Exercise with rheumatic disease: recommendations, safety and getting started

People with rheumatic disease have the same need to be active as everyone else. NHI writes that more movement and less sitting can give lower disease activity and better function, fitness and quality of life [1].

In an interview with NHI, an exercise physiologist refers to studies in which exercise did not worsen pain. The studies suggest that exercise can reduce pain and fatigue, and that disease activity and inflammation markers stay unchanged or improve [2]. This describes what research has shown so far, and is not a guarantee of how it will go for the individual.

For fitness, the advice is 150 to 300 minutes of moderate activity a week, or 75 to 150 minutes of vigorous activity, or a combination. Exercises for the large muscle groups are recommended at least two days a week, and regular exercises for mobility, balance and coordination should be added [1].

If you cannot reach those levels, the advice is to be as active as your health and ability allow. Short sessions several times a day count as well [1]. NHI also describes high-intensity training, and stresses that the load is built up gradually and that the aim is not to train to exhaustion [2].

The usual recommendations are regarded as safe, and more intensive exercise is safe if it is adapted to disease activity and how you feel on the day. Studies have not found harmful effects on disease activity. Common side effects are mild and pass, for example tiredness and muscle soreness [1].

NHI describes a 24-hour rule: if pain after a session lasts more than a day, you should adjust the intensity or choose a different type of exercise [1]. Some people fear that exercise will make the disease worse. The physiologist in the NHI interview believes this fear often rests on misunderstandings about what exercise involves [2].

NHI recommends starting where you are and increasing gradually. All movement counts, and the day can be broken up by standing more often, taking the stairs or going for short walks. Concrete goals, for example the number of steps or sessions per week, can make it easier to keep track, and activity watches and apps can be used as support [1].

The plan should be made together with you and adapted to goals, resources, finances and the challenges of the disease. A physiotherapist or others with expertise in rheumatic disease can help adjust how often, how hard, how long and what kind of exercise you do [1].

There are no general bans on activity during a flare, but intensity and type must be adapted. If joints are very painful or swollen, you should avoid heavy loading of those particular joints, while other parts of the body can be trained [1].

Gentle movements and short, easy walks can often be done and may prevent stiffness [1].

NHI writes that all clinicians should talk with you about activity, and that the level can be assessed together with a doctor or other health personnel [1]. If you are unsure how much you can exercise, or whether pain and swelling are caused by disease activity, there is reason to raise it with a doctor or physiotherapist [1].

Dr.Dropin is a supplement to the follow-up you have with your GP and rheumatologist. A physiotherapist can go through what your everyday life looks like, what is hard to carry out, and make a step-by-step plan for gradually increasing activity. You can read more about physiotherapy and about personal training.

Can I exercise if I have arthritis?

Yes. NHI writes that physical activity is regarded as safe and useful in inflammatory joint diseases, and that you should not avoid movement in order to spare the joints. The activity is adapted to disease activity and how you feel on the day [1].

How much should you exercise with rheumatic disease?

The advice is 150 to 300 minutes of moderate activity a week, or 75 to 150 minutes of vigorous activity, plus strength training at least two days a week. If you cannot manage this, the advice is to be as active as your health and ability allow [1].

Can I exercise during an arthritis flare?

There are no general bans, but intensity and type must be adapted. Avoid heavy loading of joints that are very painful or swollen, and train other parts of the body instead [1].

What is the 24-hour rule for exercise?

If pain after a training session lasts more than a day, you should adjust the intensity or choose a different type of exercise [1].

The page about physiotherapy describes what an appointment with a physiotherapist can involve. You can find more articles in the overview of articles.

This article was written by Dr.Dropin Fysikalske and is based on the sources listed below. It gives general information and does not replace an examination by a healthcare professional.

The websites were accessed and read on 22 October 2026.

1. Revmatisk sykdom og fysisk aktivitet (Rheumatic disease and physical activity). NHI.no. Updated 1 June 2026. Link

2. Lein M. Leddgikt: Bør trene hardt og effektivt (Arthritis: should train hard and effectively; interview with Håvard Haglo). NHI.no. Last updated 10 March 2026. Link