Is Arthritis Inevitable as We Get Older?
When most people think of arthritis, they picture joints gradually wearing out, like tyres on a car or a phone battery running down with use. But that’s not the full story.
Osteoarthritis isn’t just “wear and tear.” It’s better described as a mismatch between damage and repair. Everyday movement puts some strain on our joints. The body’s job is to repair that damage. Arthritis develops when the repair side of the equation can’t keep up.
And that’s the key point: most of what we do to treat and prevent arthritis is really about tipping the balance back towards repair.
Injuries Matter
If you’ve injured your knee badly — for example, a torn ACL or meniscus — your risk of arthritis later in life goes up. That’s because those injuries disrupt the joint’s ability to repair itself properly. It doesn’t mean arthritis is guaranteed, but it does stack the odds.
Busting the Big Myths
Myth 1: Exercise wears your joints out.
It’s the opposite. Movement is protective. Exercise strengthens the muscles that support your joints and helps cartilage stay healthy. Studies show that people who keep active have fewer arthritis problems, not more.
Myth 2: Surgery is the only answer.
Joint replacements have their place, but they’re the last resort. Things like weight loss, physiotherapy, and regular exercise often reduce symptoms dramatically. For many people, those approaches are enough to keep them active and independent.
Myth 3: Arthritis is only about physical stress.
We now know that your overall health plays a massive role. One study that followed more than 370,000 people in the UK for over 12 years found that carrying weight around your middle increased arthritis risk by 58%. Raised blood sugar raised risk by 13%. If you had metabolic syndrome — a cluster of issues including high blood pressure, cholesterol problems, and excess fat around the waist — your risk went up 15%.
Another study from China tracked more than 7,500 adults over 45. People with higher triglycerides, a type of fat in the blood, were more likely to develop arthritis. A big part of that was explained by having lower levels of HDL, the “good cholesterol.” In plain terms, it’s not just how much fat you carry, but also the balance in your blood that affects joint health.
Myth 4: It’s all down to your genes.
Yes, family history matters, but lifestyle usually matters more. Looking after your weight, your strength, and your overall health can make a big difference. Rheumatoid arthritis is a different condition with stronger genetic links, but osteoarthritis isn’t simply passed down like eye colour.
The Pitfalls People Fall Into
I see the same mistakes again and again:
- Avoiding exercise altogether because of fear.
- Waiting too long before asking for help.
- Carrying extra weight that loads the joints.
- Skipping strength training.
Even small wins add up. Losing just one kilo of body weight takes about four kilos of pressure off your knees with every single step. Multiply that by thousands of steps in a day and the relief is huge.
A Patient Story
Back in 2018, I worked with a woman who’d been told her only option was a knee replacement. She had moderate to severe arthritis and had already been put on the waiting list.
Instead of rushing into surgery, we took a whole-body approach. She worked with a dietitian to reduce inflammation, improved her sleep, and started regular exercise. We also did focused physiotherapy for her knee.
Within three months, she was back to gardening — her main goal. Six months later she was doing her neighbour’s garden too, and by the end of the year she was volunteering at her local community park. Surgery wasn’t needed. Not everyone gets results that dramatic, but it shows what’s possible when you tackle the condition from all angles.
What Really Makes a Difference
If you want to reduce your risk of arthritis, or improve things if you’ve already got it, here are the big levers:
- Stay active — keep moving, keep exercising.
- Strength train — build the muscles that protect your joints.
- Watch your weight — even small reductions take huge loads off your knees and hips.
- Manage your blood sugar and cholesterol — because metabolic health and joint health are connected.
- Tackle inflammation — through diet, sleep, and stress management.
Final Thoughts
Arthritis is common, but it isn’t inevitable. It’s not just “wear and tear,” and it’s not just in your DNA. The choices you make about activity, weight, and health habits really do shift the odds
So… Is Arthritis Inevitable as We Get Older?
The evidence says no.
Yes, arthritis is common. Yes, your risk rises if you’ve had major joint injuries, if you carry extra weight, or if you have metabolic health problems. But it is not guaranteed.
The UK Biobank study of more than 350,000 people showed that lifestyle factors such as central obesity and raised blood sugar make a huge difference to whether arthritis develops. The CHARLS study in China linked blood fats like triglycerides and cholesterol balance to arthritis risk. And the 2025 review of exercise therapy confirmed that staying active reduces pain and improves function.
Taken together, these studies show that while genes and ageing play a role, your day-to-day choices matter just as much — if not more.
So no, arthritis is not inevitable. Staying strong, active, and metabolically healthy gives you real control over your joint health, even as you get older.
Next time, I’ll dive into the specific types of exercise that work best for people with knee and hip arthritis, and how we use them in the clinic.