Walking, cycling and swimming are the best exercises for combating arthritis, research shows.

Experts analysed 217 clinical trials to identify the best exercises to tackle the painful condition. Around ten million Brits have osteoarthritis and 5.4 million of them have it in the knee. Some 60% of sufferers are women. It occurs when the protective cartilage on the ends of bones wears away, causing pain, swelling, and impaired movement.

The team of researchers, including from Johns Hopkins University School of Medicine in Baltimore, US, looked at studies published between 1990 and 2024 involving 15,684 participants to evaluate the best exercises for tackling the condition.

READ MORE: Scientists identify the short bursts of exercise key to long term health

READ MORE: Less than a third of primary school pupils 'are getting enough exercise'

In the research paper, author Lei Yan, of Johns Hopkins University, writes: “Exercise is one of the mainstream treatments for knee osteoarthritis, with potential effects on relieving pain and improving the quality of life. Therapeutic exercise aims to increase lower limb muscle mass, neuromotor control, and joint range of motion.

“These changes in turn lead to increased lower limb strength, minimising pain, and improving physical function. However, the large volume of data available in the literature makes the optimal type of exercise therapy for knee osteoarthritis difficult to determine.”

Around 350,000 people are diagnosed with osteoarthritis each year and the average age at which symptoms start is 55.

The research review compared the effectiveness of the following forms of exercise: aerobic, flexibility, strengthening, mind-body, neuromotor and mixed exercise. Effectiveness measures were knee pain, function, gait performance and overall quality of life. These were assessed at short term (four weeks), mid-term (12 weeks), and long term (24 weeks) follow up.

The review concluded that aerobic exercise such as cycling, swimming and walking consistently showed the highest probability of being the best treatment across all measures. It was beneficial in relieving short and mid-term pain, improving short term, mid-term, and long term function, and improving short and mid-term gait performance and quality of life.

So-called “mind-body exercise” such as yoga, tai chi and qigong saw a large increase in short term function. Neuromotor exercise such as squats and lunges resulted in a large increase in short term gait performance. Strengthening and mixed exercise appeared to provide a large increase in knee function in the medium term.

The findings are published in the British Medical Journal.

Doctoral student Lei Yan added: “Osteoarthritis is a common chronic joint disease that results in considerable pain and disability in the global population, particularly older individuals. Global trends show that population ageing and rise in obesity rates will continue to drive substantial growth in the incidence, prevalence, and attributable disability rate of osteoarthritis for the foreseeable future.

READ MORE: Less than a third of primary school pupils 'are getting enough exercise'

READ MORE: Exercise in later life 'slashes risk of death by fifth' as major benefits revealed

“The knee is the most common site of osteoarthritis, with nearly 30% of people older than 45 years showing radiological evidence of knee osteoarthritis, half of whom also have severe knee symptoms.

“The pain caused by knee osteoarthritis can substantially affect an individual’s physical function and quality of life, creating a major public health problem worldwide.”