The degree of pain in knee osteoarthritis is often inconsistent with joint structural damage. After tissue injury, pain sensitization can occur, mediated by pro-inflammatory factors enhancing neuroinflammation and nociceptive input, which triggers significant pain. Currently, low-impact aerobic exercise can inhibit neuroinflammation and enhance descending pain inhibitory pathways, thereby reducing pain; isometric resistance training, on the other hand, reduces central sensitization effects by improving central nervous system plasticity. Both are core exercises for anti-inflammation and desensitization. This article focuses on the mechanisms of neuroinflammation, emphasizing anti-inflammation, avoiding harmful movements, and promoting descending inhibitory pathways and central plasticity. Based on this, targeted intervention programs are designed to provide basis for formulating optimal exercise strategies for patients with knee osteoarthritis.