Exercises for Psoriatic Arthritis

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Psoriatic arthritis (PsA) is a systemic type of arthritis that develops in some people with psoriasis, a skin disorder that causes red, itchy scaly patches called plaques. Psoriatic arthritis causes joints to become inflamed, painful, and stiff. Regular exercise can help improve your joint mobility, range of motion, and strength to help manage symptoms and decrease physical limitations.

An illustration of a person walking to represent cardiovascular exercise, a person lifting small weights for strength training and a person stretching since they are the best the exercise practices for people who have psoriatic arthritis.

Illustration by Michela Buttignol for Verywell Health

How Exercising Helps Psoriatic Arthritis

When you have psoriatic arthritis, your immune system attacks healthy cells in your body, causing joints to become inflamed, swollen, painful, stiff, and difficult to move. Approximately 30% of people with psoriasis will develop psoriatic arthritis.

Without proper treatment, psoriatic arthritis can progress and potentially cause permanent joint damage and disability.

Common Joints Affected by Psoriatic Arthritis

The joints most affected by psoriatic arthritis are the fingers, feet, spine, and knees.

An early diagnosis of psoriatic arthritis and the initiation of treatment are important for improving the long-term outcomes of the disease.

Psoriatic arthritis treated with medication to help manage inflammation and autoimmune response. In addition to medication, regular exercise can be beneficial to maintain proper joint function, decrease pain and stiffness, and improve strength.

According to the 2018 treatment guidelines from the American College of Rheumatology and the National Psoriasis Foundation, people with psoriatic arthritis are advised to partake in some form of exercise to improve physical functioning and quality of life.

The guidelines from the European League Against Rheumatism (EULAR) also recommend regular physical activity for people with inflammatory forms of arthritis, including psoriatic arthritis, divided into the domains of cardiovascular fitness, strength training, and flexibility exercises.

What to Do

People with psoriatic arthritis can benefit from a variety of exercises that target different domains of physical fitness.

Types of Exercises

Types of exercises to explore to help manage psoriatic arthritis include:

  • Cardiovascular fitness: Cardiovascular activity is important for keeping your heart healthy and maintaining proper circulation. Cardiovascular activity can also help decrease inflammation throughout your body. Research suggests that people who are overweight have a decreased response to medication for psoriatic arthritis. Also, people with psoriatic arthritis are often at an increased risk for comorbidities (the occurrence of other diseases). Comorbidities include heart disease, heart attack (blockage of blood flow to your heart), and stroke (blockage or rupture of blood flow to your brain). Regular cardiovascular activity can help decrease your risk of developing these conditions and help you maintain a healthy weight to increase the effectiveness of your medication.
  • Strength training: Strength training is important for maintaining proper muscle balance and functional strength needed to support your joints. With any form of arthritis, strengthening the muscles surrounding your affected joints can help offload pressure on the joints. As a result, your muscles absorb more shock and force, reducing joint irritation and pain.
  • Stretching: Stretching can help improve your flexibility and joint mobility to decrease joint pain and stiffness. Aim to hold stretches for 30–60 seconds and repeat at least three times.

High vs. Low Impact

Opt for low-impact exercises such as walking and swimming rather than high-impact ones like running. High-impact workouts can cause repetitive stress on the spine and weight-bearing joints like the hips and knees.

When participating in strength training, always start with light weights and gradually increase the weight over time as you build up strength.

Exercise Tips

Regular exercise is important for everyone to stay healthy and promote optimal physical functioning. Yet, many people might find exercising unenjoyable or time-consuming. It's important to remember that exercising comes in many different forms and that getting some physical activity is always better than none at all.

The following suggestions can help make exercise easier to fit into your lifestyle:

  • Start small: While 30 minutes or more of physical activity every day is ideal, you can start in smaller increments. Begin with 10 minutes a day and increase your time as you adjust to the activity.
  • Keep it simple: Exercising doesn't have to be complicated. One of the most basic exercises that can benefit everyone is walking. Take advantage of getting outside and breathing in the fresh air.
  • Change it up: Exercise can become repetitive and boring over time without variety. Try different types of exercises that work on your strength, flexibility, and cardiovascular fitness.
  • Make it social: Exercising is often more enjoyable when you engage with others. Having friends or family members participate in physical activity with you can also help keep you motivated to maintain a regular routine. 

What to Avoid

Because psoriatic arthritis is an inflammatory condition that affects your joints, it's best to avoid activities that might stress your joints to minimize further joint inflammation and pain. High-impact activities that may have the potential to worsen symptoms of psoriatic arthritis include running and jumping.

While you may feel fatigued or sore after exercising, you shouldn't experience significant pain or increased joint swelling. If you do, it's a sign that you may have pushed yourself too hard. Rest until these symptoms subside.

When starting a new physical activity or increasing the amount of exercise in your routine, adjustments should be made gradually. This will allow your body to acclimate to the change without causing too much stress to your joints and muscles.

Should I Exercise During a Flare?

Exercise should be stopped in the event of a psoriatic arthritis flare-up. During these periods, joint pain, inflammation, and swelling may be significantly increased. Rest is most important during a flare to help decrease systemic inflammation.

Summary

Psoriatic arthritis is treated with medication to help manage inflammation and autoimmune response. In addition to medication, regular exercise can be beneficial to manage symptoms and improve your overall health.

Opt for low-impact exercises such as walking and swimming rather than high-impact ones like running. When starting a new physical activity or increasing the amount of exercise in your routine, adjustments should be made gradually.

To help motivate you, make working out a social activity by asking friends to join. Switch up your workouts to keep them engaging. You can keep it simple, with a walk outside or bike ride around your neighborhood.

Exercise should be stopped in the event of a psoriatic arthritis flare-up.

A Word From Verywell

If you're living with psoriatic arthritis, healthy lifestyle habits like regular exercise can help decrease inflammation, joint pain, and stiffness. Adding physical activity to your daily routine can also help slow disease progression and increase your responsiveness to treatment.

By taking a proactive approach to the management of your psoriatic arthritis, you can set yourself up for better long-term outcomes and improved quality of life.

Frequently Asked Questions

  • What exercises are best for psoriatic arthritis?

    A variety of stretches, strengthening, and cardiovascular exercises are best for managing symptoms of psoriatic arthritis.

  • What exercises should you avoid with psoriatic arthritis?

    High-impact activities that place repetitive stress on joints, such as running and jumping, are best avoided with psoriatic arthritis.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Psoriasis Foundation. About psoriatic arthritis.

  2. Dhir V, Aggarwal A. Psoriatic arthritis: a critical reviewClin Rev Allergy Immunol. 2013;44(2):141-148. doi:10.1007/s12016-012-8302-6

  3. Singh JA, et al. 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. Arthritis Rheumatol. 2019 Jan;71(1):5-32. doi: 10.1002/art.40726. 

  4. Rausch Osthoff AK, Niedermann K, Braun J, et al. 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Ann Rheum Dis. 2018;77(9):1251–1260. doi: 10.1136/annrheumdis-2018-213585

  5. Perrotta FM, Scriffignano S, Benfaremo D, Ronga M, Luchetti MM, Lubrano E. New Insights in Physical Therapy and Rehabilitation in Psoriatic Arthritis: A Review. Rheumatol Ther. 2021;8(2):639-649. doi:10.1007/s40744-021-00298-9

Kristen

By Kristen Gasnick, PT, DPT
Kristen Gasnick, PT, DPT, is a medical writer and a physical therapist at Holy Name Medical Center in New Jersey.