Psoriatic arthritis (PsA) can cause stiff joints. Both low impact and high intensity exercise can help relieve stiffness and inflammation. But be careful not to overexert yourself, as doing so could lead to pain.

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 decrease 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?

Anonymous

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 three days per week. Listen to your body and build up your practice gradually. It usually takes three 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.

Warm up

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 your 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.

But 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 the joints that are bothering you most. Still, make sure to gently stretch problem areas to help reduce further pain and injury.

Stretching can:

  • help you avoid injury
  • enhance your performance
  • maximize the results of your workout

You can talk with your doctor about which stretches would work best for you.

Cool down

Cooling down after an exercise session can help prevent pain and injury, just as warming up can. Again, stretching can be beneficial during the cooldown period.

Stretching at the end of your workout can help keep you limber, preventing tightness that can lead to injuries after a workout. You can try some cooldown stretches, such as:

  • Hamstring stretch: Sit on the edge of a chair and extend one leg. Lean forward slowly to stretch your hamstrings.
  • Hip stretch: Stand with your hands on a wall or countertop. Bring your right foot forward, bend your right knee slightly, and bring your left leg back so you are in a lunge position. Lean forward until you feel a stretch.
  • Quad stretch: 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. A physical therapist or personal trainer can teach you the proper way to do different types of exercises.

They can also help you modify exercises or find alternatives if pain or stiffness limits your movements.

Allow for recovery time

You can expect to feel some soreness after exercising. But if you have moderate pain after exercising or are still sore 72 hours later, you are pushing too hard. Always listen to your body and allow for recovery time.

It’s also important to rest when you’re having a flare-up. Stressing your joints during a flare may lead to long-term damage.

Stay hydrated

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 keep your joints lubricated.

In general, aim for eight glasses of water per day. Aim for an extra 6 to 8 ounces of water for every 15 minutes of exercise.

In addition to water, you can drink 100% fruit juice and milk. Tea and coffee are diuretics, so while you can drink them, they don’t really count toward your total fluid recommendation for hydration.

There’s currently no cure for PsA, but eating a balanced diet may help reduce your symptoms. Eating nutritious foods is by no means a cure, but when combined with physical activity, it can be an important factor in improving your quality of life.

A balanced diet can also help you maintain a moderate weight, which may improve your joint symptoms and reduce your risk of developing some health conditions, such as diabetes.

Certain nutrients may help reduce joint pain and skin symptoms. The results of a small 2022 study suggest that omega-3 supplementation and well-balanced diets can help with PsA symptoms.

Other potentially helpful tips include:

  • avoiding alcohol
  • avoiding smoking, or seeking out a smoking cessation program if you currently smoke
  • limiting your consumption of:
    • red meat
    • sugar
    • ultra-processed foods

Remember to 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 PsA.

Walking

Walking is a tried-and-true form of low impact exercise. It can help with endurance and benefit your spine.

Start with a few minutes per day. 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.

Try to work up to a 30-minute walk each day or take short walks whenever you can.

Here are some ways you might be able 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 per day.
  • Take the long way to add a few more steps whenever possible.
  • Walk around the block or use a treadmill.

Pay attention to how your joints move and how you feel as you walk. If you feel sore, it may be best to try a different type of exercise and return to walking tomorrow.

Weight training

Strong muscles help support your joints, and weight training can help keep your muscles strong and healthy.

In a 2023 study, researchers found that resistance training could help improve quality of life and reduce disease activity in people with PsA. Resistance training also had benefits for:

  • functional capacity
  • functional status
  • muscle strength

Aim to do strengthening exercises a couple of times per week or every other day. Give your muscles some rest between workout days.

Examples of weight training that can be beneficial for PsA include:

  • holding a 5-pound weight straight out from your body at arm’s length
  • doing pushups
  • doing squats and lunges
  • practicing Pilates

Back off from strength training for a few days if you develop swelling or pain. If the pain continues, check with your doctor before resuming the activity.

If you’re currently experiencing pain from arthritis, you can use isometric or therapeutic exercises to strengthen your muscles by tensing them without moving your joints.

Aerobic exercise

Regardless of whether you have arthritis, aerobic exercise:

  • is good for your heart
  • improves general health
  • boosts energy levels

Aerobic exercise can also help you maintain a moderate weight, which in turn helps limit the pressure on your joints and reduce inflammation.

There are lots of fun ways to get aerobic exercise, such as:

  • brisk walking
  • biking
  • dancing
  • swimming
  • using an elliptical machine
  • doing water aerobics
  • practicing 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 20 to 30 minutes 3 times per week.

If that length of time is uncomfortable for your joints, try breaking it up into 10-minute segments throughout the day.

Swimming

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:

  • Upward 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 underwater.
  • Leg swings: If necessary, hold the pool wall for balance. 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 practices for PsA

Mindful practices such as yoga and tai chi can help relieve stress and promote relaxation.

Slow, gentle movements can help improve balance and coordination. The concentration and deep breathing techniques associated with yoga can help reduce stress. And these practices often take place in a group setting, which can help you stay motivated.

Other complementary practices, such as acupuncture and meditation, may also provide benefits.

In a 2020 case study involving a 73-year-old woman with PsA, a researcher explored the effects of:

The results suggest that acupuncture, in combination with the other treatments, had the following effects:

  • increased range of motion
  • reduced edema (fluid buildup in body tissues)
  • reduced stiffness

However, more studies on PsA treatments are needed.

Exercise is an essential part of a healthy lifestyle, but it’s important not to overdo it, especially when you have PsA. Certain exercises and types of equipment are also recommended over others.

High impact exercises

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.

A small 2023 study found that participating in high intensity interval training for 3 months did not worsen inflammation in people with low to moderate PsA disease activity.

To help prevent injury, it’s important to talk with your doctor or physical therapist before trying 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.

Weights that have rubber grips can be helpful because they’re easier to hold. You can also use weights that strap to your ankles or wrists.

You may have an easier time using 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 the 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 your 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 gain as much range of motion as possible without increasing your pain.

Overexerting yourself

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 your body that aren’t feeling any soreness. For example, try walking or exercising in a pool if your hands need a break. If your toes hurt, you can still exercise your arms and shoulders.

An ice pack can help reduce joint swelling. You can try icing your joint by:

  • applying an ice pack for 10 minutes every couple of hours (but not putting ice directly on your skin)
  • using an ice pack wrapped in a towel
  • alternating between applying cold and applying heat, waiting a couple of hours in between each one

If you find that icing makes your arthritis worse, ask your doctor for other recommendations.

Some forms of exercise can cause mild soreness, which should go away in less than 48 hours. Muscle soreness is most noticeable when you first start a new type of exercise and decreases as time goes on.

But if you have moderate to severe pain during or after exercise, it means you’re pushing too hard. Pain can also prevent you from performing daily activities. Exercise should never cause pain. Take it easier next time while you work up to a more strenuous workout.

Movement is good for your body, but you should choose exercises that are easy on your joints. Most importantly, choose activities you enjoy so you’re more likely to stick with them.

Depending on your preferences, you can try walking, weight training, and swimming, among many other high intensity or low impact exercises.

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, check with your doctor to make sure there’s no joint damage.