Why exercise is exhausting for people with arthritis – 04/27/2023 – Equilibrium

Exercise can feel more difficult and draining than usual if you have rheumatoid arthritis, and not just because of the stiff and painful joints caused by this autoimmune disorder.

In an experiment involving elderly women and exercise, researchers found that even a gentle session of leg raises triggers an overreaction of the nervous system in those with rheumatoid arthritis. Light exercise also negatively affected the inner workings of your muscles and blood vessels.

The results build on previous research on rheumatoid arthritis and the nervous system and raise pressing questions about the best and safest ways that people with this disorder or similar autoimmune diseases can become and stay active.

Anyone who has rheumatoid arthritis or lives with someone who has the disease knows the damage it does to the body. Immune cells mistakenly attack healthy tissue, especially in the joints, causing swelling, pain and deterioration, as well as inflammation and fatigue throughout the body. The disease also often results in cardiovascular disease, which initially baffled doctors since the misguided immune cells do not directly target the heart or arteries.

In recent years, however, researchers have discovered that people with rheumatoid arthritis tend to have unusually reactive sympathetic nervous systems. This system is the part of our internal organism that activates the fight-or-flight response, biochemically alerting our brain, heart, muscles, and other bodily systems to prepare for imminent danger. The opposite parasympathetic nervous system reassures us by sending signals that calm sympathetic disturbances.

In patients with rheumatoid arthritis, however, researchers have found that the sympathetic system appears to be paralyzed, keeping people’s internal operations constantly on edge. The result is a high risk of hypertension and elevated heart rate, even when people are resting peacefully, which eventually contributes to cardiovascular disease.

Few of these earlier studies, however, looked at exercise, which also raises blood pressure and heart rate and alters nervous system responses. Some – and considerable anecdotal evidence – has indicated that people with rheumatoid arthritis experience more fatigue during and after activity than other exercisers. Heart rate and blood pressure also stay elevated longer after workouts.

If you’ve been diagnosed with rheumatoid arthritis, talk to your doctor or an exercise physiologist about the best way to exercise, says Hamilton Roschel, one of the authors of the study and director of the Laboratory for Evaluation and Conditioning in Rheumatology at USP (University of São Paul). And if you want to start a new routine, start slowly and maybe keep a log of how you feel during your workouts.

Of course, the study cited at the beginning of the text focused on elderly women with rheumatoid arthritis and a single session of very light resistance training. It’s not known whether the results apply equally to younger women or men with the condition, or whether other types of exercise, such as walking, might produce a similar response.

Translated by Luiz Roberto M. Gonçalves