Proper treatment for RA, including the benefits of exercise, has been the subject of debate for decades. Understanding the historical change in attitude about exercise may help you understand the thinking behind what your physician or therapist is telling you now.
In the 1950s and 1960s, people with RA were routinely treated by bed rest. It was not uncommon, in fact, for a person with RA to be placed in the hospital for one or two months in an attempt to bring the arthritis under control. Since inflamed joints do improve with bed rest (when inflamed joints are splinted or immobilized, the swelling, pain, and heat decrease), the practice continued. In this same time period, exercises were rarely prescribed for any arthritis patient (regardless of how well controlled the arthritis was) for fear that the person’s condition would worsen.
In time, some health care providers questioned the logic behind prolonged bed rest, which exerts negative effects on the body: muscles weaken, bones lose calcium and become more brittle, and overall fitness diminishes. Although joint inflammation improves with bed rest, people get out of shape while their arthritis is getting under control.
Gradually, health care providers began prescribing exercises for their patients, and over time the amount of prescribed exercise has increased. Gentle range-of-motion exercises, aimed at preserving joint motion, and cautious muscle-strengthening exercises became essential components of the exercise regimen.
In the past twenty years, people have become much more exercise conscious, and trends in therapeutic advice for people with RA reflect this. In the 1970s and 1980s, for example, several inspired investigators decided to see what would happen if they increased the level of exercise in patients whose arthritis was under control. Marion Minor, RPT, at the University of Missouri-Columbia, as well as other researchers, reported interesting results. They discovered that some individuals with arthritis can perform more advanced strengthening exercises as well as low-impact aerobic exercises with positive effects. These people appeared to benefit from the exercise in numerous ways: they had improved stamina, less fatigue, and better ability to function, and they spent less time away from work and more time away from the hospital.
What physicians and others have learned from changes in treatment adds up to this: You should exercise. Appropriate exercise can improve your energy and strength, increase joint stability, help prevent joint deformities, decrease pain, and allow you to function better. But exercise affects more than just the symptoms of arthritis; it helps build stronger bones, promotes self-esteem, improves the quality of sleep, and decreases muscle tension and anxiety. A fitness program faithfully adhered to will also benefit your lungs, your heart, and your circulation.
The recommended amount and type of exercise depend on the degree of inflammation and the pattern of joint involvement.
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ARTHRITIS