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Can People with Arthritis Exercise?

Yes, in most cases. However, the appropriate amount of exercise varies depending on which joints are involved, the amount of inflammation present, how stable the joints are, and whether the individual has received an artificial joint replacement. A skilled physician who understands the medical and rehabilitation needs of people with arthritis, working with a physical therapist who also is experienced in this area, can design an exercise plan for an individual patient. See your physician for guidance before beginning any exercise program.

How Can Exercise Help Me?

Studies have shown that exercise helps people with arthritis in many ways. Exercise reduces joint pain and stiffness, and increases flexibility, muscle strength and endurance. It also helps people lose weight and gain an improved sense of well-being.

How Can I Incorporate Exercise into My Treatment Plan?

See your doctor for individual guidance for how to include exercise into your arthritis treatment plan. In general, exercise is an important part of comprehensive arthritis management. Other parts of your treatment may include rest and relaxation, a healthy diet, medication, being taught how to conserve energy and protect your joints from undue stress, and pain relief methods.

What Kinds of Exercise are Best?

Four types of exercise can benefit people with arthritis:

• Weight bearing exercise
• Range-of-motion
• Strengthening
• Aerobic or endurance

Range-of-motion exercises are used to gently put joints through their full range of motion. They help maintain normal joint movement and relieve stiffness, as well as maintaining or increasing flexibility.

Strengthening exercises can be done with small free weights, exercise machines and elastic bands. They also include resistive water exercises and isometrics. This type of exercise helps maintain or increase muscle strength. Stronger muscles benefit people with arthritis because they help support and protect joints.

Aerobic or endurance exercises improve cardiovascular fitness, help control weight and improve overall function. Controlling your weight may be important if you have arthritis, because extra weight puts pressure on many joints. Some studies show that aerobic exercise can reduce inflammation in some joints.

Most people with arthritis can participate in a variety of sports and exercise programs, but not all of them. Before deciding to perform any of these or other types of exercises, see your doctor for advice and recommendations specific to your individual situation.

How Do I Get Started?

You should discuss the option of exercise with your doctor. Most doctors recommend exercise for their patients. Many people with arthritis begin with easy, range-of-motion exercises and low-impact aerobics. Your doctor will know which, if any, sports and exercises are off-limits and should either give you suggestions on getting started or refer you to a physical therapist.

If you see a physical therapist, it is best to find one who has experience working with people with arthritis. The therapist is responsible for designing an appropriate home exercise program for you, and should teach you about pain-relief methods, proper body mechanics (positioning the body to minimize joint stress), joint protection, and conserving energy.

What if I Feel Pain?

To minimize this possibility, start your program under the supervision of a physical therapist with experience in arthritis. You may wish to begin by first applying moist heat to sore joints, using warm towels or hot packs. Stretch gently and warm up with range-of-motion exercise. Start any strengthening exercises slowly, and progress in your program slowly. After you finish exercising, you may choose to complete your program by applying cold packs, for example, a bag of ice or frozen vegetables wrapped in a towel. (Note: People with Raynaud's phenomenon should not use cold packs.)

If your joints become painful, inflamed and red after activity, ease off your exercise program. Work with your doctor to find the cause and treat it, and consult with your physical therapist to adjust your exercises, if necessary.

How Often Should I Exercise?

Ask your doctor or physical therapist for recommendations specific to your personal situation. The guidelines below are general statements only, and should not be used to override the recommendations of a qualified health care provider.

Range-of-motion exercises can be done daily and should be done at least every other day.

Strengthening exercises also can be done daily, and should be done at least every other day unless you have severe pain or swelling in your joints.

Endurance exercises should be done for 20 to 30 minutes three times a week, unless you have severe pain or swelling in your joints.

How Much is Too Much Exercise?

Exercise that causes pain that lasts for more than one hour, or other types of significant pain, is too much. You should work with your doctor or physical therapist to adjust your exercise program if you notice any of the following signs of too much exercise:

• Unusual or persistent fatigue

• Increased weakness

• Decreased range of motion

• Increased joint swelling

• Continuing pain (lasts for more than one hour after exercising)

Should I Exercise During A Flare?

If you have rheumatoid arthritis, you may put your joints gently through their full range of motion once a day, with rest periods, during a systemic flare or local joint flare. Talk to your doctor about how much rest and movement is best for you during flares

Based on information published by the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Points to Remember

• Most people with arthritis CAN participate in exercise.

• Studies of arthritis and exercise show that exercise reduces joint pain and stiffness, increases flexibility, muscle strength, and endurance, helps you lose weight, and can even help you feel better.

• If you have arthritis, talk to your doctor, and work with the physical therapist that your doctor recommends determine the kind of exercise program most appropriate for you.

• Be sure to talk with your physical therapist or doctor about methods of pain relief that will help you exercise more easily, what to do if exercise puts too much stress on certain joints, and (if you have rheumatoid arthritis) what they recommend in case of a systemic or local joint flare.

This article was published on 1999-06-08
This article was reviewed on 2003-02-03