It’s a vicious cycle.

Exercise is known to reduce symptoms in patients with rheumatoid arthritis (RA). However, the pain associated with RA often makes it difficult for patients to exercise.

In fact, pain levels along with different variations of ability and range of motion make some types of physical activity nearly impossible for those with RA or juvenile arthritis.

Nonetheless, a new study suggests that exercise, in particular rigorous workouts, may actually be of great benefit to many patients who have RA.

The study, published in the European Journal of Applied Physiology, found that high-intensity workouts such as cycling, spin class, or interval training, may reduce the severity of pain in patients who live with rheumatoid arthritis and juvenile idiopathic arthritis (JIA).

Read More: Oral Therapies Making a Comeback in RA Treatment »

Small Study, Big Interest

Though the study was small in scope, the results were of great interest to researchers at the Norwegian University of Science and Technology. They studied seven women who had rheumatoid arthritis and 11 women who had adult-JIA.

The 18 women, ages 20 to 50 years old, participated in high-intensity interval training (HIIT) on spinning bikes for a period of 10 weeks with increased heart rates in the 85 to 95 percent maximum heart rate zone.

The initial goal of these vigorous workouts was to find out if their risk of cardiovascular disease (CVD) would decrease. Patients with RA and JIA are at an already-increased risk of CVD due to the inflammatory nature of these forms of autoimmune arthritis.

At the end of the HIIT pilot study, researchers discovered that the workouts didn’t worsen the pain or other RA-related symptoms in any of the participants. In fact, some said the exercise lessened their pain during the interval training regimen.

In addition, no increase was found in RA disease activity or RA pain levels. It was also discovered that several CVD risk factors decreased with the high-intensity interval workouts and increased heart rates.

The official conclusion of this pilot study was that “HIIT seems like a promising non-pharmacological treatment strategy for patients with RA and adult-JIA.”

Read More: Actress Megan Park Talks About Life with Rheumatoid Arthritis »

Study Encourages Exercise

The findings are important because it shows that patients with autoimmune forms of arthritis can safely exercise more than previously thought.

Years ago, patients with RA and JIA were told to avoid exercise or sports. Only lower-impact workouts such as water aerobics or yoga were encouraged.

This new study shows that many RA patients can tolerate higher levels of physical activity and more intense workouts than previously thought. Of course, every patient is different and should talk to their rheumatologist, physical therapists, and/or experienced personal trainers before beginning any new exercise program.

Limitations from this destructive disease vary from patient to patient. Arthritis Today magazine, for example, has covered triathletes and mountain-climbers with RA, but there are other patients with the disease who are severely crippled and bound to wheelchairs or walkers.

However, the American College of Rheumatology recommends even light physical activity for even the most disabled RA patients. Chair yoga or resistance bands offer good alternatives to those patients who physically can’t or aren’t willing to try HIIT workouts such as circuit training or spinning.

Read More: Dirty Air Linked to Rheumatoid Arthritis Flares »

A Trainer’s Point of View

Kelly Barker of Pennsylvania works for a nationally known gym franchise. As a child, she watched her mother suffer from RA and fibromyalgia for years.

Her mother was wheelchair-bound, battled with deformed joints and extreme pain, and followed her doctors’ strict orders of no exercise — a practice that used to be common.

From a young age, Barker turned to exercise and sports as a way to honor her mother and her body, doing what her mom was physically unable to do herself.

As she got older and became a certified personal trainer, she felt strongly that RA patients like her mother would benefit from exercise.

“I teach spin classes, yoga class, and barre classes. I have a couple of people who I work with who have RA or other chronic pain condition, and the biggest obstacle that many of them encounter is fear or impatience,” she said. “It is imperative that patients with pain or physical limitation start out slowly and listen to their bodies, but also don’t let their minds get in their own way. Many of these strong individuals can do more than they believe.”

Barker is flexible when it comes to designing workouts.

“I provide adaptations and alternative options for all of my clients, so no one in my classes feel singled out, disabled or not,” she said.

Barker added that one of her clients with RA told her that she feels like, due to her newfound love for exercise, she is “in remission — or something close to it.”