[dropcap]H[/dropcap]ow many times have you heard people who suffer from joint pain tell you they can predict the weather? Count among them people with arthritis.
So what is arthritis? The word combines arthron (from the Greek for joint) and itis (inflammation). It is a common condition that affects approximately 350 million people worldwide. Symptoms include pain, swelling, stiffness and decreased movement. The most common forms of arthritis are osteoarthritis and rheumatoid arthritis. However, there are over 100 forms of arthritis impacting both young and old, although it is more common as we age.
Osteoarthritis
Osteoarthritis (OA), sometimes called degenerative arthritis, describes wear and tear or damage to the joints. Whether through injury or age, the joints can show signs of deterioration and abnormalities: thinning of cartilage, development of bony growths called osteophytes. These changes can cause pain, swelling, stiffness and decreased range at the joint. It can affect the knees, hand, hips, neck and back. At present there is no cure for OA and treatment is focused on management of symptoms, such as:
• Pain relief, stiffness and swelling
• Exercises to improve joint mobility, strength and flexibility
• Weight control, to avoid extra load on already vulnerable joints
Physiotherapy and Osteoarthritis
• Exercise and Rehabilitation: Research has proven that exercise is one of the best treatment options for OA. Your physiotherapist can work with you to develop an individual, graduated programme that, over time, will improve your strength, flexibility and function. This may be in a gym environment, in a swimming pool or in your home. Make exercise part of your daily routine to improve your quality of life.
• Manual Therapy: Your physiotherapist has special skills that can increase range of movement and relieve pain.
• Soft Tissue Mobilisation: This will help to relieve achy muscles and joints.
• Electrotherapy: With the use of special equipment your physiotherapist can assist with reducing pain, making exercise and movement easier.
• Advice on the use of heat or cold: There is often confusion about which is better; it will all depend on whether your main problem is joint and muscle stiffness or inflammation. After a thorough assessment your physiotherapist will be able to correctly advise you.
In severe cases your doctor may suggest a joint replacement, when all other options have failed. Even if you choose this option, physiotherapy can help with your pre- and post-surgery rehabilitation.
Rheumatoid arthritis
Like OA rheumatoid arthritis (RA) also affects the joints but is an autoimmune disease that usually affects multiple joints. In autoimmune diseases the immune system, whose function it is to protect the body and fight disease, starts to attack itself. In RA the immune system starts to attack the lining of the joints, which leads to inflammation of the joints and surrounding tissues. The symptoms of RA are inflammation of the joints, which may also feel hot and tender to touch, joint pain, fatigue and joint stiffness first thing in the morning. If left untreated it can often lead to joint deformity. As with OA there is no cure and the focus is on management of symptoms through medication and lifestyle changes. The following are common symptoms:
• Joint pain, swelling, redness, warmth, tenderness
• Joint stiffness, especially first thing in the morning
• Loss of joint range
• More than one joint affected
• Joint deformity
• Fatigue
• Fever
• Anaemia
Physiotherapy and Rheumatoid Arthritis
The focus is on lifestyle changes and management of symptoms such as pain, swelling and loss of function through the following interventions:
• Exercise – for strength, flexibility and function
• Electrotherapy – for management of pain and swelling
• Pacing strategies – to cope with symptoms of fatigue
• Ice and heat – to help with swelling, redness and tenderness
If conservative management does not help with symptoms then your healthcare provider may suggest surgery to slow down exacerbation and joint deformity.
As you can see, the common theme in the management of arthritis is exercise. Your physiotherapist is a perfect choice to find a suitable programme and guide you through your journey to decreased pain and increased function.
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