Rheumatoid arthritis is a painful autoimmune disorder which occurs when your immune system attacks the lining of the membranes surrounding your joints. It is unknown what starts this process, although it is likely that a genetic predisposition is involved. Studies have shown that exercise helps the symptoms of RA, but patients do not always comply with exercise recommendations. When they do, they experience less pain and greater quality of life.
Rheumatoid Arthritis
Rheumatoid arthritis is a chronic inflammatory disorder most often affecting the small joints in the hands and feet. While osteoarthritis is caused from wear and tear, rheumatoid arthritis affects the lining of your joints and causes a painful swelling that can sometimes cause joint deformity and bone erosion. RA can also affect the entire body with fatigue and fevers. The disorder is more than twice as common in women than men and usually occurs between the ages of 40 and 60.
Symptoms
The symptoms of rheumatoid arthritis can include: joints that are tender to the touch, joint pain or swelling, firm bumps underneath the skin on your arms called rheumatoid nodules, fever, fatigue, weight loss, morning stiffness which may go on for hours, and red and puffy hands.
In the beginning of the disorder the smaller joints are affected -- wrists, ankles, hands and feet. As the disorder progresses, your shoulders, knees, hips, elbows, jaw and neck become involved. The symptoms of RA occur symmetrically in the same joints on both sides of the body. Symptoms may come and go, with flare-ups alternating with periods of relative remission when symptoms disappear. If you are experiencing persistent discomfort and swelling on both sides of your body in multiple joints, it is time to see your doctor.
Exercise
A study published in the July 2010, issue of Arthritis Care & Research found that RA patients who exercise regularly reported less joint pain, improved function and greater quality of life. The study conducted an abstract search of medical journals for studies of the impact of aerobic exercise on RA patients. The research team analyzed 14 studies including 510 patients in the intervention group and 530 in the control group. Participants were between 44 and 68 years old and had the disease anywhere from 1 to 16 years.
Dr. Baillet, one of the researchers from the University of Grenoble Medical School in France, said, "While past studies have indicated that RA patients are quite physically inactive, our study shows aerobic exercise to be a safe and beneficial intervention for this group. Further trials are needed to clearly determine the clinical impact of cardio-respiratory conditioning in the management of RA."
Exercise Compliance
A focus group study at the University of Limerick in Ireland looked at compliance rates of patients with RA to physical exercise and found them to be in the range of 43 to 65 percent. The aim of the focus group was to identify both barriers and facilitators to exercise. They found that factors including pain and fatigue, lack of professional input and embarrassment and fear of falling were the major obstacles to exercising. The main facilitators were understanding professional input, group therapy, common ground, support and addressing psychological issues.
Another study reported in the Journal of Rheumatology in 2008 looked at the influence of patient education on exercise compliance in 208 outpatients. The intervention group received training in home-based exercises and guidelines for leisure physical activity. The control group received a booklet in addition to usual medical care. At a 6-month followup, it was found that home-based exercise and leisure physical activity compliance were significantly higher in the intervention group, but this was not true at 12 months. The conclusion was that education helped, but only in the short-term.
Cautions
Speak with your doctor before beginning any exercise program and start with gentle exercises like walking, swimming or water aerobics. Avoid exercising tender, injured or inflamed joints. New pain which lasts for more than two hours after exercising means you may have overdone it.
