Can exercise help rheumatoid arthritis?
2/20/2023 by Sarah Tawfic, M.D.
When struggling with rheumatoid arthritis symptoms, like joint pain and fatigue, staying physically active can feel difficult to achieve. However, studies have shown that incorporating even small amounts of physical activity into your day can significantly improve rheumatoid arthritis symptoms and quality of life.
Research suggests that physical activity in rheumatoid arthritis can:
- Improve overall fitness, day-to-day functioning, strength and fatigue.
- Reduce the risk of cardiovascular disease, which is more common in rheumatoid arthritis patients than the general population.
- Reverse the body composition changes that can occur in rheumatoid arthritis, including breakdown of muscle and buildup of visceral, or abdominal fat.
- Slow the progression of joint destruction in both small and large joints.
- Reduce hospitalizations and lengths of hospital stays for rheumatoid arthritis flares.
Is exercise safe for people with rheumatoid arthritis?
Studies have not shown evidence of worsening joint damage from low-to-moderate intensity physical activity. However, it is important to listen to your body, especially during flares. Adjust the intensity of your workouts accordingly. If you find that one particular activity causes you discomfort (for example, walking), try replacing it with another activity that puts less pressure on the joints (for example, swimming). If you have any doubts, it's best to contact your clinician before starting an exercise regimen.
What kinds of exercise should I do?
Research has included looking at several types of exercise, including aerobic, strength training, stretching and balance exercises. Ultimately, any kind of movement was found to be beneficial. You may want to include a variety of exercises into your day or choose exercises specific to your symptoms. For example, if you struggle with pain in the joints of your hands, you may choose to spend time on gentle hand stretches and exercises. These have been shown to help preserve the finger joints and dexterity over time.
Low-impact aerobic exercises include walking, cycling, swimming and dancing. These activities carry a broad range of benefits for your heart, lungs and muscle health. They also can help you sleep better and improve day-to-day functioning.
Strengthening exercises help maintain the muscles around the joints, while protecting against the bone loss that can happen with inactivity or use of corticosteroids, a medication type frequently used in rheumatoid arthritis. These exercises rely on using some form of resistance, like a handheld weight, resistance band or a weight machine. Aim for an activity that challenges your muscles but does not worsen joint pain.
Stretching, or range-of-motion exercises, can help maintain flexibility and function in joints affected by rheumatoid arthritis. These are particularly helpful for stiff joints and can usually be done on a daily basis. The goal of these exercises is to gently allow your joints to move through their entire range of motion.
How much exercise should I do?
Any amount of physical activity is better than no physical activity. While the World Health Organization generally recommends that adults 18–64 get 150 minutes of moderate intensity exercise each week, amounts less than this can still provide health benefits. If fatigue is a problem, exercises can be done in multiple 5- or 10-minute intervals for similar health benefits as longer sessions. In fact, simply incorporating more movement into activities you already do (for example, dancing while preparing a meal) can add up over time and improve your overall health.
In all cases, it's important to start slow and listen to your body as you explore new movements. Discussing your questions and concerns on a regular basis with your arthritis care team, including your primary clinician or rheumatologist, will help. Physical and occupational therapists also can help suggest customized exercises that will be safe and effective for your specific needs. With their guidance, you can build a more active lifestyle and enjoy all the health benefits that come with it.
Sarah Tawfic, M.D., is a resident in the Internal Medicine program at Mayo Clinic in Rochester, Minnesota. She is passionate about using medical education to empower patients to live their healthiest lives.