We know that most people do not rank exercising among their favorite pastimes. And if you suffer from arthritis, which can make simple, day-to-day tasks painful, it is easy to understand why you may avoid strenuous activity.
Rheumatic disorders such as osteoarthritis, rheumatoid arthritis and fibromyalgia, can cause inflammation, swelling and pain in the joints or muscles. This often causes sufferers to become more sedentary, increasing their risk for cardiovascular disease, obesity and other conditions related to inactivity.
In addition to the physical toll, these chronic conditions can negatively affect a person’s emotional well-being. That is why special interest has been paid by researchers to exercise therapy with a mind-body component, such as the ancient form of Chinese martial arts called tai chi.
While traditional exercise can often lead to muscle soreness, joint stiffness and even injury, studies have documented the benefits of tai chi in people who suffer from these painful conditions. In the new article Tai Chi and Rheumatic Diseases, Dr. Chenchen Wang, MD, reviews the scientific evidence that takes a fresh look at this effective exercise technique for those with chronic joint pain.
But first things first …
What is Tai Chi?
Tai chi is a form of martial arts, but before you start conjuring up bad kung fu movies, understand that we’re not talking about karate. Rather than being an offensive technique, tai chi involves a series of slow, graceful movements repeated in patterns intended to teach defensive actions to physical attack.
In addition to improving balance, strength, flexibility, and cardiovascular and respiratory function, tai chi involves deep breathing, meditation and clearing one’s mind while performing the movements. It has been shown to improve mood and alleviate depression and anxiety.
The physical and mental health advantages of tai chi are why we recommended practicing it for one hour a day two to three times a week as part of our “7 Steps to a Healthier and Happier 2011″. And for people with a rheumatoid condition, this form of exercise can be particularly beneficial.
In his review, Wang summarized the research surrounding tai chi and three rheumatic disorders:
Osteoarthritis (OA), the most prevalent joint disorder, is general “wear-and-tear” arthritis. Joint cartilage breaks down providing less protection when bones rub against each other, resulting is joint inflammation, damage and chronic pain, as well as limited mobility. This is a growing problem among the elderly, and there are few effective treatments. Nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen (the pain reliever found in Tylenol) are the most commonly used medications, but these do little to alleviate pain (lowering it only by about 20%) and can come with some serious side effects. Aerobic and muscle strengthening exercises are commonly recommended for OA sufferers, but evidence suggests they only modestly decrease pain and do not necessarily impact psychological health.
Among the studies Wang cites is one by Hartman and colleagues in which 35 community-dwelling elderly participants were randomly assigned to receive either a one-hour tai chi class twice a week for 12 weeks or the control group, which received usual physical activities and routine care. The results showed that tai chi training significantly improved not only the arthritis symptoms, but also “self-efficacy, level of tension, and satisfaction with general health status.”
Dr. Wang summarizes: “As a complementary mind-body approach, tai chi may be an especially applicable treatment of older adults with OA. The physical component provides exercise consistent with current recommendations for OA (muscle strength, balance, flexibility, and aerobic cardiovascular exercise), and the mental component could address the chronic pain state through effects on psychological well-being, life satisfaction, and perceptions of health. These effects may reduce pain, improve function, and retard disease progression and disability associated with OA.”
Rheumatoid arthritis (RA) is an autoimmune disorder in which the immune system mistakenly attacks the body’s tissues causing joint swelling and deformity, and bone erosion, as well as fevers and fatigue. Cardiovascular complications account for half of all RA deaths, and osteoporosis resulting in bone fractures is another major problem. Disease-modifying anti-rheumatic drugs and biologic agents have been shown to be highly beneficial, but they are expensive.
While Wang notes in his article that existing evidence regarding the effect of tai chi on RA is limited and inconclusive, promising studies show this form of exercise may be beneficial due to its effects on muscle strength, stress reduction, and cardiovascular and bone health, as well as positive effects on mental health.
Fibromyalgia (FM) is a chronic condition causing pain in muscles, ligaments and tendons, sleep problems, functional limitations and a reduced quality of life. The pharmacologic therapies available are associated with side effects, and addiction and tolerance issues. FM sufferers commonly experience psychosocial stress, anxiety and depression. Studies of tai chi and people with FM show improvements in these physical and mental areas, along with discontinued medication use for FM.
To sum up, Wang states: “Overall, despite limited data, previous works have demonstrated that tai chi … may be highly suited to the management of symptoms of common chronic rheumatic conditions by reducing pain and improving physical and psychological health and well-being. Scientific research is under way to learn more about how tai chi affects rheumatic diseases and for which conditions it may be helpful.”
So, if you suffer from a painful rheumatic condition, it may be beneficial for you — both physically and mentally — to try out a tai chi program. Many health clubs offer classes, and if you’re too intimidated to join one right away, there is a wide range of DVD tai chi programs for people of different skill levels available for sale in retail stores and online that you can use to practice at home.
 Wang, Chenchen. “Tai Chi and Rheumatic Diseases.” Rheumatic Disease Clinics of North America. 2011; 37: 19–32.