Assessment
Your physiotherapist discusses your symptoms, goals, medical history and lifestyle, then completes a thorough assessment. Initial appointments are typically 45 to 60 minutes, so there is time to do it properly.
What We Treat
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 three clinics.
Overview
Understanding arthritis
Osteoarthritis (OA) is the most common joint condition we see, affecting roughly 1 in 5 UK adults over 45. It most often shows up in the hip, knee, hand or spine, and the message that matters most is this: it is not a signal to stop moving. The muscle you lose to rest is exactly what the joint needs to work well.
Arthritis is not one condition, and the distinction changes the plan:
- Osteoarthritis: age- and load-related joint change, and by far the most common form. NICE NG226 (2022) puts therapeutic exercise, weight management and education at the centre of care at every stage, including while you wait for a joint replacement.
- Inflammatory arthritis: rheumatoid, psoriatic and related conditions follow a different pathway. Morning stiffness lasting beyond half an hour is one of the flags we screen for, and we co-ordinate with your GP or rheumatologist rather than pressing on regardless.
For osteoarthritis, manual therapy supports the exercise programme but does not replace it, and steroid injection or surgery is reserved for specific presentations after rehabilitation has been optimised. Most patients see a meaningful improvement in pain and function within 8 to 12 weeks of structured loading work, built around what the joint can tolerate today and progressed through Track Rehab.
Physiotherapy is the first-line treatment; where an arthritic joint carries a tendon-driven component (gluteal, knee or elbow) we may add shockwave therapy, and for stiffness-led spinal OA osteopathy complements the plan. Arthritis often sits alongside low back pain, and when a joint replacement is the right call we handle the post-operative rehabilitation too.
Excellent
From 4 five-star Google reviews
Source: Google
I first started using Tom last year to help relieve back pain, he has been extremely helpful and now he's supporting me with sprint and fitness training, whilst helping with any minor injuries. Can't recommend him and his team more highly.
I went to Tom with a shoulder injury that had not improved for several months. Tom is very knowledgeable and quickly identified the issue and put me on a course of exercises that, in conjunction with a couple more sessions, steadily resolved the problem. I would highly recommend him.
Parinita was brilliant! Identified my knee problem immediately, used a range of equipment and exercises not only to strengthen my knee, but to maintain it and improve my running long-term.
Excellent service! Sanchez is a true professional who helped me heal a previous injury. Highly recommend!
Physiotherapy for arthritis can help to:
Reduce day-to-day joint pain
Strengthening the muscles around an arthritic joint improves shock absorption and reduces the load going through cartilage and bone. Pain during sensible early exercise is normal and does not mean damage. Most patients feel a meaningful difference within 8 to 12 weeks of structured work.
Keep you active at every stage
NICE recommends therapeutic exercise for everyone with osteoarthritis, including people waiting for a joint replacement. Inactivity worsens both the joint and your wider health, so we build a programme around what the joint can currently tolerate and progress it as you improve.
Improve function you actually use
Stairs, getting out of a chair, gripping a jar, walking distance: rehab targets the tasks arthritis takes away rather than abstract scores. We measure your baseline at the first visit and retest against it, so you can see the change instead of taking our word for it.
Make sense of injections and surgery
Most people with osteoarthritis never need a joint replacement. Injections and surgery are reserved for specific presentations after rehab has been optimised, and when surgery genuinely is the right call we say so, refer you to an orthopaedic surgeon and handle the rehabilitation afterwards.
Tackle the strongest modifiable risk factor
For knee and hip osteoarthritis, weight matters: every kilogram lost takes roughly 4 kg of load off the knee with each step. We do not deliver weight management ourselves, but we fold it into the plan and connect you with the right service when it is relevant.
Co-ordinate care when arthritis is inflammatory
Rheumatoid, psoriatic and other inflammatory presentations follow a different pathway from osteoarthritis. Morning stiffness lasting beyond half an hour is one of the flags we screen for. When we suspect an inflammatory cause we co-ordinate with your GP or rheumatologist rather than pressing on regardless.
Why it happens
What causes arthritis?
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Age-related cartilage wear under cumulative joint load (hip, knee, hand, spine most common)
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Previous joint injury: meniscal tear, ligament rupture, intra-articular fracture (post-traumatic OA)
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Excess body weight loading the lower-limb joints (the strongest modifiable risk factor for knee OA)
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Reduced strength and movement around the affected joint
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Family history of OA (genetic predisposition for early onset, particularly hand OA)
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Inflammatory rheumatologic conditions (rheumatoid, psoriatic, ankylosing spondylitis): managed differently
What happens at your first physio appointment?
Initial appointments are typically 45 to 60 minutes. You leave with a clear explanation of your condition, treatment recommendations, a report explaining it in simple language, and a personalised rehabilitation plan.
Follow-ups run 30 to 45 minutes, and we reassess at every visit rather than selling you a block of sessions up front.
A thorough, honest, and understandable explanation. Then the best treatment to get you back to a level of activity beyond your pre-injury status. If we can't get you better, we will recommend the world's leading healthcare professionals in London that can.
- Founded in 2015 by Tom Astley: 7 clinicians working across 3 clinics in Crouch End, Marylebone and Henley-on-Thames.
- Our team has successfully worked with local, national and international athletes at 6 major multi-sport events, from London 2012 to Gold Coast 2018, and we bring that expertise to everyone who enters our service.
- Rated 4.9 from 88 Google reviews; recognised by 5 major UK insurers, and self-funded patients book online with no GP referral.
Fees and insurance
Book directly online through Splose. Self-funded patients need no GP referral; if you are claiming through insurance, obtain prior authorisation before booking.
- Physiotherapy with Tom Astley: £85 initial consultation, £77 follow-up
- Sports and dance therapy with Laura Fornoni: £75 initial consultation, £70 follow-up
- Shockwave therapy: £230 for the initial consultation plus 3 sessions, then £80 per further treatment
- Running gait and performance reviews: £80 Base, £135 Intermediate, £185 Expert
- Recognised by Bupa, Cigna, Vitality, WPA and Simply Health
How physiotherapy works
from assessment to return to sport
Book today to get an assessment, advice, a report and a rehabilitation plan. We combine hands-on treatment with gym-based rehab to get you well, today, and we reassess at every visit.
Advice and report
A clear explanation of your condition and a report explaining it in simple language, alongside hands-on treatment: manual therapy, soft tissue techniques and joint mobilisation where they help.
Rehabilitation plan
Exercise rehabilitation tailored to your goals and condition, delivered through Track Rehab. Our clinics sit inside gym facilities, so the plan has the equipment and technology it actually needs.
Return
Structured programmes and return-to-sport testing before you go back, so you return safely and confidently. The goal is a level of activity beyond your pre-injury status, not just less pain.
What our physiotherapists treat
- Manual therapy and joint mobilisation
- Exercise rehabilitation through Track Rehab
- Dry needling for stubborn trigger points
- Shockwave therapy for chronic tendinopathy
- Sensor-based running gait analysis
- Sports massage, scar work and soft tissue therapy
- Women's health, Mummy MOT and postnatal rehabilitation
- Post-operative and ACL rehabilitation
- Return-to-sport testing
Treatment approach
How do we treat arthritis?
Physiotherapy & Sports Therapy
From £75Therapeutic 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
£230 for 3 sessionsFor 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
Frequently asked
questions
Can physiotherapy actually help arthritis or just mask the pain?
It does both, and the exercise component changes the underlying picture. Strengthening the muscles around an arthritic joint improves shock-absorption, reduces the load 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. Benefits build over 8 to 12 weeks.
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 recommends a combination of strengthening, aerobic, and range-of-motion exercise 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 early on.
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. We do not deliver it directly but will connect you to the right service.
Related What We Treat
Get Started
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in Crouch End, Marylebone or Henley.
Tom Astley Physiotherapy • Park Road Pools & Fitness, Crouch End, London N8 8JN
BookAppointments typically available within 1–2 weeks