Part of the misfortune of arthritis is due to the fact that the disease not only causes pain but dramatically alters a person’s lifestyle due to fatigue, restricted mobility, and reduced independence because of low stamina and fears about balance and falling. One in four people suffer from arthritis,1 and while there is no cure, increasing numbers of people are using tai chi for arthritis to roll back the clock and regain independence.
Research indicates that the use of tai chi for arthritis has been effective in increasing mobility, reducing joint pain, improving balance, and extending activities like standing and walking distances. Results appear to be due to the health focus of tai chi and simply the fact that it provides a gentle easy way to stay mobile and active.
Tai chi is not something that most of us grew up with. People who have arthritis are excited to learn that it not only is an activity that they can do but that it has the potential to relieve symptoms and extend periods of movement and standing. On the other hand, it’s hard to understand how tai chi can positively impact the many different versions of arthritis.
In this essay I want to connect the dots between the benefits of using tai chi for arthritis and the research that shows its efficacy. In order to get us there, let’s begin by discussing in a unique way the specific symptoms common to arthritis and why tai chi has been successful in reducing them. Then, I want to take a fun walk through research across the last three decades where medical groups have been using tai chi for arthritis to show you how medical knowledge is evolving. Lastly, we will end with a resource for you to read more and get started with a practice.
7 Benefits of Using Tai Chi for Arthritis Management
The stiffening of the joints, reduced movement and rotation, and pain combine to dramatically change the lifestyle of most people who suffer from all forms of arthritis. To make matters worse, arthritis reduces the activities a person can safely do for extended periods of time, and inactivity leads to greater stiffening of the joints and reduced mobility. It is an awful catch-22. This is why the use of tai chi for arthritis is getting so much fanfare. It is not only a safe, gentle activity unto itself, but it has the ability to restore function that leads to returning to other favorite activities like standing in the kitchen to cook for a long time, strolling through new cities, or bending down to garden.
Arthritis improvement means to regain mobility, strength, and site-specific flexibility. Here’s how a tai chi practice contributes to this.
1. Improved Joint Mobility
Tai chi movements are circular. Movement is generated from the waist causing each of the corresponding joints to circle from the shoulders out to the elbows and down to the wrists. From the hips down to the knees and even to the ankles. These gentle successive rotations release synovial fluid into the joints and warm the muscles on either side of the joints to release tension. Additionally, tai chi can be modified for seniors or anyone who has restrictions.
2. Reduced Joint Pain
The stepping, turning, pressing, and squatting of tai chi teaches how to align the limbs so that there is no weight or strain on a joint while it is turning. The posture work brings the body upright reducing spinal tension and strain across the top of the knee.
3. Balance
Tai chi teaches a continual expansion up through the top of the head and downward through the tailbone. This enables “empty” walking where weight is transferred onto an empty foot rather than falling onto the foot in front of you. Balance is eventually challenged and improved with single-legged postures with the other foot raised.
4. Increased Stamina
The graceful, slow tai chi forms take between 8 and 20 minutes to perform. While the movements are easy and gentle, it takes quite a bit of concentration to maintain proper posture and breathing throughout the form. It is a really unique practice session that expands our capacity for activities for longer periods of time and reduced exhaustion or pain afterwards because proper movement was maintained.
5. Return to Lifestyle Activities
Tai chi is pretty social and fun unto itself but it is an activity with a purpose. All practitioners have other lifestyle goals. To be fit, healthy, sleep better, less stressed, happier… What is learned in the classroom is always applied to life. For people with crippling degrees of crystallization of the joints or soft tissue loss, tai chi is often the gateway to getting back to doing things you love to like gardening.
6. Fall Prevention
Lots of research has been undertaken to reduce fall prevention because injuries from falling can set a person back physically, lead to catastrophic incidents like head injuries, and increase fear of getting out and being in certain environments. Tai chi reduces fall prevention by increasing a person’s awareness throughout their movements and by teaching how to walk without committing weight to a step. Falls most often occur because of misjudging a step or not being able to recover from a loss of balance. If weight has not yet been transferred to the stepping foot, it is easier to retract the foot and correct your course.
7. Weight Loss
Weight loss is a goal of most people with arthritis because poor nutrition is linked to some forms of arthritis like gout. Additionally obesity restricts movement, reduces flexibility, strains the knees, and worsens balance because of a high, heavy center of gravity. It would be a stretch to say that tai chi can cause you to lose weight. I don’t want to distort the facts here. But the truth is that tai chi can reduce stress levels, get a sedentary person active, create a social network, improve mood, and improve mobility. These are all tenants of healthy lifestyle changes that, along with dietary changes, promote weight loss. Read more specifically about tai chi and weight loss here.
So those are the promises of tai chi and having practiced tai chi for over 20 years now, I can attest to the multitude of students who have benefitted from it. But, I don’t want you to take my word for it. I want to introduce you to some of the research literature so that you can feel confident about making and informed decision for yourself. Most people arrive at the door of tai chi because they want to know if tai chi helps with arthritis or something else they are dealing with. While tai chi is new to them, it has centuries of research and development behind it.
The Long-Short Research History of Using Tai Chi for Arthritis Relief
It would be correct to say that there has been an explosion of research in the last two decades using tai chi to reduce the symptoms of the many different forms of arthritis. But it would also be incorrect because the explosion of research actually began several centuries ago in Traditional Chinese Medicine (TCM), long before the word arthritis came into existence.2 Treatments for gout, the buildup of uric acid, and degradation of joint tissue have been the focus of acupuncture, herbal medicine, and movement prescriptions like tai chi and qigong for a very long time.
While the western world has largely focused on dietary changes and medicine to treat arthritis, they have increasingly considered eastern modalities because of their successful track record not only with pain reduction but with providing activities that can improve or restore balance, joint mobility, and prolonged activities like standing, sitting, and walking.
Let’s take a quick tour of some research from this century. This list by no means includes all the current research. What it should paint for you is that the studies are extensive with new grants being awarded yearly. Studies are comparing tai chi to other activities and researchers are drilling down into specific types of arthritis such as fibromyalgia and osteoarthritis. Lastly, if you suffer from arthritis, it should give you confidence that eastern medicine and tai chi is a viable, non-invasive option to reduce your symptoms and increase your mobility.
Evaluating the safety and potential use of a weight-bearing exercise, Tai-Chi Chuan, for rheumatoid arthritis patients.
Okay, so I said this century but I wanted to start by backing up a bit because I find this first study to be quite funny and it shows how far we have come. It wasn’t actually a study to see if tai chi had a positive effect on arthritis. Rather, it was undertaken to make sure it didn’t hurt anybody! The authors concluded that:
No significant exacerbation of joint symptoms using this weight-bearing form of exercise was observed. Tai-Chi Chuan exercise appears to be safe.
This study had two groups doing tai chi once or twice a week for ten weeks plus two control groups that did not do tai chi. They evaluated joint tenderness, swelling, grip strength, and the time it took to walk 50 feet. They began with the premise that tai chi could exacerbate or worsen the symptoms of arthritis. They found that study groups maintained their mobility or improved. The control groups continued to decline or showed no improvement.
The effects of Tai Chi on older adults with chronic arthritis pain
This study was pretty intriguing because it focused specifically on pain. It placed men and women age 68-87 with chronic arthritis into tai chi and no-tai chi groups and measured for reported levels of pain throughout a 10-week period. The tai chi group reported reduced pain and the no-tai chi group reported increased pain.
The study rightfully stated that the control group numbers needed to be increased for future studies and they excluded more severe forms of arthritis. Results were promising however, leading to further research funding.
The effect of Tai-Chi for Arthritis (TCA) program in osteoarthritis and rheumatoid arthritis patients
This study was carried out in Korea and Australia and was unique because it compared osteoarthritis (OA) patients and rheumatoid arthritis (RA) patients who participated in 60 minute tai chi sessions twice a week. They measured for physical symptoms (pain, tenderness, swelling fatigue, and blood pressure), physical functions (balance, flexibility, grip strength) and social-psychological health status. Outcomes were strong enough to recommend tai chi for one of the groups:
[The tai chi] exercise program was more effective in pain, tenderness, grip strength, flexibility, and physical and social interaction on osteoarthritis patients than rheumatoid arthritis patients.
Tai chi for treating rheumatoid arthritis
Rheumatoid arthritis is one the most common and painful types of arthritis. It is actually an autoimmune disease that weakens the musculoskeletal system. Current treatment includes slowing down the damage to the joints and maintenance of lifestyle. It makes sense that tai chi has been studied specifically to address it. This next series of studies all focused on the effects of tai chi on rheumatoid arthritis specifically.
This study was a review of current literature at the time and concluded that “Tai Chi does not exacerbate symptoms of rheumatoid arthritis.” Woohoo! Sounds like 1991 again doesn’t it?
Effect of Tai Chi in adults with rheumatoid arthritis
I like this study. They noted that 1) movement helps arthritis but 2) a lot of sports activities further damage the joints of people with rheumatoid arthritis. They posited whether tai chi could land in the middle. Could it be an activity to promote movement but not exacerbate the problem?
They had two groups where one group did tai chi for 12 weeks and the other group received 40 minutes of RA education. Due to inconsistent results in prior research, they measured for 25 outcomes dealing with pain and movement. Click on the date-link above to see their extensive tables but by-and-large:
Overall, the Tai Chi group improved in all 25 secondary outcomes, while the control group improved in only some and never by as great an amount.
Tai chi for rheumatoid arthritis: systematic review
Things aren’t smelling like roses in the rheumatoid arthritis research. This was a study of studies and found no benefit or decrease in pain for rheumatoid arthritis subjects.
Tai Chi improves pain and functional status in adults with rheumatoid arthritis
And the pendulum swings again, this 12-week tai chi study on rheumatoid arthritis measured for improvements using a disability, vitality subscale, and the depression index, all with positive results. I really don’t know what to make of the opposing views but I wonder what all the studies would look like if you controlled for time and made them all 12 weeks.
Exploring Tai Chi in rheumatoid arthritis: a quantitative and qualitative study
This study is unique in that it included people as young as 33. It also focused only on females. Thirdly, it measured physical improvements that were associated with reduced problems from arthritis. This is really clean research. Note that they are not saying “tai chi cures arthritis!” They are saying that the group experienced lifestyle improvements that arthritis had hampered. Here’s the exact quote:
Tai Chi practice lead to improved lower-limb muscle function at the end of intervention and at 12 weeks follow-up…patients experienced improved physical condition, confidence in moving, balance and less pain during exercise and in daily life. Other experience included stress reduction, increased body awareness, confidence in moving and indicated that Tai Chi was a feasible exercise modality in RA.
Tai Chi exercise and auricular acupressure for people with rheumatoid arthritis: an evaluation study
This study compared a tai chi group to a tai chi + acupuncture group. They did not find any differences between the groups. Both experienced statistically equal improvements and the acupuncture didn’t enhance anything.
I think studies like this are a real turning point in research on tai chi for arthritis. Rather than debating if it works, they are starting from the point that it does work and are trying to squeak more benefits out of it. Not in this case, but it probably led to other combined-intervention research.
The beneficial effects of Tai Chi exercise on endothelial function and arterial stiffness in elderly women with rheumatoid arthritis
Okay, so I had to look up what “endothelial function” meant. It helps the body regulate blood clotting, the response of the immune system, and blood volume. There is an established connection between arthritis and heart disease. The question posited here is: if tai chi helps with arthritis, does it also improve measures of the heart? Super cool, right? Again, no longer debating IF tai chi helps, just to what extent.
In this study they had two groups of women. One did tai chi for three months and the other was educated for three months. This time, they measured for both an improvement in arthritic conditions and improvements in heart health. They found that endothelial function improved and arterial stiffness was reduced in the tai chi group. Boldly, they ended by saying that cardio-vascular disease researchers need to up their game and consider tai chi (my interpretation :)).
Evaluation of tai chi program effectiveness for people with arthritis in the community: a randomized controlled trial
This was a recent study and it was big. When research gets off the ground they rarely have the funds or interest to attract large pools of people. This study not only had 343 participants but it was conducted by the Arthritis Foundation, how’s that for buy in?
They had really honest results which were kind of a mixed bag:
- Improved significantly: balance by reach, helplessness, sleep, and role participation satisfaction
- Approached significance: pain, fatigue, and stiffness improvement
- No change: mobility, lower extremity strength, single-leg stance balance
Tai chi for rheumatoid arthritis
Keeping things honest, this recent study redid findings they explored in 2004 by revisiting all available literature on the benefits of tai chi for arthritis. They said that the collective results were inconclusive and therefore did not show a reduction in pain in cases of rheumatoid arthritis by practicing tai chi. They constructively criticized that the groups were too small, small study groups, study time frames ranging from 8-12 weeks were inconsistent, and there were problems with how different data sets were collected.
These results are totally fair and needed to spur on funding for controlled studies. However, they discounted many of the positive outcomes and differences between tai chi groups and the control groups.
Overall the number and size of studies are increasing. Secondly, there is a huge gap that none of the research is talking about:
If not tai chi then what?
Research has clearly documented low commitment rates to traditional fitness by arthritis sufferers because of pain and fatigue. It has also demonstrated worse joint health in some instances. On the other hand, the “motion is lotion” and “use it or lose it” truisms have propelled people with arthritis to continue to seek acceptable activities.
Using tai chi for arthritis has been proven to not cause further damage. While it hasn’t been proven without a shadow of a doubt to improve arthritis, the research is compelling enough to show that it improves the lives of people with arthritis, with none of the side effects of surgery or drugs.
Finding Tai Chi for Arthritis DVDs and Videos
If you want to give tai chi a shot, it is popular enough that there is a good chance that a class exists near you. Additionally, the tai chi community has a celebrated teacher who knows what you are going through intimately well. Dr. Paul Lam is not only a high-level tai chi instructor but purportedly overcame juvenile arthritis through practicing tai chi. He has dedicated portions of his teachings to directly focus on arthritis and has modified the tai chi form for people with joint pain and mobility restrictions.
Resources:
- 1. Traditional Chinese and western medicine understanding of gout pathogenesis
- 2. Jia, L., R. S. Wang, and D. Y. He. “Traditional Chinese and western medicine understanding of gout pathogenesis.” Rheum Arthritis 7.02 (2018): 61-64.