It's quite common for people with rheumatoid arthritis (RA) to suffer from bone damage and loss. Inflammation and the overproduction of certain chemicals such as tumor necrosis factor alpha (TNF alpha) destroy cartilage and bone.

While bone damage is a common occurrence in osteoarthritis (OA), bone loss isn't-but it can occur, especially as you get older. Eventually, thin and damaged bones reduce joint function, and increase joint pain and your risk of falls and fractures. Here are a five ways to protect your bones when you have arthritis:

1. Walk. Pain and stiffness in your knees or hips doesn't have to prevent you from enjoying this low impact aerobic activity. A Tufts University study showed that women who walk more than 7.5 miles each week had higher mean bone density of the whole body and of the legs and trunk than women who walk less than one mile per week. The study also showed that walking slows bone loss as you get older. Try to rack up 10,000 steps five days a week using a pedometer. Or, aim for 30 minutes of walking five days a week.

2. Lift weights. Building strong muscles can work wonders to improve and maintain strong healthy bones. According to Johns Hopkins Medicine, for people with arthritis (especially those taking corticosteroids), weightlifting helps increase bone density and slows the loss of bone, reducing the risk of osteoporosis.

Any effective arthritis exercise regimen must include weightlifting. Your physical trainer will be able to help you determine how much weight is right for you based on your age, stage of arthritis, and overall fitness. Try to include weightlifting at least twice a week.

3. Manage your meds carefully. Inflammation may be a major factor in bone loss in RA, but corticosteroids used to control RA also damage bones. Some doctors recommend taking calcium and vitamin D supplements with corticosteroids to reduce bone loss. Speak to your doctor about how much of these supplements you should be taking each day.

Alternatively, find out if there are other medications that would be just as effective at managing your arthritis that do not pose the same risk. For instance, some research suggests that disease modifying anti-rheumatic drugs (DMARDs) prevent systemic bone loss in RA.

4. Protect cartilage. Arthritis destroys this natural cushioning between the joints. As the condition gets worse it's possible to develop bone spurs, or for the ends of bones in the joints to erode and flatten. Keeping cartilage healthy and strong for as long as possible can delay these effects.

There are several ways to protect cartilage, which includes stretching and exercise, and taking glucosamine and chondroitin supplements. Methylsulfonylmethane (MSM) is another supplement recommended to protect joint cartilage and reduce inflammation. You can buy it on its own, or in combination with other supplements such as glucosamine. Antioxidants from fruit and vegetables also fight free radicals that destroy cartilage.

5. Balance your diet. According to a study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism, the acid/alkali balance of a diet is important to bone health. The researchers found that diets high in protein and cereal grains produce an excess of acid in the body, which can increase calcium excretion and weaken bones.

The researchers recommend eating more fruits and veggies, which produce bicarbonate in the body that protects bones. Although more research is needed, they also found that adding alkali to a diet in pill form can prevent bones from breaking down and reduce loss of calcium.

Study References

Journal: Arthritis & Rheumatism., Vol. 42(7), pp 1378-85.

Study Date: July, 1999

Study Name: Osteoarthritis and risk of falls, rates of bone loss, and osteoporotic fractures. Study of Osteoporotic Fractures Research Group.


Author(s): Arden NK, Nevitt MC, Lane NE, Gore LR, Hochberg MC, Scott JC, Pressman AR, Cummings SR.

Journal: The American Journal of Medicine, Vol. 96(1), pp 20-6

Study Date: January, 1994

Study Name: Walking is related to bone density and rates of bone loss.


Author(s): Krall EA, Dawson-Hughes B

Journal: Journal of Clinical Endocrinology & Metabolism, Vol. 94(1), pp 96-102

Study Date: January, 2009

Study Name: Treatment with Potassium Bicarbonate Lowers Calcium Excretion and Bone Resorption in Older Men and Women


Author(s): Bess Dawson-Hughes, Susan S. Harris, Nancy J. Palermo, Carmen Castaneda-Sceppa, Helen M. Rasmussen, and Gerard E. Dallal