Get moving to manage arthritis

It may be the ultimate Catch-22: many people with arthritis avoid exercise because of their painful joints, but exercise is one of the best ways to manage the pain.

"People with arthritis shouldn't be afraid of exercise," says Dr. Daniel Solomon, a rheumatologist with Harvard-affiliated Brigham and Women's Hospital. "Most exercises can be modified to match people's limitations, and the intensity adjusted as needed. Regular exercise can offer the support people need to manage their symptoms, stay active, and improve their quality of life."

Types of arthritis

Although there are more than 100 types of arthritis, the most common are osteoarthritis and rheumatoid arthritis.

Osteoarthritis occurs when the cartilage that cushions the space between bones wears away. The bones then rub against each other — particularly in the hands, shoulders, spine, knees, or hips — causing pain and stiffness in the joint and often pain in the muscles and ligaments surrounding it.

Rheumatoid arthritis is an autoimmune disease in which the body's immune system malfunctions and white blood cells attack healthy joint tissue. The result is pain, stiffness, warmth, redness, and swelling in the joints of the hands, wrists, feet, ankles, elbows, shoulders, hips, knees, and even the neck.

How exercise helps arthritis

There is no cure for arthritis, but exercise can help you manage and reduce pain. A 2021 analysis found that exercise can raise a person's pain threshold, particularly at the affected site. So, when flare-ups do strike, they may not feel as intense. Regular exercise can help dampen inflammation and improve blood flow, which can help reduce pain. In addition, exercise increases muscle strength and helps with weight loss, which takes pressure off painful joints.

But exercise is more than a pain reliever. "It can increase mobility and improve balance, issues that people with arthritis struggle with," says Dr. Solomon. "Exercise also is a proven mood booster and stress reducer."

Exercise choices for arthritis

Which exercises are best for arthritis? It depends on the type of arthritis, its location, its severity, and other factors.

"This is why it's recommended you consult your doctor and see a physical therapist to tailor an exercise program around your limitations, goals, and current fitness level," says Dr. Solomon. "Professional guidance also can offer safe instruction to avoid aggravating your arthritis and prevent injury."

While the types of exercise can vary, people with arthritis often need to focus on three areas to help manage pain and improve mobility: stretching, strength training, and low-impact aerobics.

Stretching. Joints damaged by arthritis don't move with the same ease or range of motion as healthy joints. Activities that lengthen and strengthen the muscles surrounding your joints and improve flexibility, like yoga, tai chi, and qi gong, are especially important.

"A physical therapist also can prescribe an individualized stretching routine," says Dr. Solomon.

Strength training. This type of exercise builds muscle, and larger, stronger muscles can reduce stress on painful joints. For example, lunges and squats help strengthen the quadriceps (muscles on the front of the thigh) and the hamstrings (muscles on the back of the thigh).

The quads absorb some of the force when your foot strikes the ground, protecting the knee. The hamstrings help maintain full leg extension and range of motion. Strength training can be done in different ways, such as using body weight, hand weights like dumbbells and kettlebells, and resistance bands.

Low-impact aerobics. Low-impact aerobic exercise improves endurance and mobility, which people with arthritis struggle with. "Raising your heart rate and getting sweaty also helps reduce pain and stiffness," says Dr. Solomon. Good low-impact options include cycling (on the road or on a stationary bike), walking, swimming, pool aerobics, rowing, and using an elliptical trainer.

Keep in mind that you might experience some discomfort when you begin exercising as your body adjusts to new types of movement. "But with proper guidance and taking a slow-and-easy approach, exercise can help you control your arthritis, so it doesn't control you," says Dr. Solomon.

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