The Role of Diet and Exercise in Arthritis Management

In the UK, around 10 million people have arthritis. It affects people of all ages, including children. 

What is Arthritis and its Challenges

Arthritis is the swelling and tenderness of one or more joints. The main symptoms of arthritis are joint pain and joint stiffness, which typically get worse with age. Other symptoms of arthritis can include:

• Restricted movement of the joints
• Inflammation in and around the joints.
• Warm to touch, red skin over and around the affected joints.
• Weakness in the muscles.
• Fatigue due to the chronic pain and inflammation.

Symptoms can also vary depending on the type of arthritis. 

There are two most common types of arthritis. Osteoarthritis is the most common type of arthritis in the UK, affecting around 8 million people. It most often develops in adults who are older than 45. It is also more common in women and people who have a family history of the condition. Osteoarthritis affects the smooth cartilage lining of the joint which can make movement more difficult than usual, which can lead to pain and stiffness. The tendons and ligaments usually have to work harder as a result of the condition and this can cause swelling and the formation of bony spurs, called osteophytes. If the condition causes a severe loss of cartilage, this can cause the bones to rub together which can alter the shape of the joint and force the bones out of their normal position. The joints which are usually most commonly affected by this condition are:

• Hips
• Hands
• Spine
• Knees

Rheumatoid arthritis is the other common type of arthritis and is slightly different in that it occurs when the body’s immune system targets affected joints, which leads to pain and swelling. The outer covering of the joint is usually the first place affected and then this can spread across the joint, leading to further swelling and a change in the joint’s shape. This may eventually cause the bone and cartilage to break down. Rheumatoid arthritis affects more than 400,000 people in the UK. It often starts when a person is between 40 and 50 years old and women are three times more likely to be affected than men. 

Other types of arthritis include:

• Fibromyalgia – this causes pain in the muscles, ligaments and tendons.
• Ankylosing spondylitis – this mainly affects the bones, muscles and ligaments in the spine, which can lead to stiffness and joints fusing together.
• Cervical spondylosis – also known as degenerative osteoarthritis, cervical spondylitis affects the joints and bones in the neck, which can lead to pain and stiffness.
• Lupus – this is an autoimmune condition. It can affect the body’s organs and tissues.
• Gout – this is a type of arthritis caused by too much uric acid in the body. It can cause pain, redness and swelling.
• Psoriatic arthritis – this is an inflammatory joint condition that can affect people who have psoriasis.
• Enteropathic arthritis – this is associated with inflammatory bowel disease (IBD), including ulcerative colitis and Crohn’s disease.
• Polymyalgia rheumatica – this usually affects people who are over 50 years of age. It is where the immune system causes muscle pain and stiffness.
• Secondary arthritis – a type of arthritis that can develop after a joint injury and sometimes occurs many years afterwards.
• Reactive arthritis – this can cause inflammation of the joints, eyes and urethra. It develops after an infection of the bowel or genital tract or, occasionally, after a throat infection. Occurring in just 1 in 1,000 adults worldwide, it is unlike other forms of arthritis; reactive arthritis is short term, with most people recovering within six months.

Although arthritis is often associated with older people, it can also affect children. In the UK, about 15,000 children and young people are affected by arthritis. Arthritis in children is usually known as juvenile idiopathic arthritis (JIA). The exact cause in children is not really known; however, symptoms usually improve as they get older. 

Diet and Arthritis

Having a consistently healthy diet has many benefits, including building strong bones, protecting your heart health, preventing disease, and boosting your mood. Eating a healthy diet provides the necessary nutrients that your body needs in order to create new cells, clear out toxins and have the energy needed to keep you generally fit and healthy. 

When thinking about the symptoms of arthritis, there are several foods that have been associated with fighting inflammation and improving joint pain and other associated symptoms. While diet alone may not cure arthritis, certain dietary choices can help to reduce inflammation, manage weight, and improve overall joint health. 

Some things to consider as part of a healthy diet if you have arthritis include:

• Omega-3 fatty acids – foods rich in omega-3 fatty acids, such as fatty fish including salmon, mackerel, sardines, flaxseeds, chia seeds and walnuts, have anti-inflammatory properties. Including these regularly in your diet may help to reduce joint pain and stiffness.
• To reduce inflammation – certain foods can either contribute to inflammation or help in reducing it. Inflammatory foods include those high in saturated fats, refined sugars and processed carbohydrates. Fruits, vegetables, whole grains, nuts and fatty fish can help to manage and reduce inflammation.
• Antioxidants – antioxidants found in fruits and vegetables can help neutralise free radicals that contribute to inflammation. Colourful fruits and vegetables, such as berries, cherries, spinach and kale, are rich in antioxidants.
• Vitamin D and calcium – these nutrients are important for bone health. Vitamin D helps the body to absorb calcium. This is important for maintaining strong bones. Foods like fatty fish, fortified dairy products and leafy green vegetables are also good sources.
• Weight management – maintaining a healthy weight is crucial for people with arthritis, especially people with osteoarthritis. Excess body weight can put additional stress on joints, leading to increased pain and inflammation. A balanced diet that supports weight management is beneficial for everyone, particularly in managing arthritis.
• Avoiding certain foods – including ultra-processed foods, red meat, dairy, and foods high in purines.
• Maintaining good levels of hydration – staying well-hydrated is important for overall health and can help to keep joints lubricated.

It may be useful to work with a registered dietitian in order to create a personalised dietary plan that suits your specific health needs. They can also help to monitor for any nutrient deficiencies that may arise from dietary restrictions or changes. For further reading about the importance of healthy eating, please see our knowledge base. 

Exercise and Arthritis

Regular exercise is one of the most important things you can do for your health. Being physically active can improve your brain health, help manage your weight, reduce the risk of developing disease, strengthen your bones and muscles, and generally improve your ability to do everyday activities. Physical activity also has many well-established mental health benefits. Aerobic exercises, including jogging, swimming, dancing, cycling, walking and gardening, have been proven to reduce anxiety and depression. This link between physical exercise and mental health is important when living with any chronic condition. 

While some people may worry that exercising could harm your joints and cause more pain if you have arthritis, research shows that people can and should exercise when they have arthritis. Exercise is actually considered to be one of the most effective forms of treatment for reducing pain and improving movement in patients with arthritis.

When managing a condition like arthritis, it can be useful to engage in regular exercise. Regular exercise can help to:

• Improve joint function – exercise can help to maintain and improve joint function by keeping the muscles around the joints strong and flexible.
• Maintain a healthy weight – maintaining a healthy weight is important for people with arthritis. Exercise can help in managing weight, which can reduce the strain on the joints.
• Reduce pain – regular physical activity can reduce joint pain and stiffness. It can also help in improving overall well-being and reducing stress, which can also be helpful for managing chronic pain.
• Improve muscle strength – strengthening muscles can help as this provides better support to the joints, helping to reduce the strain put upon them. This is particularly important for people with arthritis.
• Improve balance and coordination – certain types of exercise, such as balance and coordination exercises, can help improve stability and reduce the risk of accidents and falls.
• Improve mood and mental health – exercise has been shown to have positive effects on mood and mental well-being. This is important for people dealing with chronic conditions like arthritis.
• Improve sleep – getting regular good quality sleep also has many health benefits and is helpful when living with a chronic condition like arthritis.

Types of Exercise for Arthritis

Walking and aquatic exercises are particularly good for most people with arthritis as this type of exercise does not put much strain on the joints. Exercises that help to maintain and improve muscle strength can support and protect joints that are affected by arthritis. 

Aquatic exercises are done while standing in water. The water’s buoyancy helps to relieve the pressure of your body’s weight on the joints. It is particularly helpful when the hips and knees are affected. 

Examples of exercise that can be good if you have arthritis include:

• Cycling – this is another form of exercise which places minimal strain on the joints.
• Swimming – the buoyancy while exercising in water reduces the impact on the joints while also strengthening the muscles.
• Yoga – this focuses on stretching, strength and balance, helping with joint flexibility and reducing stiffness.
• Tai Chi – this Chinese martial art involves slow, gentle movements that can also help improve balance and flexibility.
• Chi Me – this is a gentle exercise technique that can be practised in either standing or sitting positions. It is Tai Chi influenced and is a simple and relaxing way to develop better flexibility and muscle strength.
• Light weights – this strengthens muscles around the joints without putting too much strain on them.
• Stretching – gentle stretching exercises can help maintain or improve flexibility in the joints.
• Golf – this activity involves a lot of walking on the golf course and the swinging motion of playing the game can be beneficial.

The NHS offers tools, tips and special offers as an incentive to encourage people to move more every day. 

Building an Arthritis-Friendly Diet

Building an arthritis-friendly diet means choosing foods that reduce inflammation and support joint health and general gut-friendly foods that support immune health. Examples of anti-inflammatory foods are:

• Oily fish – this is food rich in omega-3 fatty acids, which have anti-inflammatory properties. Examples of these include salmon, mackerel and trout.
• Lean protein – such as poultry, fish, tofu and legumes, can help support muscle health without contributing to inflammation.
• Olive oil – extra virgin olive oil contains monounsaturated fats and anti-inflammatory compounds.
• Nuts and seeds – almonds, walnuts, flaxseeds and chia seeds are also good sources of omega-3 and therefore have anti-inflammatory properties.
• Turmeric and ginger – these spices have natural anti-inflammatory properties.
• Colourful fruits and vegetables – these are rich in antioxidants and also have anti-inflammatory properties. Berries, cherries, spinach, kale, broccoli and bell peppers are all good choices.
• Whole grains – brown rice, quinoa and wholewheat provide fibre and nutrients.

Foods to avoid include:

• Saturated fats found in red meat, full-fat dairy and fried foods.
• Trans fats which are often found in processed and packaged foods.
• Added sugars can contribute to inflammation.
• Excessive alcohol intake can contribute to inflammation.

You should also drink plenty of water to keep your body hydrated as water helps with joint lubrication. You could also consider taking a vitamin supplement if you feel that your diet alone is not adequate enough. The UK government recommends that all adults and children aged 5 years and over should take a daily 10 microgram vitamin D supplement during the autumn and winter months.

Starting an Exercise Routine

If you are living with arthritis and thinking about starting an exercise routine, it is important for you to speak to your healthcare provider before you begin any new activity. 

You should then:

• Choose an activity which is low impact on the joints.
• Start slowly and gradually increase what you do.
• Consider joint flexibility exercises.
• Consider doing strengthening exercises.
• Consider working with a trainer so that you can learn the correct techniques.
• Be consistent in your exercise routine.

The Importance of Balance

It is important to strike a good balance between diet and exercise in arthritis management. Both are as important as each other and should be prioritised as such. It is important to pay attention to how your body responds to different foods and exercises and adjust your routine accordingly. Everybody is different and what works for one person may not work for another person. There may be some trial and error involved in the process; listen to your body and if something isn’t working, you can always try something else.

Versus Arthritis provides support and other services for people with arthritis in England. Their aim is to make sure that people with arthritis have all the support and information they need to live the fullest life possible with their condition.