Use-related pain
Pain that builds during activity (walking, stairs, gardening) and eases with rest. Distinct from inflammatory pain that's worst overnight.
Osteoarthritis (Hip & Knee) treatment in Toronto
Hip and knee osteoarthritis: stiff, painful joints that flare with use, ease with rest, and don't always match what shows up on imaging. Treatable with the GLA:D® program, an 8-week evidence-based education and exercise course.
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What it is
Osteoarthritis is a joint condition, not 'wear and tear' destiny.
Osteoarthritis affects the cartilage in your joints, most commonly the knee and hip. The structural changes include loss of cartilage with narrowing of the joint space, bony outgrowths (osteophytes), and changes to the joint capsule and surrounding muscles.
But here's the part that surprises most patients: imaging and symptoms only line up about 30–40% of the time in OA. Plenty of people with significant changes on X-ray have no pain, and plenty of people with painful joints have unremarkable imaging. That means your treatment plan should target your symptoms and function, not the picture.
- X-ray is not required to diagnose OA or to start care
- Symptoms and imaging only align ~30–40% of the time
- Conservative care (education + exercise) is the international first-line treatment
What it feels like
The OA presentation pattern.
Morning stiffness
Stiffness on getting up that loosens within ~30 minutes, short-duration stiffness is OA-typical, longer stiffness suggests something else.
Functional limits
Difficulty with stairs, sit-to-stand, getting in and out of cars, prolonged walking. Often the symptom that prompts the appointment.
Risk factors
Who develops hip or knee OA most often.
OA is multi-factorial, most patients have several of these. Many of the risk factors are addressable; some aren't.
- Age 40+
- Female sex (especially for knee OA)
- Prior joint injury (ACL, meniscus, fracture)
- Hard physical work over many years
- Family history of OA
- Excess body weight (knee OA in particular)
How we treat it
GLA:D® Canada, the international standard for hip / knee OA.
Back In Balance is a GLA:D® Canada delivery site. The GLA:D® program (Good Life with osteoArthritis: Denmark) is an 8-week structured course combining education sessions and supervised neuromuscular exercise, the international first-line conservative treatment for hip and knee OA.
Reported outcomes from the GLA:D® Canada registry: less pain, reduced pain-medication use, fewer days on sick leave, and increased physical activity. For patients heading toward joint replacement, GLA:D® is widely used as pre-habilitation; for many, it delays or replaces surgery entirely.
- 8 weeks · 2 education sessions + ~12 supervised neuromuscular exercise sessions
- No referral or X-ray required to participate
- Evidence-based, registry-tracked outcomes
8 weeks
GLA:D® program
30–40%
Symptom-imaging match
First-line
Conservative care
GLA:D®
Canada registry
Keep exploring
Treatments we use for this
What we'll typically pull from when we put a plan together.
GLA:D® Osteoarthritis Program
An 8-week, evidence-based education and exercise program for hip and knee osteoarthritis. Developed in Denmark, delivered at Back In Balance through GLA:D® Canada.
Learn more
Chiropractic Care
Hands-on chiropractic care for back, neck, and joint pain, adjustments, mobilizations, soft tissue work, and rehab exercises tailored to your assessment.
Learn more
Shockwave Therapy
Extracorporeal shockwave therapy (ESWT) for chronic tendinopathy, plantar fasciitis, and calcific conditions that haven't responded to conservative care alone.
Learn moreKeep exploring
Other things we treat
Often shows up alongside what brought you here.
Spinal Stenosis
Conservative care for narrowing of the spinal canal, neurogenic claudication, leg cramping with walking, and pain that eases when you sit or lean forward. Hospital-affiliated triage included.
Read the guide
Disc Injuries
Disc bulges, herniations, and disc-related sciatica. What the imaging actually means, when surgery is and isn't on the table, and the conservative pathway most patients respond to.
Read the guide
Neck Pain
Tech neck, cervicogenic headaches, post-whiplash recovery, and pinched-nerve symptoms, assessed and treated with the same hospital-affiliated rigour we bring to low back pain.
Read the guideFrequently asked questions
About osteoarthritis (hip & knee)
No. OA is a clinical diagnosis, based on history and physical examination. Imaging is sometimes useful when surgery is being considered, but it's not required to start treatment, and the picture often doesn't match the symptoms anyway.
About the clinic
Reviews
What patients say
A few words from people we've helped get back to what they love.
“Steps from College station and they direct-bill my insurance, so it's an easy visit. Real assessment, no pressure, and a plan I could actually follow at home.”
“I saw Dr. Clarke through my pregnancy for pelvic pain. Gentle, knowledgeable, and reassuring the whole way. It made a real difference to how I felt day to day.”
“Booked for a running gait analysis before a half marathon. The video breakdown of my stride was eye-opening and the exercises sorted out the knee pain that kept derailing my training.”
From the blog
Latest from the blog
Patient-language guides on the conditions and care we see most.
Book your first visit
Tell us about your osteoarthritis (hip & knee) and the front desk will match you with the right practitioner.
- Same-day appointments usually available
- Direct billing to most major insurers
- Prefer to call? (416) 660-9932