The Benefits of Cycling for Those With Arthritis, Including How It Keeps Pain at Bay
When she was in her mid-40s, Michelle Smith couldn’t understand why she had intense pain in her hands, as well as some other mysterious symptoms. “My fingers were so swollen I couldn’t even make a fist,” she says. A healthy eater and avid runner and cyclist, Smith realized she needed to determine the cause of her symptoms.
After going through two years of testing, including blood work and X-rays of her hands and feet, “I finally found a great rheumatologist who diagnosed me with psoriatic arthritis,” says the now 51-year-old. A form of arthritis that’s linked to psoriasis and often accompanied by rashes and fingernail issues, psoriatic arthritis requires its own form of treatment, as it is an autoimmune issue. “Then it took another year to find the right medication,” Smith adds.
These symptoms, Smith explains, felt entirely different than when her hands felt tired from gripping her bike’s handlebars.
“Fatigue from riding is an altogether different pain from arthritis pain,” Smith explains. “When you ride for a long time, your hands may be uncomfortable or tingle, but when you shake your hands, it goes away. The arthritis pain just never went away. My hands would just ache and my knuckles were so swollen.”
Fortunately, Smith, like many other cyclists, has been able to continue riding through her diagnosis and treatment. Riding not only helps her heart, but also her joints. “Cycling isn’t hard on the body and it’s a good way to keep moving,” Smith says.
Most experts will suggest those with arthritis keep exercising, aiming for low-impact activities like cycling, because keeping your joints moving keeps them healthy.
If you have arthritis, or suspect you do, here’s what to know about cycling with arthritis, including symptoms, treatments, and how to make the most of your rides.
What is arthritis?
Arthritis isn’t one illness, but an umbrella term for illnesses that affect the many joints in the body. Along with joint pain and inflammation, each type of arthritis also has its own set of concurrent symptoms, such as fatigue or pain. Because there are many different types of the condition, it often takes patients and their doctors, called rheumatologists, some time to determine individual treatment.
“There are two different categories of arthritis, the types related to aging and injury, and the types that are systemic and inflammatory,” Jeffrey Sparks, M.D., a rheumatologist and assistant professor of medicine at Harvard Medical School tells Bicycling.
The Two Main Types of Arthritis:
Osteoarthritis (OA): The most common type of arthritis, osteoarthritis affects more than 32.5 million U.S. adults, according to the CDC, and typically occurs in the hands, hips, and knees. When someone has osteoarthritis, the cartilage within one or more joints begins to wear away, affecting the bone and causing pain. Having had a joint injury, such as a bone break, could increase your risk of osteoarthritis, as does age, obesity, and genetics.
Rheumatoid arthritis (RA): An autoimmune and inflammatory form of arthritis, rheumatoid arthritis is slowly progressive and can affect the hands, wrists, knees, or ankles. RA is related to immune system dysfunction, meaning it attacks healthy tissues—in this case, the lining of the joints. RA typically affects the same joints on both sides of the body or multiple joints simultaneously.
Less common forms of arthritis include psoriatic arthritis, axial spondyloarthritis, gout, and juvenile arthritis, Sparks explains. These can be more difficult to diagnose and each requires its own type of care, including diet and lifestyle changes.
Sparks explains that no matter the type of arthritis, many symptoms are symmetrical or bilateral—that is, they happen in the same joint on both sides of the body—people often feel symptoms worse in one knee compared to the other, for example.
Speaking to a rheumatologist about specific symptoms is the best way to differentiate between arthritis types in order to get proper care.
What are the risk factors for arthritis?
Previously, patients and even doctors thought arthritis developed via wear and tear from activity alone, “but now we know that changes in the cartilage are unrelated to use,” Sparks explains. “Typically osteoarthritis is age-related. However, the autoimmune types can occur in the 20s to 30s, and 70 percent of patients [with these conditions] are women.”
Women are more likely to develop autoimmune disorders because they have two X chromosomes or “a larger number of genes,” according to one narrative review. This genetic quality puts women at a greater risk for the development of autoimmune diseases because there is a higher chance of mutations.
In another twist of gender, men are more likely to experience gout, while women are more likely to get osteoarthritis.
With all types of arthritis, there are strong genetic components, as well as lifestyle habits that can lead to symptoms and a diagnosis, Christian Dequet, D.O., a rheumatologist in Wasilla, Alaska explains to Bicycling. In terms of genetics, many patients will start to experience symptoms at the age at which their parents also began to have symptoms.
According to the CDC, injuries, being overweight, and some infections can make it more likely that a person will be diagnosed with some type of arthritis.
Research has shown that there are probably environmental factors related to arthritis, as well, Dequet says. For example, smoking and alcohol intake have been related to rheumatoid arthritis, while sugar and alcohol, as well as a diet high in purines from meat, but not vegetable and dairy sources, have been linked to gout.
While cycling will help keep you healthier if you're genetically predisposed to arthritis, you may be more likely to feel the symptoms because of your reliance on your joints. “Bicycling is not going to cause arthritis, but you may notice symptoms because you’re bicycling,” Sparks explains.
What are the symptoms of arthritis and how is it diagnosed?
Joint pain is the most obvious symptom of arthritis, but Sparks says another early sign is whether you can make a fist. If you experience pain when bending your fingers or stiffness keeps you from bending the joints completely, “that’s something to pay attention to,” he says. Swelling and diminished range of motion in the joints are also symptoms of arthritis, and they can vary from mild to severe.
Some symptoms stay low-grade for many years, while others progress, getting worse over time. Severe arthritis can result in chronic pain and make it impossible to handle typical daily activities, such as cleaning, walking, and typing.
There are differences, too, in when the pain seems to arise, according to the Arthritis Foundation. Osteoarthritis often gets worse with use and as the day goes on, and sufferers feel better when they rest. In contrast, rheumatoid arthritis seems to feel worse when people are resting. Likewise, people with rheumatoid arthritis may feel generally tired and ill, while those with osteoarthritis have joint pain, but few other symptoms.
If you’ve begun to ride longer or harder than you used to, and notice changes in your joints, such as pain or a lack of mobility, it’s likely that the symptom is not arthritis.
Of course, both experts suggest seeing a doctor so they can check for the condition. They’ll do so by observing your symptoms, as well as running blood tests, taking X-rays, MRIs, and ultrasounds, and performing an arthrocentesis, in which doctors use a needle to take fluid from the joints.
How is arthritis treated?
While there is no cure for arthritis, all the types of arthritis can be better managed with exercise, as well as addressing other lifestyle habits, including diet, smoking, and stress.
Having said that, Dequet adds that over-the-counter medications, such as acetaminophen and NSAIDS (Aleve and Bufferin), are often very good for common symptoms, including pain and stiffness. Sometimes even taking them in anticipation just to have as little pain as possible is helpful, both doctors say, as long as they are used judiciously. “Topical non-steroidal soothing creams that aren’t absorbed into the bloodstream are also very helpful,” Spark says.
Of course, patients who are on arthritis medication should speak to their doctor about the use of over-the-counter drugs, Dequet adds.
Likewise, both doctors say that treatment plans should be individualized to symptoms, and that many patients go through periods of experimenting with a variety of medications and lifestyle adaptations in order to find what helps them the most.
Without proper care, arthritis can cause visible and permanent joint changes, such as knobby finger joints, but often the damage can be seen only on X-rays. That doesn't mean the problem isn’t there, though. It can sometimes be extensive: Some types of arthritis affect the heart, eyes, lungs, kidneys, and skin.
What should you know about cycling with arthritis?
“Exercise is how cartilage gets its nutrients,” Dequet says. These nutrients, including blood and synovial fluid, a thick liquid between the joints, help keep the joints lubricated and flexible. “Since bicycling is lower impact, it’s a good exercise choice for people who have early osteoarthritis,” Sparks adds.
In fact, both Sparks and Dequet are cyclists who rave about the numerous benefits of cycling for arthritis patients. And research backs it up. For example, a review and meta-analysis published in Clinical Rehabilitation in 2021 involving 11 studies and more than 700 patients, concluded that stationary cycling relieved pain in individuals with knee osteoarthritis.
Similarly, a 2020 study published in Sage Open Medicine found that a six-week cycling and education intervention for the treatment of hip osteoarthritis improved function, pain, and quality of life by the end of the program for 167 patients referred from secondary care.
While cycling has been shown to help those with arthritis, it is also true that riders with arthritis need to take extra care when it comes to their bike fit. “People with very severe rheumatoid arthritis may have difficulty holding the handlebars,” Dequet says. “Your bike set-up has to be very individualized.”
If you feel unsteady or can’t hold your position very long, you should make adjustments but if the pain or discomfort doesn’t improve, see your doctor.
Finally, both doctors mention that while hand numbness is a problem for all riders, it is typically a sign to experiment with gloves or bike fit. “There is a nerve that can become compressed, and numb fingers can be dangerous,” Sparks says. If that symptom frequently arises, you might want to see a doctor to rule out arthritis, and care for those nerves so the injury doesn’t worsen.
Cycling is so beneficial for those living with arthritis that one of the major fundraisers for the Arthritis Foundation, whose mission is to find a cure for the disease, is the Annual California Coast Classic Bike Tour. In fact, this multi-day event, which requires participants to ride 525 miles over eight days, is where Dequet first met Smith.
“I first did the ride when my mom, who had rheumatoid arthritis, passed away,” says Smith. “I set my sights really high. It was a great experience.” She continues to ride long distances, including multi-day events, with her longest daily ride hitting about 90 miles.
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