We’re often told that exercise is vital for overall health, but exercise can be a daunting prospect for someone with rheumatoid arthritis. Joint pain, stiffness and even deformation combined with the sometimes-overwhelming fatigue that accompanies RA can deter even the most determined person.
Despite these obstacles, exercise is not only extremely important for people with RA, it is part of the overall treatment goal. According to the Arthritis Foundation, research shows that exercise helps alleviate symptoms and improve daily functioning.
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However, speak with your rheumatologist before you embark on an exercise program. Your doctor can outline an exercise program that will be safe for you and will incorporate different types of movement. He or she may also refer you to a physical or occupational therapist, who are specialists in the physiology of movement and rehabilitation. Physical therapists work with patients to develop individual exercise programs designed to maintain and even increase mobility and strength.
You may not even need a referral from a physician to see a physical therapist. “All 50 states have direct access to physical therapists,” says Kimberly Steinbarger, a physical therapist and academic coordinator of clinical education at the School of Physical Therapy at Husson University in Bangor, Maine. The rules differ from state to state, Steinbarger notes, and in some cases, insurance can be an issue. If your insurance balks at covering your therapy, the therapist can take care of any problems by obtaining a referral from a physician.
According to Steinbarger, one of the most important things for anyone with RA is to move. And move every day, even if that means walking around the house once or twice or doing exercises in your chair. And Steinbarger knows what she is talking about. Because in addition to being a licensed physical therapist, Steinbarger was diagnosed with RA 26 years ago, when she was in her 20s.
Although Steinbarger said it was daunting to receive a diagnosis of RA at such a young age, she has lived a full life, as normal a life as possible, given her disease. She works full time, has children and even holds a second-degree black belt in taekwondo. “I was the Maine state champion for my age group in 2012 and 2013,” she says proudly.
“Of course, I’ve had to make accommodations, but I’ve found that you can live your life with accommodations.”
It’s not always the joint pain and stiffness that makes it difficult to move, notes Steinbarger. “Often it’s the fatigue, which can be so overwhelming that you don’t even want to get out of bed,” she says. “But no matter how much fatigue I feel, I get up. I get out of bed every day.”
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And for people with RA, exercising doesn’t necessarily mean going to the gym every day and subjecting yourself to a strenuous workout. Your level of exercise depends on the degree of your disease and your disability.
It’s best to work with a health care team that includes your rheumatologist, physical therapist and occupational therapist so they can balance your exercise with your medications. “Drugs for RA have side effects and the stronger meds have even more side effects, so it’s important to take this into account when designing an exercise program,” Steinbarger advises.
One of the keys, says Steinbarger, is making modifications that help you live your life. “In my kitchen I have lightweight pots and pans and dishes. And I’ve modified my taekwondo so that I can do it without as much pain.”
It’s also important to find something that you like to do. Swimming, walking, hiking, yoga and tai chi are all beneficial for RA patients, helping to improve strength, increase functioning, prevent muscle loss and improve balance, which can help prevent falls.
And just as physicians have discovered that early, aggressive treatment is more likely to get better results, Steinbarger says that starting an exercise regimen early is equally important.
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Exercise not only benefits the joints, but it is also important for cardiovascular health. “Rheumatoid arthritis is a systemic disease. It’s inflammatory, and the inflammation attacks the heart, lungs, blood vessels and eyes,” notes Dr. Leonard Calabrese, a rheumatologist at the Cleveland Clinic. Most people with RA die of cardiovascular disease, so it’s just as important to exercise to promote cardiovascular health as joint health, says Steinbarger.
“The important thing to remember is that you can live your life, even with RA,” says Steinbarger. “You’ll have to make modifications, and you may need people to help you figure it out. And sometimes you have to ask for help. But don’t be afraid — ask.”
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Can Exercise or Physical Therapy Help Combat Rheumatoid Arthritis? originally appeared on usnews.com
