Exercise is a great way to reduce joint pain and stiffness caused by psoriatic arthritis (PsA). Although it can be difficult to imagine exercising when you’re in pain, doing some sort of physical activity will likely help.
Regular exercise can also help lower stress and enhance your sense of well-being. The key is to be mindful of your exercise routine and to listen to your body’s signals.
Talk with your doctor before beginning a new routine. They can give you some suggestions for getting started or offer advice on what movements to try or avoid.
Q: Why do I need to exercise if I have PsA? How do I build a routine?
A: Exercise is particularly important with PsA to maintain flexibility.
Regular exercise — both aerobic and more gentle forms (yoga or tai chi) — can help decrease pain and fatigue, improve mood, and maintain good spine alignment. Chronic inflammation with PsA can lead to scarring (fibrosis), decreased flexibility, and increased risk of injury.
To build a routine, make a list of types of exercise that appeal to you. Choose one that fits your schedule and budget. If you have access to a warm pool, swimming or hydrotherapy is excellent for PsA.
If you haven’t been exercising for a while, start slowly with 10- to 15-minute sessions, 3 days per week. Listen to your body and build up your practice gradually. It usually takes 3 or more weeks to create a habit, so be patient with yourself.Nancy Carteron, MD, FACR, consultant rheumatologist, University of California, Berkeley and San FranciscoAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Here are some tips for exercising to ease PsA symptoms.
Warming up before any type of exercise can help prevent both pain and injury. It’s particularly important if you have arthritis.
Stretching can help protect both muscles and joints and improve your range of motion. Dynamic stretching, or stretching that keeps your body in motion, helps increase blood flow to your muscles and is great for a warmup.
However, wait until your muscles are warm to do static stretches, which involve holding a position for 15 to 30 seconds.
Focus on stretches that avoid putting high impact on joints that are bothering you most. Still, make sure to gently stretch problem areas to help reduce further pain and injury.
Stretching can not only help you avoid injury, but it can also enhance your performance and the results you get from your workout.
Talk with your doctor about which stretches would work best for you.
Cooling down after an exercise session can help prevent pain and injury, just as warming up can. Again, stretching can be beneficial during the cool down period.
Stretching at the end of your workout can help keep you limber, preventing tightness that can lead to injuries after a workout. Try some examples of good cooling down stretches, such as:
- Sit on the edge of a chair and extend one leg, then lean forward slowly to stretch your hamstrings.
- Stand with your hands on a wall or countertop. Bring your right foot forward, putting a slight bend in the right knee, bring your left leg back so you are in a lunge position. Lean forward until a stretch is felt.
- Pull your left heel to your left glute. Repeat with your other leg.
Use proper form
Using the correct form when exercising is essential for preventing injury. You can learn the proper way to do different types of exercises from a physical therapist or personal trainer.
They can also help you modify exercises or find alternatives if pain or stiffness limits your movements.
Allow for recovery time
It’s normal to feel sore after exercising. However, if you have moderate pain after exercising or you are still sore 72 hours later, you are pushing too hard. Always listen to your body and allow for recovery time.
When you have a flare-up, it’s also important to rest. Stressing your joints during a flare may lead to long-term damage.
It’s important to stay hydrated if you have PsA, particularly if you’re exercising. Drinking fluids, especially water, can help your body flush toxins and reduce inflammation. It can also help your joints stay lubricated.
In general, aim for eight glasses of water a day. You can also try:
- coffee (no more than 2 cups per day)
- fruit juice (limit the amount, since it’s high in sugar)
There’s currently no cure for PsA, but the food you eat may help reduce your symptoms.
A balanced diet can also help you maintain a moderate weight, which may improve your joint symptoms and contribute to avoiding related diseases like diabetes.
Certain vitamins and dietary supplements may help lower inflammation and reduce pain. These include:
- Vitamin D. Salmon, milk, and eggs are all good dietary sources of vitamin D. Supplements are also available.
- Omega-3 fatty acids. These are found in nuts, seeds, and fish. You can also take fish oil as a supplement.
- Glucosamine. These supplements may help reduce inflammation, though more research is needed for PsA.
It may also help to limit the following in your diet:
- processed foods
- foods that increase your total sodium intake beyond 1,500 milligrams per day
More research is needed on nutrition for PsA.
Talk with your doctor before changing your diet or trying any new supplements.
In general, low-impact exercises are best for people with arthritis. Here are some ideas to get you moving while living with psoriatic arthritis.
Walking is a tried and true low-impact exercise. Start with a few minutes per day and try to walk on flat surfaces to reduce the pressure on your joints.
If arthritis affects your feet, make sure you wear shoes that:
- fit properly
- offer good support
- don’t pinch your toes
You can also get special insoles for added protection.
Work up to a 30-minute walk each day or add short walks in whenever you can.
To add walking into your daily routine:
- Choose the farthest parking space and walk the extra distance.
- Get up and walk around your home or yard several times a day.
- Take the long way and add in a few more steps whenever possible.
- Walk around the block or use a treadmill.
As you walk, pay attention to how you move your joints and how you’re feeling. If you feel sore, it may be best to try a different exercise and return to walking tomorrow.
Strong muscles help support joints, and weight training can help keep your muscles strong and healthy.
A 2017 study found that resistance training improved function and quality of life while reducing symptoms in people with PsA.
Aim for strengthening exercises a couple of times per week or every other day. You’ll want to give your muscles some rest between workout days.
Examples of weight training that’s beneficial for psoriatic arthritis include:
- holding a 5-pound weight straight out from your body at arm’s length
- squats and lunges
Back off from strength training for a few days if you develop swelling or pain. Check with your doctor before resuming if it continues to cause a problem.
If you’re currently experiencing pain from the arthritis, use isometric exercises to strengthen your muscles by tensing them without moving your joints.
Regardless of whether you have arthritis, aerobic exercise is good for your heart. It improves general health and raises energy levels.
Aerobic exercise also helps with weight management, which, in turn, helps ease pressure on joints and reduces inflammation.
There are lots of fun ways to get aerobic exercise, such as:
- brisk walking
- using an elliptical machine
- water aerobics
- tai chi
- using a rowing machine
If you haven’t been active recently, start slowly. Gradually increase your speed and workout time until you’re exercising for about 20 to 30 minutes, 3 times a week.
If your joints can’t handle that length of time, break it up into 10-minute segments throughout the day.
Another fun way to get some exercise is to hit the pool.
Swimming exercises some of your joints and provides aerobic activity. Water supports your hardworking joints while providing resistance to work against. Also, a heated pool can help relieve joint pain and muscle stiffness.
Remember to make gentle movements as you exercise and stop if you feel pain.
Examples of exercises you can do in the water include:
- Forward arm reaches. Raise one or both arms upward as high as you can, beginning with your arms submerged in the water.
- Arm circles. Make circles with your arms under water.
- Leg swings. Holding the pool wall for balance if necessary, swing your leg up in front of you and then back behind you.
Chlorine in pools can cause skin dryness, so you may want to take a shower and apply moisturizing lotion after swimming.
Other exercises for psoriatic arthritis
Complementary therapies like yoga and tai chi help promote stress relief. Slow, gentle movements can improve balance and coordination.
The concentration and deep breathing techniques associated with yoga can help ease stress. These practices often take place in a group setting, which can also keep you motivated.
Other complementary practices like acupuncture and meditation may provide benefits, too.
A 2018 research review found that acupuncture can improve quality of life in people with rheumatoid arthritis, though more studies are needed for PsA. Meditation may also help reduce stress and promote relaxation.
Exercise is essential for a healthy lifestyle, but it’s important not to overdo it, especially when you have psoriatic arthritis. Certain exercises and types of equipment are also recommended over others.
In general, it’s better to stick to low-impact exercises that are easier on your joints. This is especially important if PsA affects your spine.
Still, some recent research suggests that higher-impact exercises may also be beneficial for people with PsA.
To help avoid injury, talk with your doctor or physical therapist first if you want to try higher-impact exercises.
Free-weight workouts that hurt your hands
Free weights are great for doing strength training at home but make sure you’re using the right equipment.
It helps to find weights with a rubber grip, since they’re easier to hold. You can use weights that strap to your ankles or wrists, too.
You may also have an easier time with a set of nonadjustable weights. Adding or subtracting weight from a dumbbell can be difficult if arthritis affects your hands.
Be sure to learn and use correct form to help prevent injury, especially when using free weights.
If the exercise is painful or you can’t find suitable equipment, it may be better to use weight machines. These tend to be simpler to use and may help you avoid injury.
Range of motion exercises that hurt
Range of motion exercises are important for maintaining and increasing joint movement and reducing stiffness.
Try to do these exercises every day to help improve flexibility. You want to feel a stretch without forcing the motion or pushing through any pain.
When your joints are swollen or in pain, do your best to achieve as much range of motion as you can without increasing your pain.
Whatever your activity of choice is, there may be times when you’re just not up to it. Remember to listen to your body and take days off. Forcing inflamed joints into action may result in joint damage.
You can still exercise areas of the body that aren’t feeling sore. For example, if your hands need a break, try walking or exercising in the pool. If your toes hurt, you can still exercise your arms and shoulders.
An ice pack can help reduce joint swelling. Some tips include:
- Apply one for 10 minutes every couple of hours but don’t put ice directly on your skin.
- Use an ice pack wrapped in a towel.
- You can try alternating between applying cold and heat, but wait a couple of hours between each one.
If you find that icing makes the arthritis worse, ask your doctor for other recommendations.
Pain during or after exercise means that you’re pushing too hard. Exercise should never cause pain.
Take it easier next time while you work up to a more strenuous workout. Some exercise can cause mild soreness, however, which should go away in under 48 hours.
Muscle soreness will be most noticeable when you first start a new type of exercise. While it will decrease as time goes on, some soreness when exercising is normal.
Movement is good for your body, but you’ll want to choose exercises that are easy on the joints. Most importantly, choose activities you enjoy, so you’re more likely to stick with them.
If you have moderate to severe joint pain while exercising, stop immediately. This could be a sign of inflammation in the joint, which can cause joint damage.
If you’re experiencing persistent moderate pain that doesn’t go away after a day or so, talk with your doctor to make sure there’s no joint damage.