Tai Chi is a Chinese exercise practiced for centuries for both self-defense and health benefits, involving a system of movements and postures designed to connect the mind and body in a holistic manner. Tai Chi is believed to provide health benefits for the body, including increased strength, flexibility, coordination, and improved posture, and the mind, including reduction in stress, improvement in memory and concentration, and decrease in anxiety.1
What is the evidence for the effectiveness and safety of Tai Chi in RA?
Tai Chi as a form of exercise provides important general health benefits, including increased muscular strength, reduced stress, and improved cardiovascular and bone health. However, there is limited evidence from randomized, controlled trials upon which to judge the benefits of Tai Chi in terms of improving RA symptoms. Results from existing studies do, however, indicate that Tai Chi can be a safe form of exercise for patients with RA.2
A Cochrane review of clinical trials of Tai Chi was conducted in 2004. (Cochrane Reviews are systematic reviews of primary research in health and medicine, published online in the Cochrane Library. Cochrane Reviews provide the highest standard of evidence-based medicine based on clinical evidence.) The 2004 review considered results from four studies in which benefits of Tai Chi were evaluated in a total of 206 participants with RA. There were significant limitations in the studies considered in the review, including wide variation in the intensity with which Tai Chi was practiced and inadequate control of other forms of exercise that participants engaged in during the studies. The review concluded that Tai Chi did appear to result in improved joint motion in the lower extremities. However, there was no evidence that Tai Chi improved grip strength or joint tenderness. Importantly, the review also found that Tai Chi did not have any negative effects on disease activity.3
Another review of existing studies, including three studies conducted after the previous Cochrane review, found little evidence that Tai Chi was effective as a treatment for RA.4 However, findings from more recent studies indicate that Tai Chi may provide real benefits to patients with RA, including improved ACR20 response, improved physical functioning, and improved muscle function in the lower limbs, resulting in increased walking ability, and increased strength and endurance. Even though there is no definitive evidence for the benefits of Tai Chi used alone in patients with RA, promising results from more recent studies do suggest that Tai Chi may be useful and safe as an adjunctive therapy (i.e. a secondary treatment that can be used in addition to a primary treatment) for RA.2
Resources for starting Tai Chi
While questions remain to be answered concerning the effectiveness of Tai Chi in terms of improving symptoms of RA, the practice does appear to provide real benefit in terms of general health and joint function (particularly in lower extremities). Importantly, it also appears to be safe when practiced carefully and under proper supervision.
If you are interested in trying Tai Chi, talk to your doctor first to discuss your general health and ability to engage in exercise. Your doctor may know of a Tai Chi class or instructor in your area who is experienced in leading classes for individuals with RA or other disabilities.
Written by: Jonathan Simmons and Emily Downward | Last reviewed: April 2019.
Tai Chi. Natural Standard Monograph. 2012; 1-59.
Uhlig T. Tai Chi and yoga as complementary therapies in rheumatologic conditions. Best Pract Res Clin Rheumatol 2012;26:387-98.
Han A, Robinson V, Judd M, Taixiang W, Wells G, Tugwell P. Tai chi for treating rheumatoid arthritis. Cochrane Database Syst Rev 2004. Available at http://dx.crossref.org/10.1002/14651858.CD004849. Accessed 6/14/18.
Lee MS, Pittler MH, Ernst E. Tai chi for rheumatoid arthritis: systematic review. Rheumatol (Oxford) 2007;46:1648-51. https://doi.org/10.1093/rheumatology/kem151.