Is exercise good or bad for arthritis in the elderly?

Recreational exercise has achieved great popularity. Possible benefits to participants include increased longevity, decreased risk of cardiovascular disease, improved psychologic well-being, and greater fitness. Important but as yet incompletely answered concerns are whether exercise or physical overuse conditions play a role in the pathogenesis of osteoarthritis, which is virtually universal among the elderly, and whether there are any circumstances in which exercise might be beneficial for elderly patients with arthritis. In humans, anecdotal observations have suggested relationships between certain recreational activities and degenerative joint disease. The few controlled studies that exist, however, have indicated that exercise need not be deleterious to joints. Available data may be interpreted to suggest that reasonable recreational exercise--carried out within limits of comfort, putting joints through normal motions, and without underlying joint abnormality--need not inevitably lead to joint injury, even over many years. We are also witnessing thoughtful reevaluation of physical exercise as a therapeutic modality for arthritis patients. It is possible that certain patients may achieve psychologic and clinical benefit from selected exercise programs.