Reviewed by Brunilda Nazario, MD, July 10, 2008

When joints are stiff and painful, exercise might be the last thing on your mind. Yet when you have rheumatoid arthritis, exercising regularly is one of the best things you can do to take care of yourself and your joints. Here is why exercise is so important:

• People who exercise live longer, with or without rheumatoid arthritis.
• Regular exercise can actually reduce overall pain from rheumatoid arthritis.
• Exercise can keep your bones strong. Thinning of the bones can be a problem with rheumatoid arthritis, especially if you need to take steroids. Exercise helps bones keep their strength.
• Exercise maintains muscle strength.
• Regular exercise improves functional ability and lets you do more for yourself.
• People with rheumatoid arthritis who exercise feel better about themselves and are better able to cope with problems.

Is Exercise Safe If You Have Arthritis?

Is exercise safe? Yes -- certain kinds of exercise are proven to be safe for people with rheumatoid arthritis. There are three types you can do: stretching, strengthening, and conditioning.

• Stretching exercises are the simplest and easiest. They consist of stretching and holding different joint and muscle groups for 10 to 30 seconds each. Stretching improves flexibility, and daily stretching is the basis for any exercise program.
• Strength exercises involve working the muscle against resistance. This can be either with or without weights. Resistance training strengthens the muscle and increases the amount of activity you can do pain-free.
• Conditioning exercise, also called aerobic exercise, improves cardiovascular fitness. There are countless benefits to aerobic exercise! Among them, it makes your heart and blood vessels healthier, prevents disability, and improves mood and well-being. Good conditioning exercises for people with rheumatoid arthritis include low-impact activities like walking, swimming, bicycling, or using an elliptical machine. Any of these will get your heart pumping.
  
  After being cleared by your doctor, you should try to do 20 to 30 minutes of low-impact conditioning exercise on as many days as you feel you can. More is better, but any amount is better than none at all!

Exercises to Avoid if You Have Arthritis

Are there any kinds of exercise you should avoid? In general, you should be careful about activities that put a lot of stress on a joint, or are "high-impact," such as:

• Jogging, especially on paved roads
• Heavy weight lifting

That's not to say that these activities are totally off-limits. If you're interested in trying them, talk to your doctor first.

Your rheumatologist can help you create an exercise program that is right for you. This may also involve meeting with a physical therapist. Physical therapists can identify what areas you need to work on, choose the right exercises for you, and tell you how vigorously you should exercise.

There are also community exercise programs designed just for people with arthritis. People with Arthritis Can Exercise (PACE) and the Arthritis Self Help Course (ASHC) are offered by the Arthritis Foundation (www.arthritis.org).

You should work with your treatment team to design the right plan before starting to exercise, especially if you have other medical problems.

As you start to exercise regularly, you'll realize the benefits, and you'll know you've taken control of your rheumatoid arthritis. Soon, not only will your joints feel better - you'll feel better too.

SOURCES: de Jong, Z. Arthritis and Rheumatism, September 2003; vol 48(9): pp 2415-2424. Hakkinen, A. Arthritis and Rheumatism, March 2001; vol 44(3): pp 515-522. Hakkinen, A. Current Opinion in Rheumatology, March 2004, 16(2): 132-137. Munneke, M., Arthritis and Rheumatism, June 15, 2005; vol 53(3): pp 410-417. Paffenbarger, R., New England Journal of Medicine, March 6, 1986; vol 314(10): pp 605-613. Stenstrom, C., Arthritis Care Research, December 1994; vol 7(4): pp 190-197. Van Den Ende, C., Cochrane Database Systematic Review, 1998. Westby, M., Journal of Rheumatology, July 2001; vol 27(7): pp 1674-1680.