Knee osteoarthritis pain and stretching exercises: a systematic review and meta-analysis.

This systematic review and meta-analysis asked whether stretching exercises help reduce pain in people with knee osteoarthritis (KOA). Researchers searched nine databases and identified 19 randomised controlled trials involving 1250 participants, with 18 of these RCTs pooled in the meta-analysis. When stretching exercises were used alone, pain reduction on a visual analogue scale was both statistically significant and, based on the size of the effect, clinically meaningful (WMD 1.86, 95% CI 1.31 to 2.41).

When stretching was combined with other exercises, pain reduction remained statistically significant but its clinical meaningfulness became questionable (WMD 1.31, 95% CI 0.77 to 1.85). The authors note that studies testing stretching alone had small sample sizes, and heterogeneity, meaning results varied across studies, was present among the pooled trials. This limits confidence in how consistent or generalisable the pain-relief effect really is.

This review pooled data from 19 clinical trials involving 1250 people with knee osteoarthritis to see whether stretching exercises help with pain. It found that when stretching was done on its own, people reported a pain reduction that was both statistically significant and large enough to be considered clinically meaningful.

When stretching was combined with other types of exercise, pain still improved in a statistically significant way, but the improvement was smaller and it's unclear whether it was large enough to matter to patients. The researchers caution that the studies looking at stretching alone were small, and results varied somewhat between studies, which makes it harder to be fully confident in the findings. The review did not report on side effects or safety of the stretching programs.

Overall, this body of evidence suggests stretching may be linked to pain relief in knee osteoarthritis, particularly when used by itself, but the evidence base is limited in size and consistency.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This meta-analysis pooled 18 of 19 identified RCTs (1250 participants total) evaluating stretching exercise for knee osteoarthritis pain, using PEDro and Cochrane risk-of-bias tools for quality assessment. Stretching alone produced a statistically significant and, per the authors' clinical threshold, clinically meaningful reduction in VAS pain (WMD 1.86, 95% CI 1.31–2.41).

Stretching combined with other exercise modalities also produced statistically significant pain reduction, but the smaller effect size (WMD 1.31, 95% CI 0.77–1.85) raised doubts about clinical relevance. Key limitations flagged by the authors include small sample sizes in trials testing stretching alone and heterogeneity among pooled studies, both of which constrain the certainty of conclusions. The review does not report on adverse events, so no safety inferences can be drawn.

Because heterogeneity was present and study quality varied, the pooled estimates should be interpreted as indicative rather than definitive. The distinction between stretching-alone and combined-exercise programs is notable: the larger effect size for stretching alone contrasts with the more modest, less clearly meaningful effect in combined programs, an interesting pattern that invites further scrutiny of design and dosage differences across trials.