Arthritis Treatment in London
NICE names therapeutic exercise as first-line care for osteoarthritis at every stage — including while you wait for a joint replacement — yet most people are told only to rest and take painkillers, and the muscle they lose to that advice is exactly what the joint needs. We deliver NICE-aligned arthritis treatment in London and Henley for hip, knee, hand, and spine osteoarthritis: exercise, weight management, and manual therapy combined to improve pain, function, and confidence across our four clinics.
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What you're seeing
The concern
Why it happens
What drives it
- Age-related cartilage wear under cumulative joint load (hip, knee, hand, spine most common)
- Previous joint injury — meniscal tear, ligament rupture, intra-articular fracture (post-traumatic OA)
- Excess body weight loading the lower-limb joints (the strongest modifiable risk factor for knee OA)
- Reduced strength and movement around the affected joint
- Family history of OA (genetic predisposition for early onset, particularly hand OA)
- Inflammatory rheumatologic conditions (rheumatoid, psoriatic, ankylosing spondylitis) — managed differently
Treatment approach
How Tom treats it
Physiotherapy & Sports Therapy
From £77Therapeutic exercise + manual therapy is the NICE NG226 first-line treatment for osteoarthritis. Most patients see meaningful improvement in 8 to 12 weeks.
See treatment detail →Shockwave Therapy
From £80For osteoarthritis-associated tendinopathies (gluteal, knee, lateral elbow) where pain is more tendon-driven than joint-driven, ESWT accelerates response when added to the loading plan.
See treatment detail →Osteopathy
Price on enquiryFor spinal osteoarthritis where stiffness and postural pattern dominate, osteopathic articulation and case-history-led care complement the exercise programme.
See treatment detail →FAQ
Common
questions
Can physiotherapy actually help arthritis or just mask the pain?
It does both — and the exercise component genuinely changes the underlying picture. Strengthening the muscles around an arthritic joint improves shock-absorption, reduces the load going through the cartilage and bone, and improves function. NICE NG226 is explicit that exercise should be offered to everyone with osteoarthritis at every stage, including those waiting for joint replacement. The benefits typically build over 8 to 12 weeks of consistent work.
Will I need a joint replacement?
Most people with osteoarthritis never need a replacement. Surgery is reserved for specific cases where pain and disability remain severe after best-quality conservative management (structured exercise, weight management, pain education, sometimes injection). When surgery is appropriate we will tell you, refer to an orthopaedic surgeon, and continue post-operative rehab with you.
Should I avoid exercise if I have arthritis?
No — the opposite. Inactivity worsens both joint pain and overall health for people with arthritis. NICE specifically recommends a combination of strengthening exercise, aerobic exercise, and range-of-motion work for every form of OA. We design the programme around what your joint can currently tolerate and progress it as you improve. Pain during and after sensible exercise is normal in early stages and does not indicate joint damage.
Is weight loss really part of arthritis treatment?
For knee and hip osteoarthritis specifically, yes — weight loss is one of the strongest pain-reducing interventions available. Every kilogram lost reduces knee load by about 4 kg per step. NICE NG226 recommends weight management alongside exercise for any person with OA who is overweight or obese. We do not deliver weight management directly but we will help connect you to the right service when relevant.
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Book today.
Tom Astley Physiotherapy • Park Road Pools & Fitness, Crouch End, London N8 8JN
BookAppointments typically available within 1–2 weeks

