What is osteoarthritis of the knee and hip?
Osteoarthritis (OA) is the most common form of arthritis. It develops when the protective cartilage cushioning the ends of bones gradually wears down, leading to pain, stiffness, and reduced joint function. Importantly, OA affects the whole joint — the underlying bone and surrounding soft tissues, not cartilage alone. It most often affects the knees, hips, hands, and spine, typically progresses slowly over years, and while existing joint damage cannot be reversed, symptoms are generally manageable through exercise, weight management, and other conservative approaches.
OA is far from rare. In 2019, an estimated 528 million people worldwide were living with osteoarthritis — an increase of 113% since 1990 — with the knee the most frequently affected joint at 365 million cases worldwide, ahead of the hip and hand (WHO – Osteoarthritis Fact Sheet). Closer to home, a Singapore population-based screening study estimated the weighted prevalence of symptomatic knee OA in the general population at 4.7% using a conservative diagnostic algorithm and 11% using a more liberal one, with prevalence rising sharply after age 40 and higher rates among women and among Indians and Malays than Chinese (Validation of screening questionnaires for evaluation of knee osteoarthritis prevalence in the general population of Singapore).
OA also skews toward older adults and women: about 73% of people living with osteoarthritis are older than 55 years, and 60% are female (WHO – Osteoarthritis Fact Sheet). With ageing populations and rising rates of obesity and injury, WHO expects global osteoarthritis prevalence to continue increasing. If this describes you or someone you are caring for, you are far from alone — and there is a well-evidenced path forward.
How home physiotherapy helps
The reassuring part of the research is this: exercise is one of the best-supported treatments available for OA, and its benefits are not simply a matter of feeling encouraged by attention or activity. A 2024 Cochrane systematic review of 44 trials found that exercise therapy for knee osteoarthritis produced a moderate, clinically meaningful reduction in pain (approximately 13 points on a 100-point scale) and improvement in physical function (approximately 12.5 points on a 100-point scale) immediately after treatment, compared with no exercise, with benefits still present — though more modest — at 2 to 6 months follow-up (Cochrane – Exercise for osteoarthritis of the knee).
Sceptics sometimes wonder whether this is simply the effect of attention or motivation rather than the exercise itself. The evidence addresses that directly: when compared specifically against placebo or attention-control interventions, exercise still produced a slight improvement in knee pain (about 8.7 points on a 0–100 scale) and a likely improvement in physical function (about 11.3 points), confirming that exercise itself — not just the experience of being cared for — is doing the work (Cochrane – Is exercise an effective therapy to treat knee osteoarthritis?).
Hip OA has its own supporting evidence base. A Cochrane review of 10 randomised controlled trials found that land-based therapeutic exercise programmes — typically combining muscle strengthening, functional training, and aerobic exercise — reduce pain and improve physical function in people with symptomatic hip osteoarthritis, though the effect on pain tends to be smaller than what is seen in knee OA (Cochrane – Exercise for osteoarthritis of the hip). UK clinical guidance reflects this consensus: NICE recommends offering everyone with osteoarthritis therapeutic exercise tailored to their needs, combining local muscle strengthening with general aerobic fitness, noting that pain may briefly increase when starting out but that consistent, long-term adherence reduces pain and improves function and quality of life over time (NICE – Osteoarthritis in over 16s: diagnosis and management, NG226).
Home-based physiotherapy is well placed to deliver this kind of programme. Because OA management depends on consistency — not a single dramatic intervention — receiving guidance in your own home, using your own stairs, chairs, and walking routes, can make it easier to build the exercise habit that the evidence says matters most.
What a home visit looks like
A home physiotherapy visit for osteoarthritis typically starts with an assessment of your affected joint(s), your walking pattern, muscle strength, range of motion, and how your symptoms affect daily tasks — getting up from a chair, climbing stairs, walking distances. Your physiotherapist will also ask about your goals, activity levels, and any other health conditions, since OA care is most effective when it is tailored rather than generic.
From there, a structured exercise plan is introduced gradually, alongside practical advice on activity pacing, footwear, walking aids where appropriate, and weight management if relevant. NICE guidance notes that for people with osteoarthritis who are overweight or living with obesity, weight loss provides clinical benefit, and a 10% reduction in body weight is likely to be more beneficial than a 5% reduction — which is why exercise and weight-management advice are often combined in a home programme rather than treated separately (NICE – Osteoarthritis in over 16s: diagnosis and management, NG226). Subsequent visits build on this foundation: progressing exercises, checking technique, and adjusting the plan as strength and confidence improve.
Typical recovery timeline
It is worth being upfront about what "recovery" means with osteoarthritis: because joint damage already present cannot be reversed, physiotherapy is not a cure but an ongoing, evidence-based way to manage symptoms, preserve function, and slow the impact of the condition on daily life. That said, meaningful improvement is realistic and well documented.
Structured, supervised exercise programmes commonly run over 6 to 8 weeks. Real-world data from the GLA:D (Good Life with osteoArthritis Denmark) programme, drawn from tens of thousands of patients with symptomatic knee or hip OA, has reported meaningful improvements in pain intensity, walking speed, and chair-stand ability (a marker of functional leg strength) after an 8-week course, alongside reduced use of pain medication (Skou ST et al., Osteoarthritis and Cartilage, PubMed). These findings are encouraging, though it is worth noting the specific percentage improvements are drawn from real-world registry data rather than a controlled trial, and results depend on continuing to exercise. Cochrane evidence shows that treatment gains partially fade by 2 to 6 months after a programme ends if exercise is not kept up, which is why ongoing home exercise and periodic physiotherapy review, rather than a single course of treatment, tend to work best over the long term.
For a minority of people with more advanced OA who do not respond adequately to conservative management, referral for consideration of joint replacement surgery may eventually be appropriate. Most people who complete structured exercise programmes like GLA:D do not go on to joint replacement in the near term — conservative, evidence-based exercise remains a legitimate first-line approach rather than something to try only until surgery becomes "necessary."
Exercises and approaches used at home
A home physiotherapy programme for knee or hip OA typically draws on a combination of the following, tailored to your specific joint, strength, and goals:
- Targeted strengthening — quadriceps and hip abductor/extensor exercises to better support and offload the affected joint
- General aerobic conditioning — walking or stationary cycling to build cardiovascular fitness and overall function
- Functional training — practising real-world movements such as sit-to-stand and stair negotiation, alongside flexibility work, as used in structured programmes like GLA:D
- Aquatic exercise — a land-based alternative or adjunct for those who find weight-bearing exercise painful, where access allows
- Manual therapy and joint mobilisation — hands-on techniques used alongside exercise to help with pain and stiffness
- Education and load management — guidance on pacing activity, weight management, and the appropriate use of walking aids, footwear, or bracing to reduce joint load
A safety note
Most osteoarthritis symptoms are well suited to routine physiotherapy management, but a few presentations call for urgent medical assessment rather than a home physiotherapy visit. Seek prompt medical attention if you experience: a suddenly hot, red, and significantly swollen joint accompanied by fever or feeling generally unwell; a sudden inability to weight-bear or move the joint at all; a joint that locks or gives way suddenly after an injury; joint swelling and pain following trauma; or unexplained significant weight loss, night pain, or symptoms affecting multiple joints alongside your OA symptoms. These can signal conditions that need medical evaluation to rule out before starting or continuing an exercise programme.
Taking the next step
Living with knee or hip osteoarthritis can feel discouraging, especially on days when stiffness or pain limits what you'd like to do. But the evidence is genuinely encouraging: structured exercise, delivered consistently and tailored to your joint and goals, is one of the most well-supported ways to reduce pain and improve function — and it can be built around your own home, routines, and pace. A home physiotherapy visit is a practical, low-pressure way to find out what a personalised plan could look like for you. Reach out to arrange an assessment and take the first step toward moving more comfortably.
Figures above reflect outcomes reported in published population studies and clinical trials, not guaranteed individual or clinic results. Author: [Name], BSc Physiotherapy, AHPC-registered. Medically reviewed by [Reviewer Name, credentials, AHPC registration number] on 12 July 2026.
