Stiff shoulders and noisy knees do not mean you must retire to the sofa. Here is what helps joints stay useful, and when pain needs checking.
The first sign might be the noise your knees make on the stairs. Or the moment you realise reaching into the back of the car requires a small negotiation with your shoulder.
It is tempting to call this ‘wear and tear’ and start treating movement as the enemy. That would be a poor bargain. You cannot guarantee joints that never ache, but you can do a great deal to keep moving comfortably — without acquiring a gym membership you will use twice.
Not necessarily. The NHS says painless clicking in a knee is normal. A joint making a noise is not, by itself, proof that you are grinding it away. What matters more is the company the noise keeps: pain, swelling, locking, giving way or a loss of movement deserve attention.
Joint pain has several possible causes. An old injury, a tendon problem, gout, inflammatory arthritis and osteoarthritis can all give you trouble. Osteoarthritis often involves pain with activity and stiffness that eases within half an hour of getting up, but you cannot diagnose it from an article or a particularly dramatic creak.
Nor does an osteoarthritis diagnosis mean an inevitable march towards a replacement joint. Symptoms do not necessarily get worse over time. NICE recommends that care is guided by how you feel and function, rather than treating an X-ray as a verdict on what you can do. Scans are not routinely needed to diagnose straightforward osteoarthritis.
The useful question is less ‘How old do my joints sound?’ and more ‘What can I still do, and what has become difficult?’ Stairs, a walk to the shops, getting out of a low chair or lifting your arm to put on a coat tell you more about daily life than a click does.
Start with two jobs: keep moving regularly and strengthen the muscles that support your joints. For people with osteoarthritis, NICE calls tailored exercise — including local muscle strengthening and general aerobic fitness — a core treatment. It is not an optional extra for people who already own expensive trainers.
Walking, cycling and swimming are ways to build activity without making every session a test of character. Pick something you can repeat. For adults aged 19 to 64, NHS guidance aims for at least 150 minutes of moderate activity a week, plus strengthening work on at least two days. Moderate means you can talk but not sing. You can build towards that target rather than attempting it all on Monday.
At home, strength work can start with controlled sit-to-stands from a sturdy chair, or heel raises while holding a worktop for balance. Resistance bands or weights may suit you too. Start at a level you can manage and make it harder gradually. If you have an injury, significant pain or a medical condition, ask a physiotherapist or GP what is suitable rather than copying the chap doing deep squats online.
The aim is not to win an argument with your knees. It is to give them regular, manageable work.
A little discomfort when you begin exercising with osteoarthritis does not automatically mean harm; NICE says it may happen before regular exercise starts to help. But do not treat sharp or worsening pain as a badge of effort. If an activity leaves you markedly worse, ease back and get advice. During a flare, you may need to change what you do for a while rather than abandon movement altogether.
And break up long spells of sitting. A short walk around the house, a few gentle movements after a drive or standing up between meetings will not replace your weekly activity, but the NHS recommends interrupting long periods without movement. Your desk chair need not become a permanent attachment.
If you live with overweight and have osteoarthritis, weight loss can reduce pain and improve function. NICE says any amount is likely to help, while losing 10% of body weight is likely to bring more benefit than 5%. To make that less abstract, for someone weighing about 14 st 2 lb (90 kg), 5% is around 10 lb (4.5 kg). It is an example, not a target you must meet.
That does not mean every sore shoulder is a weight problem, or that you should wait until you have lost weight before exercising. Movement and weight management can work together. If changing your weight is appropriate for you, ask your GP practice about support rather than buying into a crash diet that makes Tuesday miserable.
Be wary of anything sold as a way to ‘rebuild’ a joint. NICE does not recommend glucosamine for osteoarthritis because there is no strong evidence of benefit. It also says hands-on treatments such as massage or manipulation should not be used alone as the answer for hip or knee osteoarthritis; if considered, they should sit alongside therapeutic exercise. Relief is welcome, but a pleasant half-hour on a treatment table is not the same as a plan you can keep using.
Pain relief can sometimes make movement easier, but the right option depends on your health and any other medicines you take. Ask a pharmacist or GP before choosing a medicine for joint pain; do not start or stop prescribed treatment on the strength of an article. The unexciting foundations — activity you enjoy, strength work you can repeat and sensible support when you need it — have a better claim on your time than a cupboard of joint supplements.
Book a GP appointment if joint pain is disrupting sleep or normal activities, getting worse, repeatedly returning or not improving after two weeks of home care. Morning stiffness lasting more than 30 minutes also merits a conversation. These signs do not tell you what the cause is; they tell you it is worth finding out.
Get urgent advice if a joint becomes hot and swollen, especially if you feel feverish or generally unwell. A joint infection is one possible cause and should not be left until your next convenient day off. Seek an urgent GP appointment or use the urgent-care service where you live. For very bad pain after a fall, a joint that appears out of place or an inability to bear weight after injury, go to A&E or call 999.
For a non-urgent problem, physiotherapy may be available without seeing a GP first, but the route depends on your postcode. In England, the NHS community musculoskeletal self-referral service operates in many areas, though not all. In Scotland, access varies by health board; in Wales, some areas allow physiotherapy self-referral; and in Northern Ireland, Health and Social Care trusts have their own pathways. Your GP practice or local service can tell you how to get help. You do not need to wait until you can barely manage the stairs to ask.
To keep your joints moving in midlife, exercise regularly, strengthen the muscles around them and build up gradually; if you have osteoarthritis and live with overweight, weight loss may help too. A painless click is usually less important than pain, swelling or lost function. Get persistent symptoms checked, and seek urgent help for a hot, swollen joint or a serious injury.
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