Tai Chi: Ancient Chinese Approach May Reduce Arthritis Pain

Stiff, swollen, aching joints – their throbbing, persistent pain defines arthritis for millions of sufferers worldwide.

While modern medications and surgical procedures hold promise and can often deliver at least temporary relief from the worst episodes, there’s a growing body of research that shows that some forms of exercise can also be effective in reducing arthritis pain and restoring joint mobility – without any of the side effects associated with drug therapies or surgical interventions.

One approach garnering significant attention for this purpose is tai chi (pronounced “tie chee”).

Freeing the Qi Tai chi is one of the “internal style” Chinese martial arts. Internal styles emphasize breathing and the mental components of training, and they are gentle in character.

These styles have little in common with some of the better known, more assertive Chinese martial arts — like karate — that concentrate on external form, and feature vigorous body movements, dynamic kicks and harsh punching actions. In contrast to the chopping, spinning, and thrusting of karate, tai chi consists of more than 100 specific fluid and graceful circular movements that are relaxed and slow in tempo. To some people, these movements look more like an elegant, slow motion dance than a form of martial arts. Others describe tai chi as a form of meditation in motion. In tai chi, breathing is purposefully deepened and slowed — which is believed to assist in visual and mental concentration. Practiced together, the breathing style and the specific and patterned movements relax the body and are believed to allow “Qi” (also pronounced “chee”) — Chinese for life-force or energy — to flow freely throughout the body. For centuries, the people of China have used tai chi as a means of integrating mental and physical health. But recently its graceful, flowing movements have captured the attention of Western health professionals interested in utilizing its slow and gentle ways to improve mobility and reduce pain in a variety of chronic diseases — including rheumatoid arthritis and osteoarthritis. A newly published study is among the first to provide evidence of tai chi’s usefulness in the treatment of arthritis. Study Shows Benefit for Older Arthritics Patricia Adler, R.N., an advanced practice nurse and doctoral student at Case Western Reserve University’s Frances Payne Bolton School of Nursing in Cleveland, conducted a pilot study last year to determine whether tai chi reduced joint pain in elderly arthritics. Adler studied 16 patients age 68 to 87 who had chronic arthritis pain. Half the group attended hour-long tai chi classes once a week for 10 weeks where they learned a number of specific tai chi exercises or postures. They were also encouraged to practice the movements they learned at least once each day outside of class. The other half maintained their usual activity schedules. Each week Adler secured the 16 participants’ estimates of their levels of pain on a scale of zero (no pain) to 10 (worst possible pain). Over the 10 weeks of the pilot, the average pain score for the tai chi participants dropped from 3.25 to 1.75 — but the pain score for their peers who did not participate in the exercise regimen actually increased. “Exercises such as tai chi help reduce arthritis pain by increasing circulation and stimulating repair of damaged joint surfaces,” Adler explains. “In addition, it stabilizes joint structure by strengthening the soft tissue supporting joints.” “Older people in China have been doing tai chi for hundreds, if not thousands, of years,” she adds. “Although we knew anecdotally that tai chi helps chronic arthritis pain, there hasn’t previously been research to substantiate it.” The results of Adler’s study were published in the April 2001 Journal of Nursing Scholarship. She’s presently planning an expanded study to gain further information about tai chi’s health benefits in arthritic conditions. Improved Balance, Reduced Fear of Falling According to the National Institutes of Health, improvement in joint pain isn’t the only benefit arthritics can expect from tai chi. The approach can also significantly cut the risk of falls among older people, and may be beneficial in maintaining gains made by people age 70 and older who undergo other types of balance and strength training for their arthritic joints. That news was delivered in two reports appearing in the May 1996 issue of the Journal of the American Geriatrics Society — the first involving tai chi to be published by scientists participating in a special frailty reduction program sponsored by the National Institute on Aging (NIA). In the first study, Stephen L. Wolf, Ph.D., and his colleagues at Emory University School of Medicine reported that involvement in a 15-week tai chi course reduced the risk of falling among frail elderly study participants by almost half. Wolf’s team used 10 basic tai chi movements as a foundation for the intervention to insure that all of the moves could be recalled and used appropriately by all of their older participants. The performance of the elderly patients taught tai chi was compared to the performance of a group of similarly aged patients who received a computerized balance training program during the same timeframe. At the end of the study period, not only did the tai chi participants fall less often, they also reported taking more deliberate steps, decreasing their walking speed and being much less afraid of falling than they were prior to receiving the martial arts training. Tai chi participants also had significantly lower blood pressure after a brief walk than did their peers who had not had such training. A second study, by Leslie Wolfson, M.D., at the University of Connecticut Health Center, Farmington, found that several interventions to improve balance and strength among older people were effective. These improvements, particularly in strength, were preserved over the 6-month period that participants did regular tai chi exercises. Both projects were among several in the NIA’s Frailty and Injuries: Cooperative Studies of Intervention Techniques, or FICSIT, initiative, launched in 1990 to improve physical function in old age. Low Tech, High Benefit According officials at the National Institute on Aging, the results of these tai chi studies provide a reminder that relatively “low tech” approaches should not be overlooked in the search for ways to prevent disability and maintain physical performance in later life. “The FICSIT studies have shown that a range of techniques, from the most sophisticated medical interventions to more ‘low tech’ methods, can help older people avoid frailty and falling,” says Chhanda Dutta, Ph.D., Director of Musculoskeletal Research in the NIA’s Geriatrics Program. “We must make sure that we look at every approach, especially relatively inexpensive ones like tai chi,” says Dutta. “People can do this at home and with friends once they have had the proper training.” Not Just A Feel-Good Workout As the Arthritis Foundation notes in an online article on tai chi, this gentle martial arts approach isn’t “just a feel-good workout: it’s therapy, a preventive measure and a remedy for almost every ailment, including arthritis.” “Doctors recommend tai chi for people with a variety of musculoskeletal conditions because it improves flexibility and builds muscle strength gradually,” notes Judith Horstman, author of The Arthritis Foundation’s Guide to Alternative Therapies, writing in Arthritis Today. Horstman’s advice on tai chi for people with arthritis includes the following points: Don’t try to learn tai chi from a video or a book: It’s best to learn from a teacher who can make sure you are doing the movements correctly. After you learn the basics, you can practice on your own with a video. Modify the movements if necessary. For example, many tai chi postures are done with bent knees. If you have knee arthritis, you may need to adapt these movements to be safe and comfortable. Be cautious when you have a flare or sore joint. Many experts say you can still exercise, but be careful. Remember that while tai chi is a good adjunct exercise, it doesn’t provide much aerobic or weight-bearing benefits.