But between her job working for a theater and her side business in accounting, Belasco spends more than 10 hours a day in her chair. And her sleep is less than ideal, with her average of six to seven hours in bed interrupted with worried thoughts and the bathroom. RELATED: An Anti-Inflammatory Diet Can Improve RA Symptoms in Just Two Weeks, New Research Suggests Belasco knows each of these lifestyle factors, along with diet (in her case, avoiding dairy and gluten), is important for controlling arthritis pain. But like most of us she hasn’t thought about considering these factors as a unified whole.
Take a Holistic View: Your Day Is the Sum of Its Parts
Most people who have arthritis generally understand that exercise, movement, and sleep are important for minimizing pain, not to mention boosting overall health. But we tend to consider them as isolated experiences, rather than as integral activities that together make up our day, says Lynne Feehan, PhD, a physical therapist and clinical associate professor of physical therapy at the University of British Columbia in Vancouver, Canada. Dr. Feehan and her colleagues decided to examine what people do over a 24-hour period: How much do they walk, exercise, sit, and sleep. “We can’t assume everyone is the same,” since each person spends their days in different ways, Feehan says. Because the researchers had previously studied people with knee osteoarthritis, rheumatoid arthritis, and systemic lupus erythematosus, they were able to gather this data on 172 people. During these prior studies, participants had worn activity monitors for one week and had completed questionnaires documenting their sitting and walking experiences. RELATED: 5 Yoga Poses and Exercises for Better Sleep Tonight Exercise is also key for keeping joint pain at bay, and so is movement not specifically from exercise, Dr. Tifford says. RELATED: 8 Ways to Sit Less and Move More Each Day Studies regularly document the benefits of working out for people with joint diseases. In research published in December 2016 in Arthritis Care & Research, for example, people with lower extremity joint pain and stiffness who engaged in moderate to vigorous activity for at least 45 minutes a week had improved function compared with less active adults. Unfortunately, most people with arthritis don’t exercise enough. Only 36 percent of adults with the disease meet government guidelines for physical activity (at least 150 minutes of moderate-intensity aerobic activity; 75 minutes if it is vigorous), according to research published in the American Journal of Preventive Medicine in September 2017. RELATED: How to Sleep Well Despite Rheumatoid Arthritis
Assessing Activity Levels During 24-hour Span
Feehan and her colleagues were interested in how people balance movement, sitting, and sleep throughout their day. For one thing, each of the parts interacts with the others. For example, “Evidence suggests that keeping more physically active during the day makes you more likely to have better sleep quality and duration at night,” Feehan says. Assessing various actions across the day is also important for medical professionals when counseling patients, Feehan says. “We can’t assume that a patient with knee arthritis needs to increase their physical activity, because maybe it’s their sleep or sitting behavior that are bigger issues,” she says. RELATED: Rheumatoid Arthritis: The Importance of Resting Joints
4 Types of Arthritis Lifestyles: Which One Describes You?
The team’s research, published October 6, 2020 in Arthritis Care & Research, identifies four lifestyle categories people with arthritis fall into. Use this guide to determine which category best describes you.
Make Small, Subtle Changes in Activity Levels
For people with arthritis who are not in the balanced activity group, you’ll want to head slowly and steadily in that direction, Feehan advises. Making changes in small increments make them more likely to stick, she says. Ruth Krasky, 72, who has psoriatic arthritis (PsA), doesn’t do any exercise. She does frequently move around her Tamarac, Florida, home as a way to soothe her aching joints (although like many people, the home isolation of the coronavirus pandemic keeps her from moving in other places as much as she did before). In addition to the lack of exercise, Krasky has issues with sleep, accumulating just five hours a night. Until she learned of this study, which would place her in the low sleeper category, she “never thought about how sleep might interact with my condition,” she says. RELATED: Sleep Problems and Arthritis Pain Compound to Hurt Mental Health “When you’re living with arthritis, appropriate rest and recovery is essential for your joints and muscles,” Feehan says. For some people, the pain itself prevents good slumber. If this describes you, talk to your healthcare provider to see what can be done. For others, it may just be a question of adjusting your lifestyle. Perhaps by examining your schedule you can trim time you’re lounging on the couch in the evening and turn out the lights a bit earlier, Feehan suggests. RELATED: Physical Activity Is Essential For Managing Rheumatoid Arthritis
Don’t Be Afraid to Move More
If you’re a high sitter (or high sleeper) without sufficient movement, it may be because you’re fearing exercise could cause additional pain. For most people, though, slowly increasing physical activity should not do this, Feehan says, noting that any aches you feel during or just after your walks will likely be temporary. (If the pain is severe or continues, stop exercising and speak to your physician.) “The pain most people feel is not doing damage or making the arthritis worse,” and there are tremendous benefits, she says. RELATED: I Tried Oura to Sleep Better With Rheumatoid Arthritis, and Here’s What Happened Tifford counsels his patients that if walking is too difficult for them, they might consider other forms of exercise such as cycling, spinning, or swimming. He also recommends adding a stretching activity such as yoga.
Balancing Your Lifestyle Is Worth the Effort
Lori Belasco’s issue isn’t her exercise. Like Krasky, her nightly sleep habits and daytime sitting put her in the low sleeper group. Changing these, however, “is easier said than done with my schedule,” she says, especially when she spends evenings doing work for her accounting clients. Still, she’s intrigued by the idea of striving to reach the balanced activity group. “If it would make my arthritis a lot better, that would definitely be an incentive,” she says. RELATED: 9 Quick Fixes for Everyday Aches and Pains
