Knee arthritis: is walking good for it, or bad for it?
For most people with knee arthritis, walking helps. Exercise is a core treatment in every major guideline, and walking programmes improved pain and daily function in trials. Your knee may ache a little more when you first start [1,2,3,4,5].
First things first
Exercise is treatment, not just advice
Knee osteoarthritis is “wear-and-tear” arthritis, where the cartilage that cushions the joint slowly thins and the joint changes. Every major guideline puts exercise at the centre of treatment [1,2,3,4]. The evidence for this is strong: the American Academy of Orthopaedic Surgeons (AAOS) gives a strong recommendation based on high-quality studies, and the American College of Rheumatology strongly recommends exercise [3,4]. UK guidance from NICE states that exercise is not harmful to joints with osteoarthritis [1].
Walking is one of the simplest forms of exercise. It needs no equipment and fits into daily life.
At a glance
What walking can and can’t do
| Question | What studies found | Strength of evidence |
|---|---|---|
| Does walking ease pain and help daily life? | Walking programmes improved pain, function and quality of life in the short term [5] | Moderate |
| Is exercise harmful to an arthritic knee? | NICE states it is not harmful, and regular exercise helps [1] | High (for exercise overall) |
| Does walking slow arthritis down? | People who walked for exercise had slightly less worsening on X-ray, but this shows a link, not proof [6] | Low |
| Does walking more lead to a knee replacement sooner? | In advanced arthritis, more daily steps did not raise the 5-year chance of a replacement [7] | Low |
| How does walking compare with other exercise? | Ten types of aerobic exercise were compared; Pilates and tai chi ranked highest, but the rankings are uncertain [8] | Low |
What the research shows
The details
- Pain and daily function: in trials, walking programmes improved pain, function and quality of life in the short term [5].
- New knee pain: in a large US study of 1,212 people aged 50 and over with knee arthritis, those who walked for exercise were less likely to develop new, frequent knee pain. Their X-rays also showed slightly less narrowing of the joint space [6]. People reported their own walking, and the study observed rather than tested it, so it shows a link, not proof that walking caused the difference.
- Advanced arthritis: in people with advanced knee arthritis, walking more steps each day did not raise the chance of needing a knee replacement over 5 years [7].
- Which exercise? A 2025 analysis of 67 trials (4,944 people) compared 10 types of aerobic exercise, including walking. Pilates and tai chi ranked highest, but the rankings are uncertain [8]. Sticking with exercise over the long term gives more benefit [1], so choose something you can keep up.
Getting started
Building up gently
- Start gently and build up gradually. Some extra soreness when you start is expected. NICE advises that pain may rise at first, but exercise still helps [1].
- Make it yours. Exercise should be tailored to the person, and a supervised programme, for example with a physiotherapist, can be considered [1].
- There is no proven “right” amount. The ideal number of steps, pace and walking surface is not known, so there is no single target that suits everyone.
- Weight and walking aids. Losing weight helps alongside exercise, and a walking stick or other aid can be considered if needed [1].
When to get checked
See a doctor if your knee is…
- hot, red or very swollen
- locking (getting stuck) or giving way
- more painful at night or at rest
These signs come from expert advice rather than trials.
Honest limits
What we don’t know yet
The right “dose” of walking is unknown. The evidence that walking may slow arthritis comes from observational studies in which people reported their own walking [6]. There are no Indian studies, and the rankings between exercise types are low confidence [8].
Dr Aditya Aggarwal treats knee arthritis at Aggarwal Clinic, Patiala. If pain makes it hard to start walking, an examination can help work out a plan that suits your knee.
Sources
References
- National Institute for Health and Care Excellence. Osteoarthritis in over 16s: diagnosis and management (NG226). NICE; 2022. nice.org.uk/guidance/ng226
- Bannuru RR, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578-1589. doi:10.1016/j.joca.2019.06.011
- Kolasinski SL, et al. 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Care Res. 2020;72(2):149-162. doi:10.1002/acr.24131
- Brophy RH, Fillingham YA. AAOS clinical practice guideline summary: management of osteoarthritis of the knee (nonarthroplasty), 3rd ed. J Am Acad Orthop Surg. 2022;30(9):e721-e729. doi:10.5435/JAAOS-D-21-01233
- Loew L, et al. Ottawa panel evidence-based clinical practice guidelines for aerobic walking programs in the management of osteoarthritis. Arch Phys Med Rehabil. 2012;93(7):1269-1285. doi:10.1016/j.apmr.2012.01.024
- 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;74(10):1660-1667. doi:10.1002/art.42241
- Master H, et al. Daily walking and the risk of knee replacement over 5 years among adults with advanced knee osteoarthritis in the United States. Arch Phys Med Rehabil. 2021;102(10):1888-1894. doi:10.1016/j.apmr.2021.05.014
- Luo Y, et al. Efficacy of aerobic exercises for knee osteoarthritis: a network meta analysis of randomized clinical trials. J Orthop Surg Res. 2025;20(1):557. doi:10.1186/s13018-025-05973-z
Evidence checked 5 October 2026.
Next step
WhatsApp your reports to +91 84477 30708, or call +91 98768 24676, to arrange a consultation with Dr Aditya Aggarwal at Aggarwal Clinic, Patiala. No diagnosis or treatment advice is given over WhatsApp.
General information only; it doesn’t replace a consultation. In an emergency, call 112 or go to the nearest emergency department.