At a recent meeting of leading Tai Chi and Qigong teachers and masters, the benefits of Tai Chi for arthritis through the power of Qi was a prominent discussion area. Tai Chi as a form of Qigong holds promise to help many medical conditions. Most who benefit from these practices do not care how or why – just that it works for them.

The answer given in the Tai Chi community for how these exercises benefit health is the power of Qi. There is so much to this two-letter word that entire books have been written on Qi, presenting and exploring its many dimensions. Zhang Yu Huan and Ken Rose present nice overview of the history and the range of meaning behind the concept of Qi, which includes 23 separate definitions of Qi.1 So how does this relate to Tai Chi for arthritis?

Arthritis—A Complex Disease

Many people assume that arthritis is an inevitable part of aging. But arthritis is a complex disease, which can affect children, teens and young adults as well. With over 100 types of arthritis, causes and treatment can vary.2 Hearing the many healing stories of Tai Chi and Qigong, many people have turned to these exercises in an attempt to reverse or better deal with arthritis symptoms.

Dr. Paul Lam is one of the most well-known, who turned to Tai Chi after developing disabling arthritis in his teens.3 He began studying Tai Chi with his father-in-law hoping to ease his painful arthritis and seeing the impact Tai Chi had on his condition, went on to develop a program for others suffering from arthritis and other conditions. Others have documented benefits for arthritis from a range of Tai Chi programs.4-6

The benefits for pain and inflammation are particularly notable. I have celiac neuropathy, symptoms of which typically include shooting pain, burning sensations, and numbness and tingling in the extremities. However, in my case, except for numbness in my feet and lower legs, I never experienced any of these symptoms. I feel that this is due to being a long-time Tai Chi and Qigong practitioner. And when I made certain adjustments to my practice based on my research, discussed below and in my book (Mindful Exercise: Metarobics, Healing, and the Power of Tai Chi, YMAA Publication Center), even the numbness cleared up. I have also been told by my physician that I have blood markers for rheumatoid arthritis but have never had any arthritis related symptoms.

As a researcher, it would take a range of controlled studies to determine the nature and significance of the relationship between these practices and benefits for arthritis. But as a person, Tai Chi and related practices, are something I have come to have faith in. And as noted above and below, there is a growing body of research supporting these benefits.

As one ages, normal wear and tear of the joints can result in osteoarthritis and joint inflammation. Rheumatoid arthritis is the result of an immune system attack on the body, affecting the soft tissues in your joints. Why this occurs is currently unknown.7 Rheumatoid arthritis can eventually lead to the destruction of the bone and cartilage within the joints. The primary goal of treatment is to reduce the pain associated with arthritis and prevent additional joint damage. As noted in research on Tai Chi, reduction of pain is uniform across studies for various conditions, including arthritis.4-6

In a review of 18 randomized controlled trials by Dr. Ling Jun Kong and colleagues, Tai Chi showed evidence of immediate relief of chronic pain from osteoarthritis, as well as some beneficial effects of Tai Chi on immediate relief of chronic pain from low back pain as well as osteoporosis.4 One person who came to me to learn Tai Chi had been taking five maximum doses of morphine for pain during her cancer treatment. Within 10 days of daily practice, she was completely off pain pills. She also went into remission. See my book for her complete story and related research.6

Qigong for Arthritis

Returning to the topic of arthritis, a review conducted in conjunction with the University of Medicine and Dentistry in New Jersey, and the Beijing University of Chinese Medicine, documented ten studies which included Qigong for arthritis.5 The authors note one particularly large study, in which Qigong therapy was provided to 295 rheumatoid arthritis patients who had not responded to conventional treatment (drugs). Participants practiced standing Qigong every day, and underwent acupuncture treatment. Two months later 192 patients reported complete recovery from all arthritis symptoms (pain, impaired joint function, erythrocyte sedimentation rate (ESR), and rheumatoid blood factor). They were still symptom free at the sixth month follow-up. Eighty-three patients experienced significant improvement in symptoms (no pain, but joint function was still slightly limited and ESR was still elevated). Fourteen patients reported some benefits for pain relief and movement. The authors also noted another study of 120 rheumatoid arthritis patients, reporting at the conclusion of the study and at the six month follow up a complete reversal of the disease in 23 percent of participants, and 63 percent who experienced significant improvement (most clinical symptoms including pain had disappeared). Ten percent experienced some improvement, and four percent reported no change. Other studies cited in the review has similar results, including for those which used Qigong alone.

The authors note that from a Traditional Chinese Medicine perspective, arthritis is caused by blocked Qi flow.5 They note that Qi can be translated as “breath of life.” This makes sense, since the literal translation of Qi is “air” or “oxygen.”8 The authors noted that Qigong practitioners have more efficient oxygen metabolism and a slower heart rate than non-practitioners.

Metarobic Exercise

Being able to measure Qi would be a big advance in understanding, researching, and promoting these exercises. Although we cannot measure the diverse and more subtle aspects attributed to Qi, science can measure the oxygen aspect of Qi. And oxygen use, and particularly the potential impact on oxygen deficiency in the body, is possibly the most important aspect of Qi based exercise for health. Hypoxia, which is an oxygen deficiency in the tissues, underlies or complicates almost every health condition.6 This is the reason I have proposed the term Metarobic exercise to describe the effects of Tai Chi and related exercises on the body. Benefits are not aerobic, since the heart rate is not increased to aerobic levels, and they are not anaerobic, which relates to strength-based exercises such as weight lifting. Preliminary research documents that relaxed breath-focused exercises results in a shift in the way the body uses oxygen at the cellular and metabolic level.6,9 Hence the term Metarobics.

Like many other chronic conditions (including heart, lung and kidney disease, cancer, diabetes, compromised immunity, asthma, and many other conditions), arthritis is also aggravated by hypoxia. Metarobic theory and research supports that one of the primary factors in the benefits of Tai Chi for arthritis is its potential effect on hypoxia.6 This also includes benefits of other breath-focused relaxation exercises, including forms of Yoga and Qigong, and possibly even paces of walking slower than speed walking.10

One of the hallmarks of rheumatoid arthritis is the development of new capillary blood vessels (or angiogenesis) in the joints,11 in an attempt by the body to restore sufficient oxygen levels to inflamed joints. Research suggests that this may be a result of increased hypoxia (oxygen deficiency). However the end result is a dysfunctional vascular network which does not restore tissue oxygen, but does further aggravate rheumatoid arthritis and results in swollen painful joints.11, 12 Inflammation also plays a role in Osteoarthritis, which occurs when the cartilage that cushions the joints wears away. Dr. Pfander and colleagues, in their research on the role of hypoxia in osteoarthritis, state that strongly decreased oxygen levels are hallmarks of osteoarthritic cartilage.13

Tai Chi and Qigong may reduce the formation of excessive blood vessels by enhancing blood circulation, oxygen diffusion, and oxygen metabolism, enhancing healing and cellular regeneration. This may reduce or eliminate the stimulus for excessive blood vessel growth. Metarobic theory would explain the reversal of arthritis symptoms in the above research, and in the case stories documented in my book.6 Further research would need to confirm this link, but this would explain the large number of people reporting a variety of health benefits from Tai Chi and related exercises.

Metarobic theory presents an evidence-based explanation of benefits. It can be hoped that with time and further research, Metarobic theory might help maximize the benefits of Tai Chi, Qigong, and related exercises, to result in the full relief of arthritis and other conditions. Dosage (the amount of practice) may be a key factor, as well as style or method of Tai Chi and Qigong practice. In addition to relevant research, I discuss these factors, including my own experiences, in chapter seven of my book “Essential Elements of Metarobics and Tai Ch for Therapy.”

As noted above, I never experienced the pain associated with peripheral neuropathy, which I believe was due to my daily 30 minutes of traditional Yang style Tai Chi. But based on my research, I modified my practice towards small frame Tai Chi to maximize relaxation and increased my practice to 60 minutes a day. Within a few weeks the lower limb numbness cleared up as well. Related to the Qigong and arthritis studies noted above, the question remains. Were the large percentage of patients who reported total elimination or significant improvement of arthritis symptoms more diligent in their practice? Did the few who did not experience any benefits shortcut or even skip their Qigong practice? More research is needed regarding the dosage and format in relationship to potential benefits.
According to the Arthritis Foundation, there is no cure for athritis.7 But if left untreated and unmanaged, arthritis can lead to permanent joint damage. Studies on the benefits of Tai Chi and Qigong for arthritis support that although the disease itself may not be cured; it may be possible to eliminate many if not all symptoms of arthritis.

The above is an original article by Peter Anthony “Tony” Gryffin, PhD, author of Mindful Exercise: Metarobics, Healing, and the Power of Tai Chi, Pub Date 2018, YMAA Publication Center, ISBN: 9781594396175. He is an Associate Professor at Mercer University School of Medicine, researching and teaching in the area of rural health behavior, and also mindful exercise. Tony is a life-long practitioner of various mindful exercises and arts, and is the author of articles, studies, and books in the area of mindfulness and mindful exercise.

References

1. Zhang, Yu Huan & Rose, Ken (2001). A Brief History of Qi. Paradigm Publications.

2. Healthline.com. Arthritis. Feb 2, 2023. https://www.healthline.com/health/arthritis.

3. Born Strong – Dr Paul Lam’s Memoir. Retrieved April 12, 2024. https://taichiforhealthinstitute.org/5859-2/#:~:text=Paul%2C%20as%20he%2....

4. Kong LJ, Lauche R, Klose P, et al. Tai Chi for Chronic Pain Conditions: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Sci Rep. 2016;6:25325. Published 2016 Apr 29. doi:10.1038/srep25325

5. Chen KW, Liu T. Effects of Qigong Therapy on Arthritis: A Review and Report of a Pilot Trial. Medical Paradigm. 2004: 1(1): 1-14

6. Gryffin PA. Mindful Exercise: Metarobics, Healing, and the Power of Tai Chi. YMAA Publications, August 2018.

7. Arthritis Foundation. Rheumatoid Arthritis: Causes, symptoms, treatments and more. Updated Oct 15, 2021 https://www.arthritis.org/about-arthritis/types/rheumatoid-arthritis/cau...

8. Oxford Chinese Dictionary. Oxford: Oxford University Press, 2010.

9. Gryffin PA, Diaz R. Effects of Tai Chi and Running on Blood Oxygen Saturation. Complement Integr Med 2021; aop. doi:10.1515/jcim-2020-0306

10. Gryffin PA. Comparison of Physiological Response Variations in Walking Speed. In Process.

11. Konisti S, Kiriakidis S, Paleolog EM. Hypoxia--a key regulator of angiogenesis and inflammation in rheumatoid arthritis. Nat Rev Rheumatol. 2012 Jan 31;8(3):153-62.

12. Taylor PC, Sivakumar B. Hypoxia and angiogenesis in rheumatoid arthritis. Curr Opin Rheumatol. 2005;17(3):293-298. doi:10.1097/01.bor.0000155361.83990.5b

Arthritis Foundation. Rheumatoid Arthritis Causes. Updated Oct 15, 2021 https://www.arthritis.org/about-arthritis/types/rheumatoid-arthritis/cau...

13. Pfander D, Cramer T, Swoboda B. Hypoxia and HIF-1α in osteoarthritis. Int Orthop. 2005 Feb; 29(1): 6–9.