square increasing its Amazon stake by 65% (making it the fund's third-largest holding) signaled institutional conviction returning to beaten-down tech names. Federal Reserve minutes released at 2pm showed policymakers divided – some seeing further rate cuts as "likely appropriate" if inflation cooperates, while others favored holding steady "for some time." With 10-year Treasury yields near two-month lows at 4.03%, markets interpreted this as maintaining a dovish tilt despite recent AI-driven volatility.

Bottom line: After weeks of relentless selling driven by AI displacement fears, markets are testing whether tech can stabilize based on actual business fundamentals rather than speculation about disruption timelines. For retirees, three consecutive days of modest gains suggest panic may be easing – but note that nine of 11 sectors still closed negative despite the positive headline numbers, meaning this recovery remains fragile and concentrated in the names that fell hardest.

"Just Exercise" for Osteoarthritis: Does It Actually Work, or Have We Been Overselling It?

The scoop: If you've been diagnosed with osteoarthritis – that degenerative joint disease causing pain, stiffness, and reduced range of motion in your knees, hips, or hands – your doctor has almost certainly told you to exercise. It's become the standard first-line treatment advice, repeated so often it's achieved the status of medical gospel.

A new review published this week suggests that gospel might need some footnotes.

Researchers from Adelaide University conducted an "umbrella review" – analysing five major systematic reviews covering 100 studies with 8,631 patients, plus another 28 recent trials involving 4,360 participants. They compared exercise to doing nothing, placebo treatments, painkillers, injections, and surgery.

The findings? Exercise resulted in "small" reductions in pain – between 6 and 12 points on a 100-point scale – for hip, knee, and hand osteoarthritis when compared to doing nothing. But exercise didn't seem to improve physical function any more than those comparisons. For knee and hip osteoarthritis, exercise was about as effective at reducing pain as ibuprofen and corticosteroid injections (5-10% reduction), but less effective than total joint replacement.

Now, before you use this as justification to cancel your physio appointments, there are four massive limitations in this review.

First, the review lumped all types of exercise together. They're not equal. Previous research shows aerobic exercise is best for reducing pain and improving function in knee osteoarthritis, while stretching is least effective. Treating yoga, water aerobics, and resistance training as interchangeable is like evaluating "medication" without distinguishing between aspirin and chemotherapy.

Second, they treated supervised and unsupervised exercise identically. Research consistently shows supervised training – where you've got a trainer or physiotherapist pushing you along, correcting form, and gradually increasing intensity – produces much better outcomes than doing exercises alone at home while half-watching television.

Third, they didn't account for symptom severity at baseline. Studies show people with more severe pain and worse function see better responses to exercise than those with mild symptoms. Averaging all patients together dilutes the signal.

Fourth – and perhaps most important for retirees managing this long-term – the review didn't consider exercise duration, and most study periods were around 12 weeks. The authors acknowledge this is a problem, because results "may not accurately reflect the benefits of exercise in people with osteoarthritis who commit to consistent exercise as an ongoing part of their weekly routine."

Translation: a 12-week trial doesn't tell you much about permanent lifestyle change, which is what's actually recommended.

There's one more limitation: they didn't account for exercise dose. Other reviews have found optimal benefits occur around 150 minutes of moderate-intensity exercise per week.

Put all these limitations together and what you get is a review that likely undersells the benefits of exercise for osteoarthritis – possibly significantly.

But even setting aside those limitations, a 10% reduction in pain might sound trivial when reading research papers, but it could make a meaningful difference to your actual life. The gap between "I can't walk to the shops without significant pain" and "I can walk to the shops with manageable discomfort" might be just 10 points on a 100-point scale – but it's the difference between independence and isolation.

The Adelaide researchers are right that we shouldn't oversell exercise as a miracle cure. It's not going to regenerate damaged cartilage or reverse the underlying disease. For severe cases, joint replacement remains more effective – and pretending otherwise does patients no favours.

But here's what the review also shows: exercise is as effective as the medications most people are taking (ibuprofen, corticosteroid injections), with far fewer side effects. It costs nothing beyond time and effort. It provides benefits beyond just osteoarthritis symptoms – improving cardiovascular health, maintaining muscle mass, supporting mental wellbeing, and reducing fall risk.

And perhaps most importantly: unlike medication or surgery, exercise is something you can control, adjust, and refine over time based on what your body tells you.

The question isn't really "does exercise work for osteoarthritis?" The evidence – even in this critical review – says yes, it does, to a modest but meaningful degree. The better questions are: what type of exercise works best for you? At what dose? Supervised or self-directed? And are you willing to commit to it as an ongoing practice rather than a 12-week experiment?

Because that's where the research suggests the real benefits accumulate – not in the short trials this review analysed, but in the consistent, long-term practice that becomes part of your weekly routine.

Your osteoarthritis isn't going anywhere. The question is whether you're going to manage it actively or passively.

Actionable Takeaways for L-Plate Retirees:

• Understand that "exercise" isn't one thing – type matters enormously. Aerobic exercise (walking, cycling, swimming) shows the strongest evidence for reducing osteoarthritis pain and improving function, while stretching alone is least effective. Don't assume that because you're "moving," you're getting optimal benefits – the specific type of movement determines outcomes.

• Prioritise supervised training over DIY approaches if possible. Research consistently shows professionally supervised exercise programs produce significantly better results than following photocopied sheets at home. Even a few sessions with a physiotherapist to learn proper form and progression can make the difference between marginal improvement and meaningful pain reduction.

• Recognise that 150 minutes weekly of moderate-intensity exercise is where benefits peak. This isn't arbitrary – reviews show optimal pain reduction and function improvement occur around this dose. That's 30 minutes, five days weekly, or 50 minutes three times weekly – achievable, but requires actual commitment, not token effort.

• Don't expect miracles in 12 weeks – this is a long-term management strategy. The studies showing "small" benefits used short timeframes. Consistent exercise as an ongoing weekly practice over months and years is what's actually recommended, not a three-month trial followed by abandonment when you're not "cured."

• Compare exercise to what you'd otherwise do, not to an impossible standard. Exercise provides similar pain relief to ibuprofen and corticosteroid injections (5-10% reduction) with zero side effects. It won't match joint replacement surgery for severe cases, but it beats doing nothing, and it's safer than long-term NSAID use.

• Recognise that 10% pain reduction might be more meaningful than it sounds. The difference between "can't walk to the shops" and "can walk to the shops with manageable discomfort" might be just 10 points on a 100-point scale – but it's the gap between independence and dependence, between social engagement and isolation.

Your Turn:
You've probably had the "you need to exercise" conversation with your doctor multiple times. Has it actually translated into consistent movement, or does the advice feel too vague to act on?
If you knew that aerobic exercise specifically (not just "any movement") at 150 minutes weekly with professional supervision produces the best results, would that change how you approach osteoarthritis management – or does it just sound like more work than you're willing to commit to?
When you read that exercise provides "small" pain reductions (6-12 points on a 100-point scale), does that sound disappointing and not worth the effort, or does it sound like exactly the kind of marginal gain that compounds over years into the difference between mobility and immobility?

👉 Hit reply and share your story – your insights could inspire fellow readers in future issues.

If this newsletter helped you see that the "just exercise" advice for osteoarthritis is both oversold and undersold – oversold as a cure, undersold when done properly as consistent, supervised, aerobic movement at adequate dose – consider supporting L-Plate Retiree on Ko-fi. Your support helps me keep translating nuanced health research into practical movement strategies for ageing bodies.