Gentle movement often helps a stiff, sore joint

Shorter activity can calm a steady ache

Start with one movement you need in daily life. It might be walking, rising from a chair, or lifting a cup to a shelf. Do a smaller amount at one time. Return to it later so the joint doesn't become stiff from sitting all day.

If I were beside you, I'd ask which daily task you miss most.

Warmth before movement may loosen stiffness. A cold pack afterward may soothe swelling. Enough sleep helps you cope with soreness too. Spread hard tasks across the day instead of doing them together. If you're considering medicine for the ache, check with your doctor because your other drugs and health concerns can change what's safe.

Some people find a cane or brace helpful. The fit matters, so ask someone who knows how it should sit. You don't want the support causing another sore spot.

New swelling or weakness needs a fresh exam

Fast swelling, sudden weakness, a locked joint, or abrupt trouble standing is different from a steady ache after use. One joint that feels hot and looks swollen with fever calls for prompt care. Don't try to work through those changes at home.

The next decision is simple.

When the ache returns often, an exam can help find the likely cause. An old X-ray may help, but the person also needs to hear when the ache began and examine the joint. Ask what was found, what remains uncertain, and which home care still fits. Coming to a visit doesn't mean you must agree to a procedure.

Evidence sources

1. The 2019 ACR/Arthritis Foundation guideline makes STRONG recommendations for exercise, weight loss in people with overweight or obesity, self-efficacy and self-management programmes, tai chi, cane use, hand orthoses for first-CMC joint OA, tibiofemoral bracing, topical NSAIDs for the knee, oral NSAIDs and intra-articular glucocorticoid injections for the knee; acupuncture, thermal modalities, radiofrequency ablation, acetaminophen, duloxetine and tramadol are only conditional.

   Kolasinski SL, et al. — 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee.. Arthritis Rheumatol, 2020.

2. OARSI designates arthritis education plus structured land-based exercise (with dietary weight management for the knee) as CORE treatments for knee, hip and polyarticular OA. Topical NSAIDs are Level 1A for knee OA. Intra-articular corticosteroids, intra-articular hyaluronic acid and aquatic exercise are Level 1B/2 for the KNEE only and are NOT recommended for hip or polyarticular OA. Acetaminophen is conditionally not recommended, and no oral NSAID is recommended for people with cardiovascular comorbidity or frailty.

   Bannuru RR, et al. — OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis.. Osteoarthritis Cartilage, 2019.

3. The Cochrane review of land-based therapeutic exercise for knee osteoarthritis extracted data from 54 studies, with high-quality evidence from 44 trials (3,537 participants) that exercise reduces pain immediately after treatment, and further high-quality evidence that it improves physical function. Benefit attenuates but persists for at least two to six months after the programme ends.

   Fransen M, et al. — Exercise for osteoarthritis of the knee.. Cochrane Database Syst Rev, 2015.

4. The Cochrane review of exercise for HIP osteoarthritis found high-quality evidence from nine trials (549 participants) that exercise reduced pain (SMD -0.38, 95% CI -0.55 to -0.20) and improved physical function (SMD -0.38, 95% CI -0.54 to -0.05) immediately after treatment, equivalent to about 8 points of pain relief on a 0-100 scale with a number-needed-to-treat of 6.

   Fransen M, et al. — Exercise for osteoarthritis of the hip.. Cochrane Database Syst Rev, 2014.

5. In a randomized trial of 156 US Military Health System primary-care patients with knee osteoarthritis, physical therapy beat glucocorticoid injection at one year: mean WOMAC total scores were 37.0 with physical therapy versus 55.8 with injection (mean between-group difference 18.8 points, 95% CI 5.0 to 32.6, lower is better), with secondary outcomes in the same direction.

   Deyle GD, et al. — Physical Therapy versus Glucocorticoid Injection for Osteoarthritis of the Knee.. N Engl J Med, 2020.

6. A 52-week single-blind randomized comparative-effectiveness trial in 204 people with symptomatic knee OA found Tai Chi twice weekly for 12 weeks produced WOMAC improvement of 167 points versus 143 points for standard physical therapy, a non-significant between-group difference of 24 points. Benefits were maintained to 52 weeks and the Tai Chi group had significantly greater improvement in depression and the physical component of quality of life. No serious adverse events occurred.

   Wang C, et al. — Comparative Effectiveness of Tai Chi Versus Physical Therapy for Knee Osteoarthritis: A Randomized Trial.. Ann Intern Med, 2016.

7. In 1,212 Osteoarthritis Initiative participants aged 50+ with knee OA, those who walked for exercise had a LOWER likelihood of developing new frequent knee pain than non-walkers (odds ratio 0.6, 95% CI 0.4-0.8), and less progression of medial joint space narrowing - evidence against the belief that walking wears the joint out faster.

   Lo GH, et al. — Association Between Walking for Exercise and Symptomatic and Structural Progression in Individuals With Knee Osteoarthritis: Data From the Osteoarthritis Initiative Cohort.. Arthritis Rheumatol, 2022.