Helpful or harmful? Potential effects of exercise on select inflammatory conditions

Inflammation has been characterized as a double-edged sword, requiring a balance between health as maintained by regular exercise and activities that would exacerbate inflammatory diseases. The influence of exercise on inflammation is complex and has been widely studied in both healthy patient populations as well as populations of patients with many inflammatory and/or autoimmune rheumatic diseases. Inflammatory markers can be affected by the type of exercise and muscle contraction, as well as the intensity, duration, and consistency of the exercise sessions. Because of these potentially important effects, many members of the general public, as well as some clinicians, believe that exercise could exacerbate symptoms and accelerate the progression of such conditions. The effects of different types of exercise have been studied among patients with inflammatory conditions such as ankylosing spondylitis, systemic lupus erythematosus, rheumatoid arthritis, osteoarthritis, fibromyalgia, and idiopathic inflammatory myopathies, as well as congestive heart failure, type 2 diabetes mellitus, and metabolic syndrome, which are considered low-grade systemic inflammatory diseases. This review will help exercise professionals and clinicians understand the effects of exercise on inflammatory markers, as well as offer effective treatment options and recommendations for patients exercising with rheumatic or inflammatory conditions.