Exercise and sports for rheumatoid arthritis

Photo of a sports group
PantherMedia / Robert Kneschke

There are good reasons for people with rheumatoid arthritis to stay physically active: Exercise and sports improve physical fitness and strength, and they can also help reduce disease-related exhaustion. A number of different sports are easy on the joints and suitable for people with rheumatoid arthritis.

Physical activity is important for keeping joints as mobile as possible. Exercise and sports have other advantages too: They strengthen your muscles, bones and circulatory system (heart and blood vessels). Strength and stamina are also useful in daily life – for instance, when climbing stairs.

Pain and exhaustion can make it hard to be physically active, particularly at first when your body isn't used to it yet. So it's important not to overdo it, and to make sure that the exercise you do is suitable for your stage of disease and the symptoms you have. This is also true when you have acute flare-ups.

You can talk to a doctor, physical therapist or occupational therapist about what type of exercise is most suitable for you in different situations.

What types of sports are suitable in rheumatoid arthritis?

Suitable types of sports and exercise for people with rheumatoid arthritis include the following:

  • Strengthening exercises: For instance, exercises using light weights to strengthen the muscles in the legs, arms and back.
  • Aerobic exercise: Sports that strengthen your heart and lungs, such as brisk walking, cycling, swimming and dancing.
  • Exercises and water aerobics
  • Tai chi (shadowboxing)
  • Yoga

In general, the activities that are suitable for people with rheumatoid arthritis are those that don't put too much stress on the joints. Research has shown that exercise isn't associated with risks in most people who have rheumatoid arthritis. If someone's joints are already very damaged, though, they should avoid doing intensive exercise. Evidence suggests that this kind of exercise can increase joint damage.

Personal preference is important when choosing the right type of exercise because it can only be effective if you do it regularly. Making exercise part of your daily routine is a lot easier if it's fun and makes you feel good.

Do health insurers cover the costs of sports activities?

In Germany, statutory health insurers cover the costs of group functional training classes for people with rheumatoid arthritis, for up to 24 months. Functional training involves exercises (e.g. stretching and strengthening exercises) or water aerobics, usually under the instruction of a . These classes are specially tailored to the needs of people with diseases like rheumatoid arthritis. Many people find it easier to do sports in a group too.

German statutory health insurers will only cover the costs if they have officially recognized that the organizer fulfills the required criteria. And the classes have to be prescribed by a doctor as well. Doctors can prescribe functional fitness training using a special formto ensure that it doesn’t negatively affect their budget.

Statutory health insurers will also cover the costs of rehabilitation exercise classes known as "Rehasport" if they are prescribed by a doctor. The aim of these classes is to improve your stamina, strength, coordination and mobility. They are offered for groups and usually include 50 sessions spaced out over an 18-month period.

You can find out more about sports activities for people with rheumatoid arthritis by contacting support groups, for instance.

What does research say about the different types of sports?

Physical activity can improve your fitness, strength and overall mobility. A systematic review of studies has also shown that it can reduce the exhaustion associated with rheumatoid arthritis.

Strengthening exercises

A series of studies have looked into the effect of strengthening exercises, especially in the arm and leg muscles. Participants in the studies did exercises using light weights or strengthening equipment for 30 to 60 minutes, two to three times per week. This improved their strength and also reduced arthritis-related limitations somewhat. It was easier for them to do everyday tasks like getting dressed and washed or handling dishes and cutlery. But the exercises had no effect on the pain.

Aerobic exercise

Other studies investigated how aerobic exercise influences rheumatoid arthritis symptoms. Here, too, the classes were held two to three times per week. Most sessions lasted between 45 and 60 minutes. Different types of aerobic exercise were tried out, such as cycling or swimming, often in combination with other exercises. The intensity of exercise was moderate. In other words, it was strenuous but didn't increase the participants' pulse too much.

Aerobic exercise was found to have positive effects too: It improved quality of life, slightly reduced limitations in daily life and also relieved pain somewhat.

Water aerobics

Because doing exercises in water hardly puts any strain on the joints, water aerobics is often recommended for people who have problems with their joints. The benefits of water aerobics have been tested in several studies. But the research results so far aren't enough to be able to tell whether water aerobics can relieve rheumatic symptoms such as pain, or improve joint function.

Tai chi and yoga

There's hardly any research on the effects of tai chi and yoga in rheumatoid arthritis, so it's not possible to draw any reliable conclusions.

Al-Qubaeissy KY, Fatoye FA, Goodwin PC, Yohannes AM. The effectiveness of hydrotherapy in the management of rheumatoid arthritis: a systematic review. Musculoskeletal Care 2013; 11(1): 3-18.

Baillet A, Vaillant M, Guinot M, Juvin R, Gaudin P. Efficacy of resistance exercises in rheumatoid arthritis: meta-analysis of randomized controlled trials. Rheumatology (Oxford) 2012; 51(3): 519-527.

Baillet A, Zeboulon N, Gossec L, Combescure C, Bodin LA, Juvin R et al. Efficacy of cardiorespiratory aerobic exercise in rheumatoid arthritis: meta-analysis of randomized controlled trials. Arthritis Care Res (Hoboken) 2010; 62(7): 984-992.

Bundesarbeitsgemeinschaft für Rehabilitation (BAR). Rahmenvereinbarung über den Rehabilitationssport und das Funktionstraining. January 1, 2011.

Büssing A, Ostermann T, Lüdtke R, Michalsen A. Effects of yoga interventions on pain and pain-associated disability: a meta-analysis. J Pain 2012; 13(1): 1-9.

Cramp F, Hewlett S, Almeida C, Kirwan JR, Choy EH, Chalder T et al. Non-pharmacological interventions for fatigue in rheumatoid arthritis. Cochrane Database Syst Rev 2013; (8): CD008322.

Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database Syst Rev 2017; (4): CD011279.

Lee MS, Pittler MH, Ernst E. Tai chi for rheumatoid arthritis: systematic review. Rheumatology (Oxford) 2007; 46(11): 1648-1651.

Munneke M, de Jong Z, Zwinderman AH, Ronday HK, van Schaardenburg D, Dijkmans BA et al. Effect of a high-intensity weight-bearing exercise program on radiologic damage progression of the large joints in subgroups of patients with rheumatoid arthritis. Arthritis Rheum 2005; 53(3): 410-417.

Rausch Osthoff AK, Juhl CB, Knittle K, Dagfinrud H, Hurkmans E, Braun J et al. Effects of exercise and physical activity promotion: meta-analysis informing the 2018 EULAR recommendations for physical activity in people with rheumatoid arthritis, spondyloarthritis and hip/knee osteoarthritis. RMD Open 2018; 4(2): e000713.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

Comment on this page

What would you like to share with us?

We welcome any feedback and ideas. We will review, but not publish, your ratings and comments. Your information will of course be treated confidentially. Fields marked with an asterisk (*) are required fields.

Please note that we do not provide individual advice on matters of health. You can read about where to find help and support in Germany in our information “How can I find self-help groups and information centers?

Updated on May 20, 2020
Next planned update: 2023

Authors/Publishers:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

How we keep you informed

Follow us on Twitter or subscribe to our newsletter or newsfeed. You can find all of our films online on YouTube.