Questions and Answers About Arthritis and Exercise
Adapted from the National Institutes of Health
This fact sheet answers general questions about arthritis and
exercise. The amount and form of exercise recommended for each
individual will vary depending on which joints are involved, the
amount of inflammation, how stable the joints are, and whether a
joint replacement procedure has been done. A skilled physician who
is knowledgeable about the medical and rehabilitation needs of
people with arthritis, working with a physical therapist also
familiar with the needs of people with arthritis, can design an
exercise plan for each patient.
What Is Arthritis?
Arthritis is a general term that refers to many rheumatic
diseases that can cause pain, stiffness, and swelling in joints and
other connective tissues. These diseases can affect supporting
structures such as muscles, tendons, and ligaments and may also
affect other parts of the body. Some common types of arthritis are
osteoarthritis, rheumatoid arthritis,systemic lupus erythematosus,
gout, juvenile rheumatoid arthritis, ankylosing spondylitis, and
psoriatic arthritis. Osteoarthritis is the most common.
Should People With Arthritis Exercise?
Yes. 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 with weight reduction and contributes to an improved sense of
How Does Exercise Fit Into a Treatment Plan for People With
Exercise is one part of a comprehensive arthritis treatment
plan. Treatment plans also may include rest and relaxation, proper
diet, medication, and instruction about proper use of joints and
ways to conserve energy (that is, not waste motion) as well as the
use of pain relief methods.
What Types of Exercise Are Most Suitable for Someone With
Three types of exercise are best for people with arthritis:
exercises help maintain normal joint
movement and relieve stiffness. This type of exercise helps
maintain or increase flexibility.
exercises help keep or increase muscle
strength. Strong muscles help support and protect joints affected
Aerobic or endurance
exercises improve cardiovascular
fitness, help control weight, and improve overall function. Weight
control can be important to people who have arthritis because extra
weight puts extra pressure on many joints. Some studies show that
aerobic exercise can reduce inflammation in some joints.
How Does a Person With Arthritis Start an Exercise Program?
People with arthritis should discuss exercise options with their
doctors. Most doctors recommend exercise for their patients. Many
people with arthritis begin with easy, range-of-motion exercises
and low-impact aerobics. People with arthritis can participate in a
variety of, but not all, sports and exercise programs. The doctor
will know which, if any, sports are off-limits.
The doctor may have suggestions about how to get started or may
refer the patient to a physical therapist. It is best to find a
physical therapist who has experience working with people who have
arthritis. The therapist will design an appropriate home exercise
program and teach clients about pain-relief methods, proper body
mechanics (placement of the body for a given task, such as lifting
a heavy box), joint protection, and conserving energy.
Step Up to Exercise: How To Get Started
Discuss exercise plans with your doctor.
Start with supervision from a physical therapist or qualified
Apply heat to sore joints (optional; many people with arthritis
start their exercise program this way).
Stretch and warm up with range-of-motion exercises.
Start strengthening exercises slowly with small weights (a 1 or
2 pound weight can make a big difference).
Use cold packs after exercising (optional; many people with
arthritis complete their exercise routine this way).
Add aerobic exercise.
Consider appropriate recreational exercise (after doing
range-of-motion, strengthening, and aerobic exercise). Fewer
injuries to arthritic joints occur during recreational exercise if
it is preceded by range-of-motion, strengthening, and aerobic
exercise that gets your body in the best condition possible.
Ease off if joints become painful, inflamed, or red and work
with your doctor to find the cause and eliminate it.
Choose the exercise program you enjoy most and make it a
What Are Some Pain Relief Methods?
There are known methods to stop pain for short periods of time.
This temporary relief can make it easier for people who have
arthritis to exercise. The doctor or physical therapist can suggest
a method that is best for each patient. The following methods have
worked for many people:
supplied by warm towels, hot packs, a bath,
or a shower can be used at home for 15 to 20 minutes three times a
day to relieve symptoms. A health professional can use short
waves,microwaves, and ultrasound to deliver deep heat to
noninflamed joint areas. Deep heat is not recommended for patients
with acutely inflamed joints. Deep heat is often used around the
shoulder to relax tight tendons prior to stretching exercises.
supplied by a bag of ice or frozen vegetables
wrapped in a towel helps to stop pain and reduce swelling when used
for 10 to 15 minutes at a time. It is often used for acutely
inflamed joints. People who have Raynaud's phenomenon should not
use this method.
(water therapy) can decrease pain and
stiffness. Exercising in a large pool may be easier because water
takes some weight off painful joints. Community centers, YMCAs, and
YWCAs have water exercise classes developed for people with
arthritis. Some patients also find relief from the heat and
movement provided by a whirlpool.
include traction (gentle, steady
pulling), massage, and manipulation (using the hands to restore
normal movement to stiff joints). When done by a trained
professional, these methods can help control pain and increase
joint motion and muscle and tendon flexibility.
(transcutaneous electrical nerve stimulation) and
are two additional methods that may provide
some pain relief, but many patients find that they cost too much
money and take too much time. TENS machines cost between $80 and
$800. The inexpensive units are fine. Patients can wear them during
the day and turn them off and on as needed for pain control.
also helps reduce pain. Patients can
learn to release the tension in their muscles to relieve pain.
Physical therapists may be able to teach relaxation techniques. The
Arthritis Foundation has a self-help course that includes
relaxation therapy and also sells relaxation tapes. Health spas and
vacation resorts sometimes have special relaxation courses.
is a traditional Chinese method of pain relief.
A medically qualified acupuncturist places needles in certain
sites. Researchers believe that the needles stimulate deep sensory
nerves that tell the brain to release natural painkillers
(endorphins). Acupressure is similar to acupuncture, but pressure
is applied to the acupuncture sites instead of using needles.
How Often Should People With Arthritis Exercise?
exercises can be done daily and should
be done at least every other day.
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.
exercises should be done for 20 to 30 minutes
three times a week unless you have severe pain or swelling in your
What Type of Strengthening Program Is Best?
This varies depending on personal preference, the type of
arthritis involved, and how active the inflammation is.
Strengthening one's muscles can help take the burden off painful
joints. Strength training can be done with smallfree weights,
exercise machines, isometrics, elastic bands, and resistive water
exercises. Correct positioning is critical, because if done
incorrectly, strengthening exercises can cause muscle tears, more
pain, and more joint swelling.
Are There Different Exercises for People With Different Types of
There are many types of arthritis. Experienced doctors, physical
therapists, and occupational therapists can recommend exercises
that are particularly helpful for a specific type of arthritis.
Doctors and therapists also know specific exercises for
particularly painful joints. There may be exercises that are
off-limits for people with a particular type of arthritis or when
joints are swollen and inflamed. People with arthritis should
discuss their exercise plans with a doctor. Doctors who treat
people with arthritis include rheumatologists, general
practitioners, family doctors, internists, and rehabilitation
How Much Exercise Is Too Much?
Most experts agree that if exercise causes pain that lasts for
more than 1 hour, it is too much. People with arthritis should work
with their physical therapist or doctor to adjust their exercise
program when they notice any of the following signs of too much
Unusual or persistent fatigue
Decreased range of motion
Increased joint swelling
Continuing pain (pain that lasts more than 1 hour after
Should Someone With Rheumatoid Arthritis Continue To Exercise
During a General Flare? How About During a Local Joint Flare?
It is appropriate to put joints gently through their full range
of motion once a day, with periods of rest, during acute systemic
flares or local joint flares. Patients can talk to their doctor
about how much rest is best duringgeneral or joint flares.
Are Researchers Studying Exercise and Arthritis?
Researchers are comparing the development of musculoskeletal
disabilities, including arthritis, in long-distance runners and
nonrunners. Preliminary results show that running does not increase
the likelihood of developing osteoarthritis.
Researchers also are looking at the effects of muscle strength
on the development of osteoarthritis. Other researchers continue to
look for and find benefits from exercise to patients with
rheumatoid arthritis, spondyloarthropathies, systemic lupus
erythematosus, and polymyositis.
Where Can People Find More Information on
Arthritis and Exercise?
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a