Exercise for Osteoarthritis - November 2025 Newsletter
Exercise for Osteoarthritis
Hello, this is Dr. Ellen. In this month’s newsletter, I want to talk about what might be the most important but oftentimes under-addressed intervention to help those with osteoarthritis, namely, exercise. I will give an overview of osteoarthritis, including the treatment approaches available, and then focus on some of the potential benefits of exercise as well as what the different categories of exercise have to offer those with osteoarthritis.
By the way, if you haven’t had a chance to see my previous newsletters, you can find them on my website, www.drellencutler.com under ‘Free Resources’.
What is Osteoarthritis?
Osteoarthritis (OA) is a degenerative condition affecting one or more joints. As it begins to develop, OA can damage all the tissues of the joint, including the joint’s cartilage (or the meniscus in the knees or discs between the vertebrae) that overlies the bones of the joint, the bones themselves, the tendons and ligaments of the joint, and the moist synovial membrane lining the joint. It is the most common form of arthritis and most commonly seen in older people, affecting many millions worldwide. Women are more likely than men to have OA, especially after age 50. However, younger people can also develop OA, often as the result of joint injury. The most commonly affected joints are the hands (particularly the end joints of the fingers and the base and end joints of the thumbs), knees, hips, neck, and lower back.(1,2,3)
For some, OA is relatively mild and does not affect day-to-day activities. For many others, it can cause significant joint pain and, after rest or inactivity, a period of stiffness. Decreased activity because of the pain can lead to muscle weakness, which causes more stress on the joint. As damage progresses, swelling and loss of joint motion can develop. Small bony growths may grow on the edges of the joint and fragments of bone or cartilage can break off and float inside the joint space. Joint damage usually develops gradually over years, but in some it may worsen more rapidly.(1,2)
Treating Osteoarthritis
OA is an ongoing process and cannot be reversed. Medical treatments are designed to help decrease pain and improve function. A number of over-the-counter medications can be used. Acetaminophen (e.g., Tylenol) may help those with mild to moderate pain, but should not be used in excess in order to prevent harm to the liver. Nonsteroidal anti-inflammatory drugs (aka NSAIDs) such as ibuprofen and naproxen may help decrease pain and decrease low level inflammation, but can cause adverse effects such as stomach upset, bleeding problems, and liver and kidney damage. NSAIDs are sometimes used topically (as is capsaicin cream) with good effectiveness and often less side effects. Stronger prescription medications are sometimes employed for ongoing pain, but use of these should be closely monitored by the prescribing physician. Cortisone injections into the joint might relieve pain for a few weeks, but the number of injections each year is limited to prevent the worsening of joint damage by the cortisone itself. Injections of hyaluronic acid might relieve pain by providing some cushioning in the knee, though some research suggests that relief is the result of a placebo effect. Surgical interventions are only used in later stages of OA in order to reduce treatment-resistant pain and/or regain function in the affected joint.(4,5)
However, in earlier stages of OA, emphasis should be placed on more conservative measures. Physical and lifestyle therapies should be the central focus, with regular physical activities often being the most important part of an overall treatment plan. Physical/occupational therapies can be helpful. Short-term pain relief may be achieved through applications of hot and cold packs, transcutaneous electrical nerve stimulation (TENS), soft tissue work, chiropractic, and acupuncture. Psychological cognitive behavior therapy (CBT) and balance training may also help decrease ongoing pain in OA. Improvements in function may be further attained through the use of gentle range of motion exercises for the affected joint(s), bracing and adaptive equipment, and, often most importantly, specifically designed physical exercise programs.(4,6)
Exercise for Osteoarthritis
Physical exercise helps diminish the pathological changes of OA. It has been found to have a positive effect on the non-cellular substances that make up the joint cartilage, improve the appropriate degradation and subsequent replacement of organelles within cells (autophagy), expedite the removal of aging and dysfunctional cells (apoptosis), and improve regulation of the local inflammatory response.(7) The effects of exercise help decrease pain, increase the range of motion of the joint, improve the strength of muscles that help move and stabilize the joint, and increase overall function by increasing aerobic capacity and improving body mechanics.(6)
Many different types of exercise are used to help those with OA. Aerobic exercises (such as walking, cycling, and swimming) are the most widely used in those with OA, but their intensity needs to be tailored to each individual. Low-intensity aerobic exercise is usually better for those with severe OA, while those with milder OA may be better served with higher intensity aerobic exercise.(7) In those with knee osteoarthritis, a recently published study found aerobic exercise is likely the most beneficial exercise modality for improving pain, function, gait performance, and quality of life.(8)
Aquatic exercise in the early stages of OA can alleviate the stiffness of the knee joint, whereas land exercises can be performed after the joints have a certain degree of flexibility and are better at improving pain and enhancing function. Resistance (strength) training, which uses resisted muscle contraction with or without movement, is effective in improving muscle strength. Neuromuscular training targets balance, coordination, and postural and movement training (such as tai chi or qigong). They can improve the physical function and have a positive psychological impact on those with OA. Also, new intervention methods such as virtual reality and sports games are being developed to help improve people’s physical and psychological conditions.(7)
The Ellen Cutler Method (ECM)
Over my years of practice, I have seen many individuals that were diagnosed with OA. I have used ECM energetic testing methods to determine if there were specific reactivities related to their joint complaints, as well as to identify optimal lifestyle choices. Once uncovered, I have used ECM clearing methods to desensitize the identified reactivities. My testing has often revealed exercises or other activities that were exacerbating the joint pain. Once the intensity of the activity was decreased or the activity was modified, there was often improvement in their joint pain and physical function.
I have found that those moving toward a whole food plant-based diet and avoiding pro-inflammatory foods such as sugars and other refined carbohydrates, dairy products, and alcohol report improvement in their symptoms. This is done in conjunction with having a full spectrum digestive enzyme at the beginning of each meal (such as Dr. Ellen’s Way ‘Digest Supreme’)(9). I have also found particular supplements, namely InflammEnz Plus™, ‘Disc & Joint’ and pHysioProtease®, all by Proenzol, most often test as beneficial and I usually receive positive feedback from patients using them.
Till next month, please be well, be healthy, and remember…
“But if there's one osteoarthritis treatment an individual with osteoarthritis should do every day, it's exercise.”
― from “Exercise: Rx for overcoming osteoarthritis” at https://www.health.harvard.edu/staying-healthy/exercise-rx-for-overcoming-osteoarthritis
Dr. Ellen
References:
“Osteoarthritis – Symptoms and Causes” at https://www.niams.nih.gov/health-topics/osteoarthritis
“Osteoarthritis” at https://www.mayoclinic.org/diseases-conditions/osteoarthritis/symptoms-causes/syc-20351925
“The Best Medicine For Joint Pain Isn't What You Think, Expert Says” at https://www.sciencealert.com/the-best-medicine-for-joint-pain-isnt-what-you-think-expert-says
“Osteoarthritis – Diagnosis and Treatment” at https://www.mayoclinic.org/diseases-conditions/osteoarthritis/diagnosis-treatment/drc-20351930
“Treatments for Osteoarthritis” at https://www.arthritis.org/health-wellness/treatment/treatment-plan/disease-management/treatments-for-osteoarthritis
“Osteoarthritis Management: Updated Guidelines from the American College of Rheumatology and Arthritis Foundation” at https://www.aafp.org/pubs/afp/issues/2021/0115/p120.html
“Exercise for Osteoarthritis: A Literature Review of Pathology and Mechanism” at https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2022.854026/full
“Comparative efficacy and safety of exercise modalities in knee osteoarthritis: systematic review and network meta-analysis” at https://www.bmj.com/content/391/bmj-2025-085242
ECM’s ‘Digest Supreme’ at https://drellencutler.com/digest-supreme
* These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, mitigate, or prevent any disease.
