Musculoskeletal Health

This section covers arthritis and other conditions that affect bones or muscles. Many people with these conditions worry that exercise will make their condition worse, but apart from a few exceptions, it will actually be very beneficial.

There is more information on how being active helps with arthritis on the Arthritis Research UK website, including useful videos and exercise sheets that will help with many common muscle and joint pains.

Most work related ill health is due to musculoskeletal disorders and stress or depression. Going to work is good for you and it is worth doing what you can to keep working. There is useful information and advice here about how to keep healthy at work.



Fibromyalgia is an unpleasant condition that causes joint and muscle pain all over the body. It also causes tiredness.

It is difficult to treat. The most promising treatment includes exercise combined with cognitive behavioural therapy.  If you suffer from fibromyalgia you will find that exercise helps by improving your fitness and quality of life, it will also reduce your tiredness. In addition it may help reduce the pain you feel.

Your GP or physiotherapist can help design a personal exercise program to help you or may be able to refer you to an exercise referral scheme (depending where you live). Any exercise is likely to include a mixture of aerobic and strengthening exercises.

What type of exercise is right ?

Aerobic exercise, such as walking, cycling and swimming. A number of studies have shown that aerobic exercise can improve your quality of life and may reduce your pain.

Resistance and strengthening exercise, can help with muscle strength and improve your quality of life. They must be carried out on the advice of a professional though, or your symptoms may worsen.

You might want to start with tai chi, yoga or pilates which will help you build up your muscles and may encourage you to move onto something more strenuous.

It is worth doing though, studies have shown that people with fibromyalgia who carried out strengthening exercise felt less tired, could function better and felt happier.

How much exercise should you do?

It is important that you start slow and build up your activity. Don’t overdo it and make sure you have rest periods between bouts of activity.

There is more information on how being active helps with this condition on the NHS Choices website


Osteoarthritis is a condition that affects the joints, it is very common in older people. It is the most common type of arthritis in the UK and around 1 million people see their GP about it every year.

Many people with osteoarthritis are afraid to exercise because they think it will damage their joints and make their arthritis worse.

Despite what many people think there is no evidence that exercise makes osteoarthritis develop or makes it worse, and in fact physical activity can help people who have the disease.

Being more active if you have osteoarthritis can help in several ways. Doing aerobic exercise raises the level of endorphins in the body. Endorphins make you feel good and more importantly reduce the feeling of pain. Regular exercise may lead to you losing fat and building up muscle which will help to support your damaged joints. Losing weight also reduces the stress on joints.

It is best to start with small, steady increases in how hard you work your joints. Keep going though, regular exercise can be more effective than medication in reducing pain, and the side effects are all good ones (you’ll feel better, be healthier and improve your quality of life).

Even more significantly, if you are over 35 and have osteoarthritis along with other health problems including cardiovascular disease, diabetes or cancer you have an increased risk of dying early. Even small amounts of exercise such as walking around the house during adverts on the TV makes a difference.

All in all, despite what you might think, exercise is great for people with osteoarthritis.

You can find out more about how exercise is  beneficial to people suffering with osteoarthritis on the arthritis research website

What type of exercise is right?

You should try low impact activities such as walking, rowing, swimming or cycling. Doing some aerobic exercise is great for producing endorphins and reducing pain, try to get active every day. Start small if you aren’t used to exercise, perhaps with a daily walk, then build up to longer walks or other activities.

Activities that help keep you flexible will be very beneficial, for example yoga, tai chi and pilates. Building muscle up around affected joints is also very helpful so some resistance or strength building exercise is a good idea.

You can do lots of exercise, but it is worth talking to your doctor before taking anything new up. As long as your doctor is happy and you let any instructors or gym supervisors know that you have arthritis you should be fine.


Osteoporosis is a condition that affects the bones, causing them to become weak and fragile and more likely to break.

Our bones start to lose density after the age of around 30, so it is really important to make sure we do everything we can to develop strong bones when we are young. There is also increasing evidence that regular exercise can help prevent bone loss associated with getting older.

Weight bearing exercise and resistance exercise is best for building strong bones.

If you already have osteoporosis walking is very good for you, as is balance, strength and coordination exercise such as Tai Chi, yoga or pilates.

Improving your coordination and balance will help reduce your risk of falling.

NICE guidance recommends that people with osteoporosis are encouraged to walk, especially outdoors as this helps vitamin D production which is also good for your bones.

Please note though that any activity that puts you of risk of falling isn’t a good idea, if you suffer from osteoporosis it’s wise to avoid activities such as skiing or contact sports.

What type of exercise is right?

Weight bearing and strength building exercise are good for osteoporosis. It is really important that you avoid any activity that puts you at risk of falls or damage to your bones.

Walking is a great way to get started. A short daily walk will start to help you build up your fitness and give you confidence to try new activities. Vitamin D is important for bone health, so any outside activity you do will be beneficial.

You could try some resistance training, look for classes such as Yoga or a weights class, or join a gym where you use equipment designed to help you build up muscle.

Rheumatoid Arthritis

Rheumatoid arthritis is a common, painful condition characterised by swollen and painful joints. It affects the whole body and can cause muscle wasting and lead to increased obesity.

Many people worry that exercise will make their condition worse, thinking it may damage their joints or increase the inflammation and pain.

Research has proved that this isn’t the case. Exercise has a very positive effect on reducing the effects of rheumatoid arthritis and does not result in increased damage to joints. As long as your arthritis is under control it is great to exercise, and if you want to keep mobile you really do need to do it.

Gentle exercise is good for all people with rheumatoid arthritis. The more you do, either increasing the amount or intensity of the exercise, the more benefits you get. Strength-building exercise is great as it helps build up muscle and can help overcome the muscle wasting that many patients suffer. Start slow – walking or swimming are both recommended, but then if you can, try adding in stretches, aerobic exercise and strength building activities.

We don’t recommend high impact activities or contact sports though.

NICE guidelines state that people with rheumatoid arthritis should have access to specialist physiotherapy with the aim of improving their general fitness and encouraging regular exercise.

What type of exercise is right?

Keeping active is really important if you have rheumatoid arthritis. Any activity you can do to improve flexibility and build up your strength is good.

Your doctor might be able to offer you specialist physiotherapy. Use of weights to help build up strength around affected joints is helpful.

Keeping active will also help your overall health. A regular daily walk, swim or bike ride will help keep you fit and maintain your muscles.You could also join an exercise class doing pilates, Yoga, Tai Chi or a range of other low impact activities.

Prevention of Falls

Older people tend have an increased risk of falling. This is because as we age our muscles don’t work as well. By the time people reach 80, they have the potential to lose 40 per cent of muscle strength. This affects everyone, whether they have a medical condition or not. Some medical conditions can make the risk much higher, and the risk of breaking a bone if you do fall can be high.

General activities such as walking or cycling don’t seem to help prevent falls, but muscle strengthening and balance exercises make a significant difference.

Tai Chi, Yoga and Pilates all help.

A recent study has shown that this doesn’t just help healthy older people, but also reduces the risk of falls in older people suffering from dementia.

How often?

If at risk of falls you need to do 3 hours of strength and balance exercises per week.

Strength building exercise is most effective if it is combined with balance training.

Ideally you should exercise 3 times per week.

NICE guidelines say:

Older people at risk of falling should be offered balance and strength training.

What type of exercise is right?

Here is a useful video that gives six simple exercises that will help prevent falls. Balance and strength building exercises will help. Tai Chi, Pilates, Yoga, dancing, playing bowls all help you to balance. Balancing is something you can get better at – the more you practice balancing and stretching the more you can do it. As you build up core muscle strength it gets easier.  Keeping active is important too, try a regular daily walk and avoid sitting still for too long each day.