Jennifer Freeman, MD
Jennifer Freeman, MD

Doctor of Medicine (M.D.) in 2008 from UT Health San Antonio, Surgeon at TRACC Dallas

Oct 27, 2018 5 min read

RA and Exercise: Does Exercise Help with Pain and Inflammation?

As part of a well-rounded treatment strategy, it is important to include exercise for rheumatoid arthritis (RA). Though it may seem difficult or challenging to exercise, especially when dealing with chronic pain, physical activity is necessary to increase joint function, strengthen muscles, and improve overall health and energy levels.

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While exercise is very important in RA treatment regimens, there are a few risks. Be sure to practice safe exercises and combine them with stretching and strength building activities for better physical health.

How Does Exercise Help RA?

RA causes several clinical manifestations which result in decreased or poor mobility, chronic pain, depression and overall lack of energy. Physical exercise is strongly recommended for RA patients to reduce joint pain and prevent these symptoms from impacting their quality of life.

Moderate and regular physical activity helps to keep joints and muscles in motion and build muscle strength. This is important for RA patients who may begin to notice severe decreases in mobility and increases in painful joint stiffness. Physical activity and controlled stretching can also help to increase flexibility which is necessary for those who suffer from RA to be able to continue to perform day-to-day activities.

Additionally, by performing consistent physical activity, cardiovascular strength improves which helps prevent heart disease and other medical complications that relate to RA.

RA patients also tend to suffer from chronic fatigue, depression, and immune system complications that make them more susceptible to infections and illness. Exercise can counter these negative outcomes by improving emotional well-being, increasing energy levels, and boosting immune system function.

Benefits of Exercise for RA

There are some important benefits of developing a consistent and balanced exercise plan for RA. Here are some of the top benefits of exercise for RA:

  • — Fight against fatigue
  • — Improve sleep patterns
  • — Improve energy levels
  • — Increase joint range of motion
  • — Improve joint flexibility
  • — Reduce joint pain
  • — Increase bone and muscle strength
  • — Prevent heart disease and other medical complications
  • — Boost immune system function
  • — Improve emotional and mental well-being
  • — Decrease levels of depression

Just as patients take specialized medications regularly, so too should they exercise regularly to improve health and fight against disease symptoms. They should think of their exercise program as just another medication in their treatment arsenal!

When to Exercise With RA

Forms of physical activity or stretching should be performed daily even if only for 10 minutes. Every little bit helps! The key is to exercise consistently even if it needs to be done at a slower pace, as opposed to exercising vigorously but infrequently (or not at all).

Though you may exercise, go for a walk or stretch daily, it may become difficult to continue during a flare-up. If you have concerns about exercising during a flare-up, speak to your doctor or physical therapist about activity options that are less stressful on joints. It’s important to reduce discomfort during a flare-up, and there may be simpler exercise options that are more suitable for you.

Types of Exercise for RA

Those with RA can still perform regular physical activities and even play certain sports. Depending on the disease stage, many RA patients continue to stick to their regular exercise routines or modify them to protect joints from stress and further damage.

Some common and recommended exercises for RA include (but are not excluded to):

Walking

Walking is good for the body and the mind. It helps increase mobility in muscles and joints without a lot of stressful impact. Walking also helps to improve the cardiovascular system and maintain overall levels of physical health.

There are countless places to walk, and it can be combined with social activity as well. Start out walking slowly and for small amounts of time like 30 minutes. Gradually build your way up to longer and more adventurous walks. Walking for just half an hour each day can make a big difference in relieving joint stiffness and improving mood levels.

Bicycling

Bicycling is an excellent cardiovascular exercise which is critical for RA patients in preventing heart disease. Biking either stationary or on flat roads and pathways is a low-impact activity and easy on the joints.

By performing regular bike exercise, patients can improve their leg muscle strength and decrease morning stiffness. Over time, patients will notice an improvement in joint mobility and overall levels of health.

Swimming

Swimming is a great way to improve joint function. Research has shown that exercising in water, also known as hydrotherapy, is the most effective form of physical activity for RA patients. The buoyancy of the water allows RA patients to do more exercise without causing stress and strain on their joints.

Many patients who do water exercises such as swimming or water aerobics see tremendous improvements in joint pain and stiffness. It is also associated with better emotional happiness and overall wellbeing.

Movement

Movement exercises, like yoga and tai chi, are effective and low-impact forms of stimulating body activity, improving flexibility through stretching and strengthening muscles. RA patients who perform movement exercises benefit from reduced joint pain and stiffness.

Both forms of movement activities are also linked to lower depression and reduced stress levels. These activities include meditation, mindfulness, and deep breathing in addition to physical exercise.

Strength Building

Patients working with a physical therapist may build muscle strength through the use of free weights, resistance bands, and weight machines. By strengthening muscles, it reduces the amount of stress placed on weakened joints as the muscles around them grow stronger and more supportive.

With stronger muscles, daily activities that were once difficult to perform with RA can become easier again. Patients often find their ability to grip and lift items improves because of their increased muscle strength.

Stretches for RA

In addition to building muscle and cardiovascular strength, RA patients should also incorporate stretching into their daily routines. Stretching is necessary for everyone to improve flexibility and range of motion. It is especially important for those who suffer from RA and experience daily morning stiffness.

Here are some of the stretches to perform in the morning and before any physical activity:

  • — Leg and hamstring stretches by reaching to touch your toes with bent knees
  • — Finger and wrist stretches by bending and lifting wrists and curling and flexing fingers
  • — Cross-body arm stretches and reaching overhead to stretch out arms and shoulders
  • — Neck and shoulder stretches through gentle and slow head rotations

By holding stretching positions for 10 to 20 seconds and doing a variety of stretches daily, it will improve flexibility and mobility. Perform a variety of stretches within the first hour of the day as well as before any planned physical activity.

Making Your Exercise Plan

Exercise for RA is critical in the overall treatment plan. However, appropriate types and levels of exercise depend on the disease stage and each patient’s unique case. Talk to your rheumatologist about the recommend types of exercise that will work best for you.

You may also consider working directly with a physical therapist for additional support. Always be sure to protect your health and not push your body too hard. Light, consistent exercise can go a long way towards improving RA symptoms and enhancing mental and emotional well-being.