Exercise has many benefits for people with rheumatoid arthritis (RA), from alleviating joint pain and stiffness to improving muscle strength, balance, and mood. It can also “help reduce your blood pressure, cholesterol, and blood sugar levels,” says Eric Ruderman, MD, professor of medicine-rheumatology at Northwestern University’s Feinberg School of Medicine in Chicago. But the pain and fatigue associated with RA can make physical activity challenging.
Dr. Ruderman points out that being physically active doesn’t require intense workouts. “It’s not about getting on a treadmill and jogging four miles,” he says. “There’s almost always some physical activity you can do.”
As Janice McInnes, a physical therapist at Brigham and Women’s Hospital in Boston, told me, “You’ll need to tune into your abilities and make the most of them. Learning how to pace yourself for energy conservation is both a science and an art.”
Ruderman recommends Pilates because it combines stretching and strength-training movements. “Your joints are more than just the bones, cartilage, and capsules around the joints,” he explains. “Strengthening the muscles around a joint can improve pain in that joint.”
If you have swollen joints in your lower extremities, such as your feet or ankles, it’s best to limit weight-bearing activities. Kim Huffman, MD, PhD, an associate professor of medicine in the division of rheumatology at the Duke Molecular Physiology Institute in Durham, North Carolina, suggests activities such as swimming and aqua jogging. Exercising in water puts less pressure on your joints, making movement less uncomfortable.
Timing matters, too. RA pain is usually most intense in the morning, so engage in physical activity later in the day when your joints are less stiff. Be sure to warm up for 5 to 10 minutes, then do some gentle stretching before and after your workout.
“Stretch daily to check the mobility of all your joints and help reduce stiffness,” McInnes says.
When you’re exercising, listen to your body. “If a particular activity or move doesn’t feel good, don’t do it,” Ruderman advises. Either modify the activity or try something else.
If you’re in the midst of a pain flare-up, exercise at a lower intensity or for a shorter period of time, Dr. Huffman says. “This is an ideal strategy, especially if it means reducing but not eliminating exercise for a few days until you can resume your regular routine.”
Talk to your doctor about whether you can safely take a nonsteroidal anti-inflammatory drug (NSAID) or acetaminophen before engaging in an activity when RA pain flares up.
“Don’t assume that because you have rheumatoid arthritis, you shouldn’t exercise,” Ruderman says. “That’s the opposite of what’s right.”
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