The Best Exercises for People with Psoriatic Arthritis

There’s a myth that exercise can make joint conditions such as PsA worse. But the opposite is true — getting active can actually help reduce inflammation throughout your body and reduce your symptoms.

If you have psoriatic arthritis (PsA), you can increase your fitness just like someone who doesn’t have the condition — and get all the benefits that come with it. And your risk of joint inflammation and flares is low.

Here’s why exercise is especially important when you have PsA — and how to do it while protecting your joints.

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Why exercise is important for people with PsA

Fatigue in PsA can be difficult because it can prevent you from exercising. Ironically, exercising can actually decrease fatigue over time.

One review article from 2021 notes that exercising when you have PsA may improve your quality of life and reduce your pain and fatigue.

Exercising when you have PsA may also help:

• improve your range of motion
• increase your strength
• reduce your disease activity

If you have overweight or obesity, reducing your body fat through a combination of exercise and dietary changes may also help reduce your disease activity, according to research.

Additionally, exercise — especially resistance training — may help build or maintain your bone mineral density, contributing to prevention of osteoporosis.

Research shows that people with PsA may be more likely to have lower bone mineral density and may be at higher risk of osteoporosis and fractures, mainly due to the effects of medications for PsA.

The best types of exercises for people with PsA

Many types of exercise can be appropriate for you if you have PsA. More research is needed to find out which types of exercise work best for PsA, but many types can have benefits.

Just make sure the exercise you’re doing doesn’t cause pain in joints that are already inflamed.

Aerobic exercise

Aerobic exercise, also known as endurance exercise or cardio, is any type of physical activity that increases your breathing and heart rate, according to the American Heart Association.

Aerobic exercise can be great when you have PsA because it helps reduce pain, fatigue, disease activity, and the risk of related heart issues. It can also improve quality of life, according to one review of 13 studies.

If you’re experiencing chronic joint pain and fatigue, you may need to start with low impact exercise that’s gentle on your joints.

The National Psoriasis Foundation recommends these forms of exercise for people with PsA:

• walking — anything from a quick walk around the block to an epic hike
• indoor or outdoor cycling
• yoga
• tai chi
• swimming
• exercising in warm water

Higher intensity endurance activities, such as running and high intensity interval training (HIIT), can have major benefits if you’re able to do them.

One small 2019 study found that people with PsA who did HIIT for 11 weeks had significantly less fatigue at the end of the study period, with no increase in pain.

Whatever your speed, make sure to wear a comfortable pair of running shoes and insoles if a healthcare professional has recommended them.

Resistance training

Resistance training, also called strength exercise or weight training, helps increase and maintain your muscle mass.

Research suggests that it also has a host of other benefits for older adults, including helping to maintain bone density, reduce frailty, and improve blood sugar regulation.

When you have PsA, building your muscles with resistance training can help reduce the work your joints have to do.

You can use free weights, weight machines, resistance bands, or your own body weight. One example is strengthening exercises such as pushups.

Here are some therapeutic strengthening exercises for your joints from the Psoriasis and Psoriatic Arthritis Alliance:

• For your fingers and hands: Place your palms on a table or counter, then lift each finger, one by one. Repeat 5 times.
• For your lower back: Lie on your back with your knees bent and your hands on your stomach. Tighten your abs and lift your buttocks. Hold for 10 seconds, and then lower back to the floor. Repeat 10 times.
• For your toes: Wiggle your toes. Repeat 10 times.

Flexibility training

Also called stretching, flexibility training can help you stay limber and maintain or improve the range of motion of your joints.

Here are some therapeutic flexibility exercises for your joints from the Psoriasis and Psoriatic Arthritis Alliance:

• For your neck: While sitting upright in a chair, turn your head to one side and hold for 10 seconds as you feel a stretch. Then turn your head to the other side and hold the stretch for 10 seconds. Repeat 5 times.
• For your feet and ankles: Lift your feet off the floor and rotate your ankles in one direction, drawing circles in the air with your toes. Then change direction. Repeat 10 times.
• For your jaw: Open your mouth as wide as it will go. Hold for 5 seconds. Close your mouth and relax. Repeat 5 times.

The Canadian Association of Psoriasis Patients recommends finding times to stretch throughout the day. For example, you can stretch while you’re watching TV or take conscious stretch breaks during your workday.

Tips for exercising with psoriatic arthritis

Here are a few things to consider when you’re planning your exercise routine with PsA:

• Aim to exercise at least three times per week: The Psoriasis and Psoriatic Arthritis Alliance recommends this frequency for both strength and cardio exercise. But make sure to modify exercises if you’re experiencing joint pain.
• Make it fun whenever possible: Enjoy the great outdoors, work out to music you love, or get active with friends.
• Take steps to stay motivated: Mark down every day you exercise on a calendar. Invite friends to join you regularly. Consider joining a class.
• Start slowly if you feel fatigued: Exercise can reduce your fatigue in the long run, but feeling fatigued can deter you from getting started. It can help to start with short, gentle bouts of exercise such as daily walks or bike rides.
• Something is better than nothing: Especially on days when you’re experiencing flares, pain, fatigue, or all of the above, you might not feel like doing any exercise. But simply walking for a few minutes can go a long way toward helping you keep up your movement routine and boost those endorphins (your body’s natural feel-good chemicals).
• Listen to your body: It’s normal to feel a bit sore when you’re new to exercising. But if you feel sharp pain or significant discomfort, consider choosing a different activity or starting more slowly.
• If an exercise becomes easy, consider taking on more challenges: If you’re getting used to an activity and it isn’t making you break as much of a sweat as it used to, you may be ready to tackle a bigger challenge.
• Modify as necessary: You’ll want to avoid using some joints when they hurt. But if you’re used to using them for your regular exercise, it can be helpful to have alternative activities ready.
• Talk with your doctor or a physical therapist: They can recommend exercises and a regimen tailored to your needs. They can also tell you which exercises to avoid or modify.

What to avoid when exercising with PsA

If a joint hurts, the Psoriasis and Psoriatic Arthritis Alliance recommends modifying your exercise to go easy on that joint. Otherwise, you may end up causing more injury.

For instance, on a day when you’re experiencing knee pain, you may want to go swimming instead of taking a walk.

Remember, while it’s normal for stretching to lead to mild joint aches and for lifting weights to cause some muscle soreness afterward, exercise should not ever cause sharp or severe pain. If you experience acute pain, stop the exercise right away.

Avoid strength training if the joints you’re using are hot to the touch. And speak with the doctor who treats your PsA or a physical therapist for personalized exercise modifications.

Post-exercise care and recovery

Cooling down after exercise with stretching, walking, or other gentle movement can help you avoid feeling sore or stiff the next day.

The Canadian Association of Psoriasis Patients recommends that people with PsA spend 5–15 minutes cooling down after a workout.

Depending on the exercise, you may find that areas of your skin experiencing flares are getting dry or irritated, such as after going to the pool. Applying a barrier cream before exercising and after showering can help if you’re feeling dry.

If you’re experiencing heat and inflammation in your joints, it may help to apply a cold pack for about 10 minutes every 2 hours.

Massage may also help if you’re feeling stiffness after exercise or in the morning.

Takeaway

Exercise can seriously help with your PsA. It can improve your overall health and may help reduce your disease activity, fatigue, and risk of related conditions such as cardiovascular disease.

If you haven’t been active for a while, start slowly and try to get in a bit of movement every day. Take it slow and gradually increase the time and intensity you spend on exercise. Your joints will thank you.