Tai chi for Arthritis Relief

Tai Chi for Arthritis Relief
Gentle movements of the ancient Chinese exercise tai chi are one of many alternatives to help elderly people find pain relief.
By Jeanie Lerche Davis
WebMD Feature
Reviewed by Charlotte E. Grayson Mathis, MD
The movements of tai chi are gentle, graceful, mystical -- and, for elderly people, a very safe way to relieve arthritis pain and gain balance, strength, and flexibility. Tai chi is one of many alternative therapies that can provide relief from pain, possibly letting you cut back on pain medications.
Early mornings in large and small cities in China - and increasingly in America's parks, hospitals, and community centers - people are practicing tai chi. It is an ancient tradition said to have developed in medieval China, to help restore health of monks in poor physical condition from too much meditation and too little exercise.
Chi (pronounced chee) is the Chinese word for energy. In the healing arts, tai chi is used to promote the movement of energy through the body -- similar to blood being pumped through the body, explains Cate Morrill, a certified tai chi instructor in Atlanta. Morrill spends much of her time in teaching classes for seniors, many of whom are unfamiliar with this practice. "But after five, 10, 15 minutes of tai chi, they report having pain relief," she tells WebMD.
Virtually all major health organizations - including the Arthritis Foundation -- recommend tai chi as an activity for seniors because it provides balance of body and mind.
"The movements of tai chi keep the body fresh and allow the person to find a freer range of motion in the joints, greater flexibility, better balance," Morrill explains. Tai chi is often called "moving meditation," because it is relaxing, because the focus is on breathing and creating inner stillness -- quieting the mind, relaxing the body. When people focus on breathing and on the movements, they aren't focused on their worldly worries.
Older adults who try tai chi find the benefits flow into their everyday lives in surprising ways, Morrill tells WebMD. "Everyday stuff like gardening and cleaning the house -- even basic moves like getting in and out of a bathtub - are easier when muscles are strong and flexible, when there is proper balance and body alignment."
What Happens in Tai Chi Class
Tai chi movements are full of natural symbolism - "Wind Rolls with Lotus Leaves," "Brush Dust Against the Wind," and "White Crane Spreads Wings."
Yet the application of these moves is very practical: "Folks with arthritis in the knees tend to not bend their knees very much when they walk, so they tend to have a stiffer gait. Some tai chi exercise work to increase the knee flexibility," says Morrill.
For example, in the movement "Wave Hands Like Clouds," the focus is on the hands, which seem to drift like clouds in the air. But as the hands wave, the rest of the body is in continual slow motion, Morrill explains. The hips are driving the body motion -- as one leg bends, the other stretches, then the motion switches to the other side of the body. The arms rotate at the shoulder to strengthen shoulder muscles, which encourages the arms to stretch out fully. As weight is shifted, the body is slightly turned to produce flexibility in the waist and strength and flexibility in side muscles.
This movement may last only two minutes or so; during the hour-long class, seniors will complete at least 20 different sets of movements, says Morrill.
Seniors should not try learning tai chi from a video or DVD, she adds. A class setting, with qualified instructor who has worked with seniors, is essential. "Elderly students need an instructor who can correct their posture. If someone has severe arthritis in the left knee, they may not be able to do moves like someone who has a light case of arthritis. It's the instructor's job to modify movement to make it as safe and painless as possible for each student ... to select moves that are most appropriate."
Also, there's the camaraderie that comes from a class, Morrill tells WebMD. "People with arthritis tend to not get out much, but tai chi classes let them realize there are others in the same situation, so friendships develop, people support each other, they find other people they can share skills with. One might do the grocery shopping because the arthritis in her legs isn't too bad - and her friend does the cooking."
Gain Back 8 Years of Youth
According to legend, "if you meditate and do tai chi 100 days in a row, you gain back eight years of youth," says Morrill.
While many of today's tai chi movements have roots in martial arts, the goal is indeed therapeutic. Progress is measured in terms of coordination, strength, balance, flexibility, breathing, digestion, emotional balance, and a general sense of well-being.
Tai chi and other types of mindfulness-based practices "are intended to maintain muscle tone, strength, and flexibility, and perhaps even spiritual aspects like mindfulness - focusing in the moment, focusing away from the pain," says Raymond Gaeta, MD, director of pain management services at Stanford Hospital & Clinics.
Parag Sheth, MD, assistant professor of rehabilitation medicine at Mt. Sinai Medical Center in New York, saw the popularity of tai chi on a visit to China 15 years ago. "We saw it every morning - thousands of people in the park doing tai chi, all of them elderly," he tells WebMD.
"There's logic in how tai chi works," Sheth says. "Tai chi emphasizes rotary movements -- turning the body from side to side, working muscles that they don't use when walking, building muscle groups they are not used to using. If they have some strength in those support muscles - the rotators in the hip -- that can help prevent a fall."
The slow, controlled movements help older people feel secure doing tai chi, he adds. "Also, they learn to bend on one leg -- to control that movement - which is something you don't get to practice very often," says Sheth. "That's important because, as we get older and more insecure, we tend to limit our movements and that limits certain muscles from getting used. When people strengthen those muscles slowly, when they find their balance, they learn to trust themselves more."
A study published in 1997 found that seniors who took 15 tai chi lessons and practiced for 15 minutes twice daily were able to significantly reduce their risk of falls. Since then, several more studies have pointed to the physical benefits of tai chi for the elderly.
• One six-month study, a group of elderly people who took part in tai chi were about twice as likely to report that they were not limited in their ability to perform moderate-to-vigorous daily activities - things like walking, climbing, bending, lifting. The seniors in that study also reported better overall quality of life - in terms of bodily pain, mental health, and perceptions of health and independence.
• Another study of seniors with arthritis showed that those who took a 12-week tai chi course got around better and had less pain in their legs. Yet another study found that people with arthritis who took a 12-week tai chi class had stronger abdominal muscles and better balance afterward.
• A review of four studies on tai chi found that it does not appear to significantly reduce pain or lessen the severity of rheumatoid arthritis. However, it does significantly improve range of motion in the joints of the legs and ankles. Those who got the most benefit reported participating more in their tai chi classes and enjoying them more compared with those who were in a traditional exercise program.
"I'm an absolute huge fan of tai chi," says Jason Theodoskais, MD, MS, MPH, FACPM, author of The Arthritis Cure and a preventive and sports medicine specialist at the University of Arizona Medical Center.
Any type of motion helps lubricate the joints by moving joint fluid, which is helpful in relieving pain, he says. "Tai chi is not a cure-all, but it's one piece of the puzzle. What's good about tai chi is that it's a gentle motion, so even people who are severely affected with arthritis can do it. Also, tai chi helps strengthen the joints in a functional manner... you strengthen muscles in the way your body normally uses the joints."