Around two thirds of people in the UK living with rheumatoid arthritis do almost no physical activity, according to a review of exercise research published in the Journal of Aging Research. That inactivity is making the disease harder to live with.

The review describes a vicious circle. Pain and fatigue make people move less, and moving less costs them muscle. The Mayo Clinic warns that weak muscles put more stress on the joints, which can make pain worse.

The fear behind it is misplaced. High-intensity programmes running for two years produced no increase in damage to the large joints or the small joints of the hands and feet, the review found, and the muscle loss driving that circle can be reversed.

Everyone With Arthritis Can Exercise

The American College of Rheumatology (ACR) gives the blunt answer: everyone with arthritis can exercise safely. What differs is the type of exercise, not whether it is allowed.

The benefits split by condition. The ACR says people with osteoarthritis can reduce symptoms, improve joint movement and increase coordination through strengthening and stretching, while those with rheumatoid arthritis benefit from weight-bearing exercise.

Pain relief is part of the payoff. The Mayo Clinic says exercise can lower joint pain and leave people feeling less tired, because strong muscles take the load that would otherwise fall on the joints.

Fatigue shifts too. The Journal of Aging Research review notes that 42 per cent of rheumatoid arthritis patients experience severe fatigue, and that both aerobic and resistance exercise reduce it.

Why Movement Eases Sore Joints

There is a mechanical reason to keep moving. The review explains that after long periods of rest, the fluid inside a joint is squeezed out from between its surfaces. Resuming movement restarts the natural lubrication.

Cartilage responds to use as well. The compression and decompression delivered by regular exercise stop cartilage tissue becoming fragile, while exercise strengthens ligaments and even short periods of immobility weaken them.

Movement widens the joint's range, too. The review found joint mobility increased after a short, intensive programme, even in patients with active disease.

The Best Low-Impact Workouts

'Low-impact' exercise means activity that is gentle on the joints. The Mayo Clinic recommends it particularly for people whose arthritis affects the hips, knees or ankles.

The US Centers for Disease Control and Prevention (CDC) lists the joint-friendly options: brisk walking, cycling, light gardening, dancing, tai chi, swimming and simple water movements such as shoulder shrugs and ankle circles.

The ACR names walking, swimming and cycling as its recommended aerobic choices, while warning that recreational activity should not completely replace exercises prescribed by a specialist for the affected joints.

Cycling earns its place on results. The Journal of Aging Research review reports it improved aerobic capacity, muscle strength and joint mobility by roughly 17, 17 and 16 per cent respectively, with no worsening of disease activity.

Water is the gentlest option of the lot. The ACR highlights aquatic exercise because water reduces the stress on the joints, and the review found as little as two 30-minute sessions over four weeks significantly reduced joint tenderness and improved knee movement.

Dancing performed well too, with the review reporting gains in aerobic power alongside positive changes in depression, anxiety and fatigue.

Range-of-motion work rounds it out. The Mayo Clinic suggests stretching the arms overhead or rolling the shoulders forwards and backwards, most of which can be done daily, while the ACR says gentle yoga and tai chi improve balance and lower the risk of falls.

The CDC offers the most practical test. The best activities are fun, easy to get to, cause little or no pain, and are the ones a person will stick with.

What Strength Training Adds

Aerobic exercise is only half the picture. The ACR says strengthening work builds both muscle and bone strength, which supports the joints and reduces the stress placed on them.

The CDC sets the dose at a minimum of two days a week, using weights or resistance bands that do not cause joint pain, with difficulty raised in small steps as the body adapts.

The results are the strongest in the evidence. The Journal of Aging Research review reports that a two-year strength training programme in early rheumatoid arthritis improved muscle strength by 19 to 59 per cent, alongside reductions in pain, morning stiffness and disease activity.

It also undoes the muscle loss. Around two thirds of rheumatoid arthritis patients lose muscle mass as the disease progresses, the review says, and resistance training reverses that loss, cuts fat and improves physical function without making the disease more active.

The review calls progressive resistance training, meaning strengthening work that gets gradually harder, the most effective exercise for muscle size and strength in rheumatoid arthritis, and safe even at high intensity. Its verdict on what works best is that the optimum programme combines aerobic and resistance training.

Starting Slowly and Staying Safe

Doing too much too soon is the classic mistake. The CDC advises starting slowly, adding that some pain, stiffness or swelling is normal at first and that joint pain from activity should get better over time.

Preparation helps. Mayo Clinic guidance suggests warmth beforehand from a hot pack or shower, five to 10 minutes of range-of-motion work, then up to 20 minutes of ice afterwards to settle swelling.

Sessions can be broken up. The CDC says bouts of just five or 10 minutes are beneficial, and that reaching the weekly total of at least 150 minutes of moderate activity delivers the full benefit however it is spread.

Symptoms should guide the effort. The ACR advises using less resistance or taking longer breaks if arthritis symptoms worsen, and seeing a physiotherapist if that worsening persists.

Some signals mean stop. The Mayo Clinic warns that sharp pain, or pain worse than usual, may mean something is wrong, and advises slowing down at any sign of swelling or a change in skin colour around the joints.

What Stops People Moving

Knowing the benefits is not the same as acting on them. The Journal of Aging Research review lists pain, fatigue and low confidence among the barriers, alongside cost, poor transport and the time it takes to reach a gym.

The revealing part is what separates those who manage it. Active and inactive people with arthritis ranked the same top three barriers, but the review found active participants rated their impact significantly lower and received more encouragement from those around them.

The ACR suggests building that in deliberately: set realistic goals, keep a log, exercise with a friend, and decide in advance how to handle the obstacles likely to derail the routine.

When to Speak to a Doctor

The best exercises depend on the type of arthritis and which joints are affected, which is why the ACR recommends talking to a doctor or physiotherapist first. They can tailor a routine and adjust it as symptoms change.

Flare-ups need their own plan. The Mayo Clinic advises asking the care team what to do when symptoms worsen, often sticking to range-of-motion work or water exercise while keeping the body moving. The CDC says anyone whose pain or other symptoms become severe should contact their doctor rather than push on.

Frequently Asked Questions

  • Can people with arthritis exercise safely?
    Yes, everyone with arthritis can exercise safely. The type of exercise may vary depending on the condition, but exercise is generally beneficial.
  • What are the benefits of exercising with arthritis?
    Exercise can reduce symptoms, improve joint movement, increase coordination, and reduce fatigue. It also strengthens muscles, which can alleviate joint stress.
  • What types of exercises are recommended for arthritis?
    Low-impact exercises such as walking, swimming, and cycling are recommended. Strength training and range-of-motion exercises are also beneficial.
  • How should one start an exercise routine with arthritis?
    Start slowly with low-impact exercises, consult a healthcare professional for a tailored routine, and gradually increase intensity while monitoring symptoms.
  • What precautions should be taken when exercising with arthritis?
    Warm up before exercising, avoid exercises that cause joint pain, and stop if you experience sharp pain or unusual swelling. Consult a doctor if symptoms worsen.
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