In February the Osteoarthritis Research Society International (OARSI) released new recommendations on minimizing the grating aches and pains of osteoarthritis. Key among those recommendations was -- you guessed it -- exercise.

“There have been a slow but steady number of studies in recent years that have looked at exercise for osteoarthritis, and they all agree that it’s very, very important,” says Duke rheumatologist Virginia Kraus, MD. She and Duke pain specialist Francis Keefe, PhD, talked a bit about the new proof behind the old strategy: keep it moving.

Know all the right moves: Kraus says that, in general, the two types of exercise that are the safest and the best tolerated by people with arthritis are aquatics and biking -- especially recumbent biking, because the low seat and back support allow the pedaler to get good aerobic training without weight or strain on the leg joints.

Try the Y: For years the Arthritis Foundation has supported specialized aquatic and land-based exercise programs for arthritis patients. The programs were developed by rheumatologists and physical therapists, and the classes are offered at most YMCAs across the country.

New studies have proved that patients who followed one of the arthritis exercise programs saw lasting improvements in pain, fatigue, strength, and arthritis symptoms after eight weeks.

Don’t dismiss the NSAIDs: According to the new OARSI treatment guidelines, some doctors and patients may be too quick to spurn nonsteroidal anti-inflammatory drugs (NSAIDs) such as Aleve and Celebrex, because of gastric complications and concerns over possible heart health risks.

The OARSI review of available data led the experts to conclude that short-term use of NSAIDs may be very beneficial in many patients, and the benefits may outweigh the risk of side effects in some people.

Minding the pain: Arthritis pain really is different from other types of pain, according to a small study reported last year. That’s because the pain caused by arthritis is processed in the parts of the brain that also control emotions, including fear and distress.

Accordingly, mind-body techniques such as guided imagery, meditation, and other relaxation-based pain management techniques may be particularly effective in helping to treat arthritis pain, says Keefe.

The arthritis rehabilitation program at the Duke Center for Living offers a specialized arthritis treatment plan, which includes exercise such as the Arthritis Foundation aquatic and land-based programs. Medicare and insurance companies reimburse part of the cost -- for more information, call 919-660-6640.

Both the aquatic and the standard exercise programs are also available from the Arthritis Foundation as videos that people can do at home.