Exercises to manage psoriatic arthritis pain

Share on Pinterest

Moderate exercise can lead to health benefits such as improved endurance and weight loss. Exercise can also help reduce joint pain and stiffness and improve range of motion.

The following exercises may help ease the symptoms associated with PsA.

Tai chi

Tai chi is a form of Chinese martial arts. It focuses on breathing, gentle movements, and meditation. Tai chi may reduce joint pain in people with PsA and help them maintain joint mobility and strength.

While many reports show that people with various types of arthritis see improvements in pain levels and mobility when practicing tai chi, evidence supporting these claims is often low quality or anecdotal.

However, many may still find that practicing tai chi benefits their PsA management.

Yoga

The benefits of yoga include improved strength, mobility, sleep, and mental well-being. As a result, it is a common recommendation for treating many arthritic conditions.

For example, a 2019 review concluded that yoga may improve pain and flexibility in people with knee osteoarthritis. A 2018 review also had similar findings.

There is a lack of direct evidence on the efficacy of yoga for PsA, but it still may benefit many with the condition. Talking with a doctor before starting new exercise regimes is important.

Walking

Walking is a low impact aerobic activity that may help people with PsA. Walking can help build strength, improve joint mobility, and provide a light cardio workout.

If PsA affects the knees, feet, or ankles, a person should talk with their doctor about shoe inserts or other walking aids to reduce stress on the affected joints.

Swimming

Swimming provides a full-body workout. It can improve joint stiffness and relax the muscles.

Swimming is also low impact, meaning a person can work out without putting stress on their joints.

Resistance training

Lifting weights can help improve muscle strength and support strong joints. A person should plan to have 2–3 days per week of weight training.

Individuals can use isometric holds if their joints are painful. An isometric hold works the muscle without moving the joint.

Maintaining mobility is a key consideration of PsA treatment.

Stretching can help keep joints mobile and strengthen the muscles that support them. While all stretching will in some way be beneficial, people may wish to focus on areas of particular PsA symptoms. Working with a physical therapist can be beneficial in developing an effective stretching regime.

Stretches that can help manage PsA symptoms include:

Fingers and hand stretches

Stretches that may help strengthen hand muscles include:

• Fist clenches: Spread the fingers and thumbs as far as they will go and hold. Now, ball the hands and clench as hard as possible. Release and repeat.
• Single-finger pinching: Spread the fingers and, starting with the first finger, pinch into the thumb one at a time. Repeat for all fingers and on both hands.
• Wrist rotations: With the hands balled, slowly rotate the wrists in a circular motion and repeat in the other direction. Stretching the clenched fist in a vertical and horizontal plane can also help.
• Wrist flexion and extension stretch: Hold both hands out in front, with palms facing downward. Gently clasp the back of one hand across the knuckles and pull it downward, flexing at the wrist. Return to the starting position, and grasp the palm of the target hand. Pull it upward and back toward the body, hold, release gently, and repeat on the other hand.

Foot and leg stretches

Arthritis symptoms are common in the feet, ankles, and knees. Stiffness and weakness in these joints can greatly impede mobility. The following stretches and movements can help to strengthen these joints.

• Toe clenches: While sitting down or lying with the weight off the feet, splay the toes as far as comfortable and clench them as tight as possible. Repeat to stretch the small joints in the toes and muscles throughout the foot.
• Toe extension: Sit comfortably with feet on the floor, pick up one foot and cross it across the knee of the other leg. Hold onto the heel of the foot with one hand and the toes with the other. Gently extend the toes backward toward the ankle until feeling a stretch. Repeat with the other foot.
• Ankle extension: Sat comfortably in a chair, lift one foot onto the thigh of the other leg. Gently grasp the underside of the forefoot and flex at the ankle joint. Pull the forefoot up toward the shin until feeling a gentle stretch in the back of the ankle and calf muscle. Now, push the foot away from the shin until feeling a gentle stretch across the top and front of the ankle. Repeat on the other leg.
• Ankle rotation: Sitting comfortably in a chair, slowly lift one foot off the floor. Point the foot and toes straight, and slowly rotate the whole foot in a circular motion, moving at the ankle joint. Repeat this rotation clockwise and counterclockwise. Repeat with the other foot.
• Calf stretch: Stand about one foot from a wall, facing it. Place both palms on it around shoulder height and step one foot backward, keeping it straight and slightly bending the knee of the front leg. Keeping both heels firmly on the ground, lean into the wall until feeling a stretch down the calf and ankle of the rear foot. Return to standing and repeat on the other leg.
• Seated leg raise: Sitting comfortably in a chair, with both feet on the floor, slowly raise one leg straight in front, bending at the knee. Hold the leg straight for as long as is comfortable and slowly lower it. Repeat multiple times on each leg to help stretch out and strengthen knee ligaments. Repeat on both sides.
• Sit/stands: Sitting comfortably on a chair, standing up without using the hands for support. Once standing, slowly sit back down again without using the hands for support. This can help to stretch and strengthen muscles in the hips, lower back, knees, and ankles.

Back and neck stretches

The neck and back are common sites of muscle tightness in many people. Arthritic conditions can impact the joints in this area and worsen symptoms. The following stretches may help improve back and neck health.

• Knee to chest: Start by lying flat on the back, with knees bent and both feet flat on the floor. Gently clasp both hands behind one knee and slowly bring it up toward the chest. Feel the stretch in the glutes and lower back, hold, and release. Repeat on the other side.
• Trunk rotation: Sitting comfortably in a chair, crossing the arms at chest level, resting the palms on the opposite shoulder. Slowly rotate the torso to one side to create a stretch through the lower back and obliques. Return to the start position and repeat on the other side.
• Shoulder blade squeezes: Sit or stand comfortably with arms loose by the sides. Keeping the shoulders level, squeeze the shoulder blades together and hold. Release and repeat.
• Shoulder rolls: Sit or stand comfortably with the arms hanging loose by the side of the body. Focusing on moving the shoulder blades only, bring the shoulder up and back toward the ears in an arc. Follow this arc with the shoulder blades to bring the shoulders down, circling forward, and up to the starting position.
• Chin tucks: Start by standing or sitting comfortably with the arms by the sides. While looking straight ahead, slowly bring the chin and head down as if nodding. Continue to pull the chin back into the upper chest and hold.
• Neck rolls and rotation: When sitting or standing comfortably, gently rolling the head clockwise or counterclockwise can help stretch the joints around the neck and upper back. Slowly rotating side to side, or up and down can also help.

Certain exercises can worsen PsA symptoms.

For example, exercises that stress the joints can lead to additional pain or stiffness. These exercises include running, high intensity interval training, or playing a high impact sport.

A person should stop doing any exercise that causes their symptoms to get worse. A healthcare provider or personal trainer can recommend safe, alternative routines that will not aggravate a person’s symptoms.

PsA can affect the hands and feet, causing stiff joints, pain, and swelling. There are several steps a person can take at home to help relieve pain in these areas, especially while exercising.

For example, taking good care of the hands and feet can help prevent extra discomfort. Try the following tips before or after exercising:

• Use a foam roller to massage the wrists and arches of the feet.
• Wear gloves to prevent nail damage.
• Massage any stiff joints.
• Take breaks when exercising and rest frequently when walking long distances.
• Use cold or hot compresses to reduce swelling or pain.
• Regularly stretch the feet and legs.
• Use inserts to help alleviate pain from walking.
• Get proper footwear that provides support, stability, and space for swelling.
• Soak the hands and feet for short periods to alleviate joint pain, and use moisturizer afterward to prevent the skin from drying out.

Light-to-moderate exercise can help a person stay healthy. It also provides some relief from joint stiffness and inflammation. However, people with PsA should avoid any exercise that puts additional stress on the joints.

Both low impact cardio workouts, such as swimming or walking, and resistance training can help a person gain the benefits of exercise and prevent pain.

Making lifestyle changes, such as taking better care of the hands and feet, can also help.