For people with arthritis, life is governed by pain. You may not even realize how much you’ve given up if you’ve been slowly adapting to each progressive “new normal”—each adaptation likely represents a narrower range of what you used to be able to do.

Stephen P. Messier, PhD, director of the J.B. Snow Biomechanics Laboratory at Wake Forest University, led a study to determine what really works for arthritis pain. His conclusion: Exercise—specifically a plan that includes walking and some resistance training.

But what types of exercise really work? That’s what the WE-CAN (Weight-Loss and Exercise for Communities with Arthritis in North Carolina) trial tested. Participants went to community centers for group workouts for 18 months, enough time to make their new routine a permanent habit.

The exercise component: 60-minute sessions three days a week consisting of aerobic walking for 15 minutes…20 minutes of moderate resistance-training for the lower body using weight machines…a second walking phase for 15 minutes…and a cooldown of 10 minutes. Many people think they can’t do resistance training if they have arthritis, but developing the muscles that support joints improves mobility with less pain. In a prior study called START, researchers found that low-intensity workouts with less resistance and more repetitions than high-intensity programs were as effective and easier.

The diet component: In the WE-CAN trial, participants followed a low-­calorie diet—1,100 calories for women and 1,200 calories for men with 15% to 20% protein (at least 1.2 g of protein per kilogram of ideal body weight)…less than 30% fat with less than 10% saturated fat…and 45% to 60% carbohydrates. The control group did not get a diet-and-exercise plan, but both groups received five one-hour nutrition-and-health-­education sessions over 15 months and a phone session every other month.

Results: At the end of 18 months, the exercise-and-diet participants had, on average, a 30% reduction in pain and lost more weight than the control group.

Applying the Lessons Learned

Work with a trainer experienced in resistance training who can personalize a program based on your abilities and challenge you without causing pain. Exercises can be done with free weights and/or machines, starting with a low number of repetitions and building up to three sets of 10 to 15 reps.

Find or create an exercise group, even if it’s just one other person. The group dynamic is important for sticking with an exercise program. To find a group: The Arthritis Foundation (Arthritis.org)…Silver Sneakers (SilverSneakers.com).

Find activities you like. Being active throughout your lifespan happens only when you do exercises you enjoy.

Start slow if needed. When you start walking for fitness, your pain may increase at first. But once you get into the habit, you’ll be able to walk with more ease. Start with five or 10 minutes at a comfortable pace, and build from there.

Back off if you’re having a bad day. Don’t tax yourself during a flare-up, or perhaps replace weights with elastic bands such as Theraband.

Don’t forget your diet. Weight reduction reduces stress on joints, and that translates to less pain.

Other types of body work help, too. Almost any exercise is going to reduce pain by 20% to 25%. To improve flexibility, consider yoga, tai chi and stretching classes.

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