I've had it for over 20 years.
I play squash regularly and that definitely helps.
However, a couple of years ago (I'm 48) it started to get worse and I was struggling with severe pain and loss of mobility.
My GP put me onto some new meds (salazopyrin) and my life has been transformed. I didn't realise how much discomfort I'd been putting up with for so long until, overnight, the pain was gone.
So, don't let it get you down but DO make sure that your medical professionals are giving you the best treatment.
I'm not a professional pilot but if I was I think I would try to work S/H rather than L/H so as to increase the need for moving around rather than sitting on my arse for long periods.