Is HIIT Safe for Inflammatory Arthritis?

Credit: Adobe Stock/Marco Attano

High-intensity interval training (HIIT) — short bursts of intense exercise followed by rest — is gaining popularity for its quick, effective workouts. But for people with inflammatory arthritis, including rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA), the idea of pushing hard during exercise can feel intimidating — or even risky.

A new review of clinical trials shows encouraging news: HIIT appears safe for patients with inflammatory arthritis and may actually offer important physical and quality of life benefits — without flaring up symptoms or worsening the disease.

To manage inflammatory arthritis, experts recommend a mix of medications and nondrug therapies to reduce inflammation, ease symptoms and protect joint function. Commonly used medications include nonsteroidal anti-inflammatory drugs (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs), which are effective but can be expensive and may cause side effects like stomach issues, infections, or liver and kidney problems.

“Notably, non-pharmacological therapies are gaining momentum in supporting patients with inflammatory arthritis,” wrote a team of investigators from the Manchester Metropolitan University, U.K. “Growing evidence underscores the beneficial effects of physical activity and exercise in improving symptoms and reducing systemic inflammation associated with inflammatory arthritis.”

Investigators analyzed data from nine clinical trials involving nearly 600 people with various types of inflammatory arthritis. Participants were divided into HIIT and control groups, with results measured across disease activity, pain, fatigue, fitness and quality of life.

Most studies found no worsening of disease activity after HIIT. One study even showed reduced inflammation in people with axSpA. This means HIIT does not appear to trigger flares or worsen arthritis symptoms.

Fatigue improved in some studies, especially in the short term. Pain levels stayed about the same for most, though one study found significant pain relief after HIIT. So, while not everyone experienced dramatic symptom changes, some patients felt better overall.

Every study that measured heart and lung fitness showed clear improvements in the HIIT groups. Patients saw increased stamina and oxygen capacity, which is important for energy and long-term health.

Some patients reported better energy, mood and social functioning after doing HIIT. Although the improvements varied, they suggest HIIT can have a positive effect on daily life and well-being.

Some studies showed small reductions in waist size and fat mass, but most did not find significant changes in weight, BMI or muscle mass. These body changes may require longer-term training.

Scans and MRIs showed no signs of increased inflammation or joint damage from doing HIIT, which reassures that it’s safe for the joints in the short term.

Importantly, no studies reported harmful effects from HIIT. While investigators note more research is needed, especially with larger and longer trials, this growing body of evidence suggests that HIIT can be a safe, effective option for people living with inflammatory arthritis — when supervised and appropriately tailored.

While the review of HIIT for inflammatory arthritis offers helpful insights, there are some important limitations. Many of the studies were small and short term and may not fully reflect real-world experiences, especially since participants were likely more motivated or experienced with exercise than the average person. Some studies lacked proper blinding or had overlapping data, which could affect accuracy. The results might also be influenced by other healthy lifestyle changes participants made during the studies, like improved diet or overall activity. More long-term, well-designed research is needed to confirm the findings and ensure they apply to a broader range of patients.

“High-intensity interval training shows promise as a therapeutic exercise intervention for patients with inflammatory arthritis,” investigators concluded.