Background: Osteoarthritis (OA), especially knee OA, significantly affects older adults through cartilage degeneration that impairs mobility and induces pain. Generalized nodular osteoarthritis (GNA) exhibits bony nodules and shares underlying mechanisms with knee OA. Contributing factors include aging, obesity, and joint injuries, which also lead to considerable socio-economic repercussions. Management focuses on regular physical activity; for knee OA, strengthening and neuromuscular training are advised, whereas GNA management encourages aerobic and resistance exercises to improve quality of life. Patients and Methods: This study involves a comparative observational trial with 100 participants from outpatient rheumatology clinics, focusing on Knee Osteoarthritis (KOA) and Generalized Nodular Osteoarthritis (GNOA). Participants, aged 45 or older, underwent a standardized conservative management plan including pharmacological therapy and a supervised exercise program over 8 to 12 weeks. Outcomes were assessed at baseline and after 12 weeks using various scales for pain, function, quality of life, and physical performance, with data analyzed using SPSS and a significance level set at p<0.05. Results: The comparison of the sex distribution in two groups showed that Knee osteoarthritis (28.0% males, 72.0% females) and Generalized nodal osteoarthritis (10.0% males, 90.0% females), revealing a statistically significant difference (p=0.022). The VAS scores for Knee osteoarthritis pre- and post-treatment, showing a decline in scores below 8, with 70.0% of patients scoring above 8 after treatment (p=0.000). For Generalized nodal osteoarthritis, before treatment, 48.0% scored 7 and after treatment, 80.0% scored above 8, also statistically significant (p=0.000). Conclusion: Findings reveal a higher prevalence of Knee Osteoarthritis (KOA) in females at 72% and Generalized Nodal Osteoarthritis (GNOA) at 90%. Following treatment, pain scores significantly increased, with Visual Analog Scale (VAS) scores rising from 0% to 70% for KOA and from 18% to 80% for GNOA, indicating potential exacerbation of inflammation rather than relief.