Rheumatoid Arthritis

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Exercising with Rheumatoid Arthritis
By John Henry Dreyfuss 
Published 8/6/2009 
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For someone with rheumatoid arthritis (RA), exercise may seem daunting, even impossible, but exercise is essential when it comes to managing RA symptoms. Exercise can reduce stiffness and pain and make everyday activities easier. It can also combat the fatigue and low mood so often associated with RA. That said, it’s important to schedule your exercise appropriately and not to overdo it: Exercise more when your symptoms are less pronounced; rest when they’re really bothering you.

Another advantage of exercise for people with RA is the benefit to your heart and circulatory system. According to studies published in several rheumatology journals, people with rheumatoid arthritis have a greater risk of heart disease than the general population. While the exact cause is unknown, the inflammation associated with RA is likely a factor.

Exercise has also been shown to prevent bone loss, a common problem among rheumatoid arthritis patients, especially in premenopausal women and people taking steroids. According to a study published recently in Rheumatology International, moderate physical activity (30 minutes of walking, three to five times a week) reduced the rate at which bones lost density, by half!

Your Exercise Options
So, what forms of exercise are best for people with RA? There are plenty, including stretching, strengthening and conditioning.

According to Samer Narouze, MD, a specialist in pain management at the Cleveland Clinic, aqua therapy (or water aerobics) is one of the best exercises for people with RA. Exercising in the water relieves the pressure on your joints and can make getting in shape much less painful. The water also provides additional resistance while you exercise and can rapidly but gently improve your condition.

Yoga is another excellent activity for people with rheumatoid arthritis. “The combination of relaxation techniques, stretching and exercise is particularly good for people with RA,” points out Cleveland Clinic rheumatologist Rula Hajj-Ali, MD.

Pain specialist Steven Krause, PhD, also of Cleveland Clinic, agrees: “By increasing flexibility, yoga helps people restore normal activity with less pain. Yoga also makes people relax, which decreases the intensity of pain, since relaxing may in fact inhibit pain signals.”

No matter what form of exercise you choose, be sure to start with stretching. Stretching is especially important for people with rheumatoid arthritis, because of RA’s effects on the ligaments, the tendons and their sheaths. Stretching helps to condition these connective tissues and will thereby reduce the number and intensity of pain signals that they send to your brain.

When it comes to activities that put a lot of stress on a joint or are high impact, like jogging and heavy weight lifting, be careful. You don’t have to avoid these activities, but you should talk with your rheumatologist before engaging in them.

Exercises for People with RA

 Type What-it-Is What it does Activities to Try
Stretching Stretching and holding different joint and muscle groups for 10 to 30 seconds each ErroImproves flexibility and makes other exercises easier; reduces painrScript Aqua therapy, individual stretching exercises, yoga, Pilates
Strengthening Working muscles against resistance, with or without weights Strengthens muscle and permits more activity with less pain Weight training, Pilates, yoga
Conditioning (aerobic) Moving in a way that gets your heart pumping and makes you breathe harder Improves cardiovascular fitness; improves mood and sense of well-being; reduces pain Walking, swimming, bicycling, using an elliptical machine


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