"Is it okay for me to exercise?"
It's a question I'm asked several times a week by my patients with arthritis. Here's my usual answer: Keep moving. I generally suggest that my patients be as active as possible as long as it does not cause significant pain or other bothersome symptoms.
But I realized long ago my advice was not based on hard data. That's why a study published earlier this year in the journal Arthritis Care and Research is so important. It provides some of the best evidence to date on the effect of exercise on osteoarthritis of the knee.
News about how to avoid osteoarthritis is not trivial. Of the more than 100 types of arthritis, this is the most common. Often called the "wear and tear" type of arthritis, it accounts for enormous suffering. This condition causes pain, stiffness and reduced mobility.
Nearly 15 million people have osteoarthritis, and the knee is the most commonly affected joint. It is an expensive problem. Americans spend millions of dollars each year seeing doctors and buying medications for knee osteoarthritis. Many of them end up having surgery. About 300,000 knee replacements are performed each year in this country. Most occur because of osteoarthritis.
Even now, the cause of osteoarthritis is unknown. There are no reliable ways to prevent it. So, studies like this one are important for understanding not only the risks and benefits of exercise but also why certain people get this joint disease.
In this new study, exercise did not increase the risk of osteoarthritis of the knee among more than 1,200 healthy adults. During a nine-year period, researchers based at the Boston University School of Medicine surveyed people about their physical activity. X-rays of the knees were taken at the start of the study and again toward the end. New cases of osteoarthritis occurred at similar rates among those who exercised regularly and those who did not.
That's good news. The findings should reassure us that we are not "wearing out" our joints by regular exercise. On the other hand, exercise didn't protect anyone either. That is, exercise did not appear to reduce the risk of arthritis among study subjects. Even so, the findings should encourage people to exercise regularly as recommended by standard guidelines.
Current guidelines recommend at least 30 minutes of moderate-intensity exercise most days of the week. You'll be more likely to stick with an activity you like, so "shop around" for an exercise program that suits you. Low-impact aerobic exercises, such as brisk walking or biking, are good choices.
Even though there is no reliable way to prevent osteoarthritis, you can lower your risk by:
- Maintaining an ideal body weight.
- Training well and wearing proper protective gear when playing sports.
- Seeing your doctor promptly if you have persistent joint pain or swelling.
This latest research did not assess the impact of exercise on people who already have arthritis. Still, my advice is generally the same: It's better to move than to sit still. You may need to change activities from what you did in the past. For example, if you were a runner and have developed significant osteoarthritis of the knee, swimming is probably a better choice.
What’s your exercise routine? How does exercising—or not exercising—affect your arthritis?
Arthritis
More than 60 million Americans are living with arthritis, and more than half of those are under 65. In fact, arthritis is the leading cause of disability in Americans older than 15—but it doesn’t have to be that way. Arthritis: Keeping your joints healthy is a special health report from Harvard Medical School that describes steps you can take to protect your joints, reduce pain, and improve mobility. The report also explains how arthritis affects the joints and other structures, how kinds of arthritis are diagnosed and treated, and how to minimize the impact of arthritis in your life.
Are you Living With Arthritis? Connect with others with similar health concerns and issues. Click here to join the group.
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Comments: 9
I'm glad your doctor and I agree on this! With arthritis (and many other conditions), it's not rare for different doctors to give different advice. And that can be pretty confusing. But evidence is mounting that exercise can provide significant benefits for people with or without arthritis.
To Priscilla t. - thanks for the feedback and thanks for reading!
What a nice, common-sense article! Beautifully formatted, too! Thank you so much.
I worry about my knees because I am over 350 lb. I know that's bad for the knees and will just hurry along the degeneration. Anything you suggest to put off the inevitable would be appreciated, Dr. Shmerling.
PS. I used to swim a lot, but now we can't afford to join places around here that have pools.
Unfortunately, there is not a long list of options available to slow or reverse the progression of most types of arthritis. That's the bad news. The good news is that even when joint deterioration cannot be stopped, the progression may be very slow. That is, you might be just a little bit worse in 5 years than you are now.
It does depend on the type of arthritis you have. For example, rheumatoid arthritis may cause relatively rapid joint damage, but there are medications available that can slow or even halt the deterioration.
For the most common type of arthritis - osteoarthritis (also called degenerative joint disease) - weight loss is probably the only option that makes much difference in joint deterioration over time. Medical insurance may cover water-based therapy (so-called "aquatherapy") if supervised by a physical therapist. An exercise bicycle or elliptical machine (purchased or through an exercise facility) may be something you can do if walking is difficult. Work with your doctor, physical therapist or a trainer to find an activity you can do that you enjoy. Keep doing your best to be active, and good luck!