What Are the Best Exercises for Rheumatoid Arthritis?

Rheumatoid arthritis (RA) can cause symptoms that make it difficult or painful to do daily activities. This can discourage people from exercising. After all, if your usual activities — like walking or bending — are difficult, then won’t exercise cause more pain or make your symptoms worse? But exercise can actually be a good idea for people with RA. 

Let’s take a closer look at why exercise can help someone with RA — and what kind of exercises may be best.

What are the benefits of exercise for rheumatoid arthritis?

Exercise is an important part of living with RA. Regular exercise directly impacts the symptoms and progression of RA. Exercising with RA has these benefits: 

• Improved pain control

• Improved muscle health and function

• Slowed progression of joint damage

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Exercise also improves your general health, which can provide some bonus benefits for your RA. First, it improves your heart function. This is especially important because RA can increase your risk of heart disease. Exercise also helps you maintain a comfortable weight and improves your sleep quality. Both of these benefits decrease your body’s level of inflammation, which may also lessen your joint pain. 

What kind of exercise is best for people with rheumatoid arthritis?

When you have RA, it’s best to add a variety of both cardiovascular and resistance training into your routine. Cardiovascular, or aerobic, exercise gets your body moving and your heart rate up. Examples of this include:

• Jogging

• Walking

• Riding a bicycle

• Swimming

Resistance exercise, or muscle strengthening, helps strengthen your muscles. Examples of this include:

• Weight lifting

• Yoga

• Pilates

There are four different types of exercise that can be part of any exercise program and can be done at any level, even if you’re just starting out. Let’s review them below.

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1. Stretching

Stretching before and after exercise can help improve flexibility and reduce the risk of injury. Stretching helps avoid muscle shortening and stiffness around the affected joints. Try to stretch daily to the point of feeling tightness but not overstretched. Most people can hold each stretch for 10 to 30 seconds, with 2 to 4 repetitions for each major muscle.

Stretching exercise can be done on its own or in combination with other types of exercise. Stretching is commonly used for warm-ups and cooldowns. The Exercise is Medicine initiative recommends that people with RA do a long warm-up and a gradual cooldown during their workouts.

2. Resistance training

Weight lifting, flexing muscles against gravity, and using a weight machine or resistance bands can help build strong muscles and improve joint stability. This is particularly important because RA may lead to a loss of up to 70% of muscle strength over time.

In people with RA, resistance training may improve:

• Muscle strength

• Quality of life

• Functioning

• Pain

• Mental health

In one small study, improvements in strength and mental health were seen after 12 weeks of strength training.

When strength training, here are some tips to follow: 

• Keep a schedule. Make sure to train each major muscle group, 2 to 3 days per week, with a day of rest in between.

• Focus on a muscle group. Do 2 to 4 sets of 8 to 12 reps for each muscle group.

• Don’t overdo it. Make sure to rest for 2 to 3 minutes between each set.

• Challenge yourself. Gradually increase the weight, number of reps, or sets as the exercise gets easier. 

3. Cardiovascular exercise

Aerobic exercise for people with RA can help keep your heart strong (improve your cardiovascular condition). And it can improve your overall health and endurance. Aerobic exercise should be done 3 to 4 days per week. Exercise sessions can be 30 to 60 minutes each day — all at once, or split into shorter sessions.

Examples of cardiovascular exercise that can benefit those with RA include:

• Walking

• Cycling

• Jogging

• Running

• Hiking

Aquatic exercise can count as both aerobic and resistance exercise. This includes:

• Swimming

• Water aerobics

• Walking in the water

You may need to try a couple of different activities before you find one that you enjoy and that feels right for your body. Whatever you choose, it’s important to start slowly and gradually increase the intensity. Even walking, which can seem like a very low-intensity exercise, can have positive effects on cardiovascular health.

If exercise is too uncomfortable for you, do your exercise on days when pain is controlled. Avoid exercise that’s too intense or too repetitive. During flare-ups, lower the exercise intensity. Or switch to more gentle exercises or another type of exercise such as stretching. 

Older adults with RA should also not shy away from exercise. A combination of aerobic with resistance exercise can increase strength and endurance in older people with RA.

4. Body awareness and motor control exercise

Exercises that focus on body awareness and motor control may help maintain function and reduce falls in people with RA. These exercises can improve:

• Balance

• Posture

• Agility

• Coordination

Most of these exercises combine movement with mental focus. This type of exercise is better done with a physical therapist or a professional trainer because they may involve single leg exercises or the use of stability balls. Sessions can be 2 to 3 days per week for 20 to 30 minutes a day.

Finding an exercise routine with rheumatoid arthritis

The best form of exercise for RA is one that you enjoy and will do regularly. This may include different activities for different people. Many daily activities, like cleaning or yard work, already include whole-body exercise and can be beneficial for RA.

Talk to a healthcare professional to see what exercise type, intensity, and duration is best for you, depending on where you are in your journey with RA. Once you have your exercise program, try to be consistent.

Another important consideration for people with RA is doing exercises for small hand joints. Doing simple exercises daily, like hand stretches, can help with small joint flexibility and strength.

How much should someone with rheumatoid arthritis exercise?

The general exercise guidelines are to aim for one of the following options per week: 

• Moderate physical activity: 150 minutes

• High-intensity exercise: 75 minutes 

This goal is safe if you have RA too. So, what’s moderate versus high intensity? Here are some examples of each: 

• Moderate intensity typically means an exercise that increases your heart rate. But it doesn’t make you so short of breath that you can’t talk while exercising. Examples of moderate-intensity exercise include brisk walking, heavy cleaning, or mowing the lawn. 

• High or vigorous intensity exercise, like hiking or jogging, is exercise that makes it difficult to have a conversation at the same time. 

Maybe 30 minutes a day, 5 days a week sounds like too much. If so, start with 10 minutes a day, or only 2 to 3 days a week. You can also break down the exercise into about 3 short, 10-minute sessions during the day to get started. You can then increase your time or intensity, but take as many breaks as you need. 

Any amount of exercise is better than no exercise. Start slowly, and do as much as your body will let you do. As you get used to exercising regularly, you may be able to do more.

The CDC also recommends regular muscle-building exercise. You can combine this with cardio. Or you can do strengthening and cardio on different days of the week. Mixing up the type of exercise you do may make it more fun and help you to stick to your exercise routine. 

Even if you start exercising regularly, you may have days where pain or joint stiffness make exercise difficult. On these days, you may need to adjust the type and amount of exercise you do based on what feels safe for your body. Remember, on these days, any amount of exercise is better than no exercise. For some people, water exercises, like swimming or water aerobics, can be good exercise options. This is especially true during times of joint pain and stiffness. 

What are some things to keep in mind when starting an exercise program?

The first step in starting an exercise program is deciding to start one. Once you have decided to start exercising with RA, there are a few more things you may want to consider:

• How to choose an exercise activity: Pick an activity, or a couple of activities, that you enjoy.

• How to stay comfortable: Make sure to wear comfortable clothes and supportive shoes.

• How to start: The best thing to do is to start slowly and let your body get used to whatever exercise you’re doing.

• How to make it fun: Consider exercising with friends, joining an exercise class, or setting exercise goals each day or each week. All of these things can make exercise more fun and may motivate you to keep going.

• How to take it easy: You may have days where joint pain or stiffness make reaching your goals difficult. Be kind to yourself and take it easy on those days.

• How to keep it healthy: Always make sure to talk to your healthcare team about your exercise plans so that you can be sure your exercise program is safe for you.

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Written by:

Kelly Elterman, MD

Kelly Elterman, MD, is a board-certified anesthesiologist by the American Board of Anesthesiologyand has been practicing clinically since she finished her residency training in 2013. Along with her training, she has over 10 years experience in anesthesiology.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Reviewed by:

Itza Rivera, MD

Dr. Rivera is a board-certified physical medicine and rehabilitation specialist. She completed her medical degree and residency training at the University of Puerto Rico School of Medicine, and her neuromuscular disorders subspecialty training at Northwestern University.

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