If you have clients with arthritis, you may already know that pain is one of their barriers to exercise. Making clients understand that exercise can help them not only with their pain but also with their function is sometimes a challenge. But at least your clients are trying. A study in the May issue of American Journal of Preventive Medicine found that people with arthritis don’t exercise enough, and more than a third don’t exercise at all.

Researchers reviewed data from the 2002 National Health Interview Survey, which included 6,829 people who had been diagnosed with arthritis and 20,676 people without arthritis. Just 37% of adults with arthritis met the least stringent physical activity guidelines established in 2001 by a panel of experts in arthritis, physical activity and public health. Participation rates at the more rigorous, federally recommended levels of physical activity were even lower—30% (compared with 33% for people without arthritis).

“We can’t tell from this survey which came first—the inactivity or the problems with function,” said co-author Jennifer Hootman, PhD, of the Centers for Disease Control and Prevention, in a press release. “But we do know that getting people with arthritis active actually improves function.”

The authors say that fear of pain and the misconception that exercise can harm joints are obstacles to exercise. Risk factors related to inactivity include frequent anxiety or depression, especially among women, and severe joint pain among men. “If we can get people with arthritis over the initial pain barrier by addressing their pain and getting them more active, they’ll actually have less pain in the long term,” Hootman said.