Tai Chi Followed at Home on Video Eased Knee Osteoarthritis Pain

CATEGORY: MOBILITY, BONES & JOINTS

Knee osteoarthritis is the wear-and-tear joint condition in which the cartilage cushioning the knee gradually thins, leaving the joint sore and stiff. There is no cure, and movement is the mainstay of easing it, which usually means a class, equipment or an instructor. A 2026 randomized trial tested a version with none of those. Adults who followed tai chi at home from online videos, unsupervised, saw walking pain fall 2.7 points on a 0-to-10 scale over 12 weeks, against 1.3 points in the comparison group.¹

A Coin Toss Decided Who Got the Videos

The RETREAT trial enrolled 178 adults who met the clinical criteria for knee osteoarthritis. Which half received tai chi was settled at random, not by preference and not by a clinician. That is what separates this from watching who takes up exercise on their own, because the two groups should differ only in what they were handed. The tai chi half got 12 weeks of slow, flowing postures and controlled breathing, a practice sometimes called moving meditation, delivered entirely through online video. No instructor. No class. Nobody watching. The trial was set up in advance as a superiority test, meaning tai chi had to beat the comparison group rather than merely match it.¹ Almost everyone stayed the course: 96% finished.¹

Pain Down 2.7 Points Against 1.3

Walking pain was rated on a 0-to-10 scale. It fell by 2.7 points on average with tai chi and by 1.3 points in the comparison group, roughly double. Physical function, the ordinary business of stairs and rising from a chair, also improved more with tai chi. Both differences were statistically significant, meaning chance is an unlikely explanation. A clinically meaningful drop in pain, the kind a person actually notices, was reached by 73% of the tai chi group and 47% of the comparison group.¹

Eleven Trials, and a Review That Narrows It

Tai chi is low-impact, so it works the muscles supporting the knee without loading the joint hard, and its slow pace may also shift how the brain registers pain. A 2025 review pooling 11 randomized trials of 854 people found home practice of tai chi and similar Chinese exercises linked to greater gains in pain and function than routine home rehabilitation.² Another 2025 review narrows the claim. Tai chi beat health-education comparison groups, but across two trials pitting it against physical therapy or resistance training, the gains came out similar.³ A video program also suits some people and not others, particularly where balance is already a problem.

Key Takeaways

• Unsupervised online tai chi roughly doubled the reduction in knee-osteoarthritis walking pain over 12 weeks: 2.7 points against 1.3 on a 0-to-10 scale.
• A pain drop large enough to notice was reached by 73% of the tai chi group and 47% of the comparison group.
• The whole program ran on online videos at home. No in-person instruction, no supervision, and 96% of the 178 participants finished.

References

1. Zhu SJ, Hinman RS, Nelligan RK, et al. Online Unsupervised Tai Chi Intervention for Knee Pain and Function in People With Knee Osteoarthritis: The RETREAT Randomized Clinical Trial. JAMA Internal Medicine. 2026;186(1):15–25. link
2. Wang W, Lu H, Yan C, et al. Home-based traditional Chinese exercise for knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Frontiers in Medicine. 2025;12:1665680. link.
3. Lee H, Sung SH, Lee S. The effectiveness and safety of tai chi on knee pain: a systematic review and meta-analysis. Healthcare. 2025;13(13):1615. link.