Physical activity and exercise for patients with rheumatoid arthritis

It is important for all members of the treating team to endorse and emphasise the benefits of physical activity to patients with rheumatoid arthritis (RA). Encourage patients to maintain or increase their physical activity. Some patients may worry that disease activity and pain could be increased by exercise. Although some pain can be expected, reassure patients that the benefits of physical activity significantly outweigh the risks.

Land- and water-based aerobic exercises are beneficial for patients with RA at all stages of disease. Regular aerobic exercise improves physical function, helps maintain ideal body weight and benefits psychological and cardiovascular health. Low-impact land-based exercise (eg stationary cycling, walking) or low- to moderate-intensity water-based exercise are preferred for patients with painful joints or high disease activity. Muscle-strengthening (anaerobic) exercise is also recommended to prevent muscle wasting. Weightbearing exercise improves bone health.