Can an Osteopath Help With Osteoarthritis?

By Dr. Anthony Dileo (Osteopath)

Movement may still help more than you think.

Osteoarthritis is one of the most common conditions I see in clinical practice. It can affect knees, hips, hands, the spine, shoulders and feet — and for many people it gradually changes how confident they feel with movement, exercise and day-to-day life.

Many people come into the clinic after being told they have “bone on bone” arthritis. Often they are worried they should stop exercising, avoid walking, or that surgery is their only option.

While osteoarthritis is a real condition and can absolutely be painful, scans do not always predict pain levels or long-term function as clearly as people think. In many cases, movement, strength and confidence can still improve significantly.

At Kallista Osteopathy, I regularly work with people living with osteoarthritis across the Dandenong Ranges including Kallista, Belgrave, Monbulk, Emerald, Upwey and surrounding areas. While osteoarthritis cannot always be “reversed,” many people can still improve their mobility, strength, confidence and quality of life significantly with the right management approach.

What Is Osteoarthritis?

Osteoarthritis is often described as “wear and tear,” but that explanation is overly simplistic.

Osteoarthritis is a complex condition involving changes to joint cartilage, bone, muscles, movement patterns and inflammation. Factors such as age, previous injury, genetics, activity levels, recovery, sleep, strength and overall health can all play a role.

Importantly, osteoarthritis does not always progress in a straight line, and imaging findings do not always match how much pain someone experiences.

Some people have significant arthritis visible on scans but very little pain, while others experience substantial symptoms despite relatively mild imaging changes.

Does “Bone on Bone” Arthritis Mean You Should Stop Moving?

This is one of the biggest misconceptions I hear.

When people are told they have “bone on bone” arthritis, many understandably assume movement must be causing further damage. Over time this can lead to fear, less activity, stiffness, weakness and reduced confidence.

In reality, appropriately dosed movement is one of the most evidence-based treatments we have for osteoarthritis.

That does not mean people should ignore severe pain or simply push through symptoms. But in many cases, avoiding movement entirely can actually make osteoarthritis harder to manage.

Joints are influenced by many factors beyond cartilage alone. Strength, sleep, inflammation, confidence, nervous system sensitivity and overall activity levels all play a role in how people feel.

Pain and damage are not always the same thing.

Which Areas Are Commonly Affected?

The most common joints I treat for osteoarthritis include:

• Knees

• Hips

• Lower back

• Neck

• Hands and thumbs

• Shoulders

• Big toe joints

Knee and hip osteoarthritis are particularly common in people trying to remain active as they get older.

Can Osteopathy Help Osteoarthritis?

In many cases, yes.

Osteopathy may help reduce pain and stiffness, improve movement and help people feel more confident returning to activity. However, good osteoarthritis management is usually not about one single treatment.

The best outcomes typically come from a combination of:

• Education and reassurance

• Strengthening exercises

• Gradual movement exposure

• Activity modification and pacing

• Improving mobility

• Load management

• Sleep and recovery

• Hands-on treatment where appropriate

I often explain to patients that complete rest can sometimes make osteoarthritis worse. When people become fearful of movement, they often move less, become weaker, stiffer and less confident — which can further increase pain and sensitivity.

Appropriately dosed movement is one of the most evidence-based treatments we currently have for osteoarthritis.

Common Myths About Osteoarthritis

“Exercise will wear the joint out faster.”

Current evidence does not support this idea. Appropriate exercise is considered one of the first-line treatments for osteoarthritis and is recommended in most modern clinical guidelines.

“Pain means I’m damaging myself.”

Pain is complex. While it can sometimes reflect tissue irritation, it is also influenced by inflammation, stress, sleep, strength, fear of movement and nervous system sensitivity.

“Nothing can be done except surgery.”

For some people, surgery may eventually become appropriate. But many people are able to improve function and reduce symptoms significantly through conservative management first.

Real Clinical Examples

Knee Osteoarthritis and Fear of Movement

One patient in her late 60s came in with persistent knee osteoarthritis and had almost stopped walking entirely because she believed she was “grinding the joint away.”

Over time she had become weaker, stiffer and increasingly fearful of movement.

We focused on gradual strengthening, pacing, walking tolerance and hands-on treatment to help settle symptoms and improve confidence. Within a few months she had returned to regular walking and gardening with significantly less pain.

Hip Osteoarthritis and Delaying Surgery

Another patient with hip osteoarthritis had been told surgery was likely inevitable.

While surgery may still be appropriate at some stage, we first focused on improving hip strength, mobility and overall conditioning. His pain reduced significantly and he was able to comfortably return to golf and daily activities while delaying surgery.

These types of presentations are common. Often the goal is not perfection, but helping people move better, stay active and regain confidence in their body again.

What Does the Evidence Say?

Modern osteoarthritis guidelines consistently support:

• Exercise therapy

• Strength training

• Education and self-management

• Weight management where appropriate

• Long-term lifestyle approaches

• Staying active

Manual therapy may also help as an adjunct treatment, particularly when combined with exercise and movement-based rehabilitation.

Clinically, one thing I think is sometimes underestimated is the importance of reassurance. Many people improve once they understand that movement is safe and that pain does not always equal damage.

What Role Does Osteopathy Play?

I see osteopathy as one part of a broader osteoarthritis management approach.

Hands-on treatment may help reduce stiffness and discomfort, particularly during flare-ups, but long-term improvement usually also involves movement, strength and self-management strategies.

My role is often to help people:

• Move more comfortably

• Improve mobility

• Build confidence with activity

• Reduce fear around movement

• Stay active safely

• Understand their condition more clearly

I don’t think passive treatment alone is enough long term, but it can be very useful when combined with exercise and education.

Are Some Treatments Overpromised?

I think osteoarthritis management can sometimes become overly focused on “quick fixes.”

This may include:

• Fear-based messaging

• Expensive gadgets

• Over-reliance on scans

• Claims of permanently “realigning” joints

• Passive treatment-only approaches

• Supplements with limited evidence

That does not mean these approaches never help, but osteoarthritis management is usually more about improving function, movement and quality of life over time rather than finding a miracle cure.

When Should You Seek Help?

It may be worth seeking assessment if you are experiencing:

• Persistent joint pain or stiffness

• Reduced mobility

• Difficulty walking or exercising

• Pain affecting sleep

• Loss of confidence with movement

• Recurrent flare-ups

Early management is often helpful. Many people wait until symptoms become severe before seeking help, but addressing movement, strength and activity levels earlier can sometimes improve long-term outcomes.

Final Thoughts

Being told you have “bone on bone” arthritis can sound frightening, but it does not automatically mean you should stop moving or give up on exercise.

While osteoarthritis is a real condition, many people can still improve significantly with the right approach. In my experience, helping people stay active, build strength, improve confidence and better understand their pain is often where the biggest changes occur.

At Kallista Osteopathy, treatment focuses on practical, evidence-based care tailored to the individual — with the goal of helping people move more comfortably and continue doing the things that matter to them.