Is exercise good or bad for arthritis?

Good, when the type and amount fit your joints. The CDC says physical activity can help people with arthritis reduce joint pain and improve function and mood, and NIAMS lists range-of-motion, strengthening, balance and low-impact activities as parts of a well-rounded program for osteoarthritis. Some soreness is normal when you start, and the CDC notes that joint pain from activity should get better over time.

Can physical therapy reverse arthritis?

No. Physical therapy doesn't regrow cartilage or change what an X-ray shows. What it can change is the strength, motion and control around the joint, which affect how much the arthritis limits your walking, stairs and daily tasks.

How is arthritis in the back treated?

Mostly with activity rather than rest. NIAMS notes that osteoarthritis can cause stiffness and pain in the neck or lower back, and its treatment advice includes exercise, weight management and pain relief. Physical therapy for back arthritis usually combines movements that ease your symptoms, trunk and hip strengthening and gradually longer walks, with a physician involved if there's leg weakness, numbness or another warning sign.

Should I use heat or ice for arthritis pain?

Either can help. NIAMS notes that heat increases blood flow, tolerance for pain and flexibility, while cold numbs the nerves around the joint to reduce pain and may relieve inflammation. Use whichever makes it easier to move, and protect your skin with a layer of cloth.

Arthritis Physical Therapy in Buffalo, NY | Lake Erie Physical Therapy

Q: Do I need a referral for arthritis physical therapy?

With most plans, no: New York lets you start physical therapy without a referral for up to 10 visits or 30 days, whichever comes first, though some plans still require one to pay. Medicare doesn't require a referral to start, but your physician certifies the plan of care, and some Medicare Advantage plans need prior authorization. Call us and we'll help you check your plan.

An arthritis diagnosis often comes with an unspoken instruction to take it easy. The evidence points the other way. The Centers for Disease Control and Prevention (CDC) says physical activity can help people with arthritis reduce joint pain and improve function and mood, and that people with arthritis may benefit from seeing a physical therapist when they begin. Arthritis physical therapy at Lake Erie Physical Therapy is built on that idea: find the kind and amount of activity your joints tolerate, then build on it so you can keep doing what matters to you.

Osteoarthritis and the other kinds

Osteoarthritis is the most common type of arthritis. The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) describes it as a disease in which the tissues in the joint break down over time, and adds that this does not happen because of simple wear and tear. It most often affects the hands, knees, hips, neck and lower back. Common signs include:

Pain when you use the joint, which may improve with rest
Stiffness in the morning or after resting, usually lasting less than 30 minutes
Swelling, especially after a lot of activity
A joint that feels loose or unstable

Anyone can get it, but NIAMS notes that it becomes more common with age, is more likely in women, especially after 50, and is linked to past joint injuries or surgery, extra body weight, repetitive overuse and family history. Pain can also lead to fatigue, poor sleep and low mood, which is worth mentioning at your visit.

Rheumatoid arthritis, psoriatic arthritis, gout and other inflammatory types are different. They need a medical diagnosis and treatment, usually from a rheumatologist or your primary care physician. Physical therapy can work alongside that care to keep you strong and moving, but it doesn’t treat the disease itself. The rest of this page is mostly about osteoarthritis.

What arthritis physical therapy looks like

Osteoarthritis physical therapy starts with a one-on-one evaluation of how your joints move and what your days ask of them: the stairs at home, a walk to the store, getting down on the floor with grandkids, nine holes of golf. Then we build a plan around the kinds of exercise NIAMS describes for a well-rounded osteoarthritis program:

Strengthening with weights or exercise bands for the muscles that support the joint
Range-of-motion and stretching work to keep stiff joints limber
Balance and agility exercises that support everyday tasks
Low-impact activity you can keep doing on your own, such as walking, cycling or tai chi

The CDC also lists swimming and water exercise among joint-friendly options. We don’t offer aquatic therapy, but a community pool routine can be part of your home program.

Depending on your joints, treatment may also include hands-on care for stiffness, pain-relieving modalities when indicated, and practice with a cane or walker if you need one; NIAMS notes that devices like these can help you move around safely, provide stability and lower pain. For knees and hips, weight matters too: NIAMS notes that for people who are overweight, losing weight can help reduce pain, prevent more injury and increase mobility in the joints. Our knee pain and hip pain pages go deeper on those joints.

How much to aim for

The CDC recommends that adults with arthritis work toward at least 150 minutes a week of moderate aerobic activity, muscle-strengthening activity on at least 2 days a week, and, for older adults, balance activities as well. You don’t have to start there. The CDC notes that just 5 or 10 minutes at a time is beneficial, and NIAMS advises starting any exercise program slowly and giving yourself time to adjust.

Arthritis in the back and neck

NIAMS notes that osteoarthritis can cause stiffness and pain in the neck or lower back, and that as the spine changes, some people develop spinal stenosis. Imaging shows what the joints look like, not how they respond to movement, so we start with how your back behaves. Using the McKenzie Method of Mechanical Diagnosis and Therapy (MDT), we test repeated movements and positions to find the ones that ease your symptoms, then add trunk and hip strengthening and build up how far you can walk. If walking brings on leg pain that eases when you sit, that can point to stenosis. Our back pain and spine care page explains our spine approach.

Handling flare-ups

Arthritis tends to have good weeks and bad ones. A few principles help:

Expect some soreness when you start. The CDC says it’s normal to have some pain, stiffness or swelling after starting a new physical activity program, and that over time, arthritis joint pain from activity should get better. If it doesn’t, or if symptoms become severe, contact your health care provider.
Scale back rather than stop. On a bad day, try a shorter or easier version of your routine instead of skipping movement altogether.
Use heat or cold for comfort. NIAMS notes that heat increases blood flow, pain tolerance and flexibility, and that cold can numb pain and may relieve inflammation.
Break up repetitive tasks. NIAMS suggests avoiding repetitive motions, such as frequent bending.
Leave with a plan. By the end of care, you should know which exercises calm your joints down and how to adjust activity when they flare.

Talk to a doctor first if

Physical therapy does not replace a medical diagnosis. See a physician before starting therapy, or promptly during it, if:

A joint becomes hot, red and swollen, especially with a fever (seek care the same day, since infection is possible)
One joint swells suddenly and severely without an injury
Several joints are swollen at once, morning stiffness lasts well beyond half an hour, or you also have a rash or feel unwell, which can point to inflammatory arthritis
A joint gives way, locks or looks deformed after a fall or twist
Back pain comes with new leg weakness or numbness, or any change in bladder or bowel control (emergency)
Pain wakes you at night no matter how you lie, or comes with unexplained weight loss or a history of cancer

After discharge

Arthritis is long-term, so your plan has to outlast your visits. You’ll leave with a program you can keep doing at home or at a gym. If you’d rather keep exercising at our clinic, our Keep It Going program costs $10 a visit or $70 a month for unlimited visits. It’s usually not covered by insurance and requires a prescription for maintenance exercise from your referring physician, medical clearance from your family physician and a signed waiver. If you do go on to a joint replacement, we also provide rehab after surgery.

Coverage and getting started

With most plans, you can start physical therapy in New York without a referral for up to 10 visits or 30 days, whichever comes first, though some plans still require one to pay. Medicare doesn’t require a referral to start: we write the plan of care, and your physician, nurse practitioner or physician assistant certifies it. Some Medicare Advantage plans require prior authorization; our Medicare page explains the details.

Looking for arthritis treatment in Buffalo that keeps you moving? Call (716) 332-4838 or request an appointment. We’re at 531 Virginia Street, a short walk from the Allen/Medical Campus Metro Rail station.

Sources

Written by the Lake Erie Physical Therapy clinical team. This page is general information, not a diagnosis; your physical therapist will assess your situation in person.

Physical Therapy for Arthritis