What Kinds Of Physical And Occupational Therapy Will Help My Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is a chronic, progressiveprevent joint stress, support joints, and decrease joint
disease which may lead to considerable disability. Whilestiffness.
there are no cures for RA, recent developments inWrist splints and ring splints are useful for reducing
biologic therapy make it possible to place manyinflammation and preventing deformity in the hands.
patients into remission.Joint stress in the feet can be reduced by using a
In addition to medications though, it is important to addsupporting pad at the sole of the foot and by using
adjunctive treatments such as physical therapy andmetatarsal pads. Visco-elastic soles may help reduce
rehabilitation which help to increase functional capacity,shock loading occurring in the legs with walking.
provide pain relief, and also provide patient education.For RA patients with serious neck involvement,
Before starting therapy, physical assessments shouldparticularly with the first and second vertebrae, a
include: functional assessments (what the patient isPhiladelphia collar may be needed. The Philadelphia
capable of at the present time), range of motion,device provides excellent immobilization and may be
muscle strength, posture, and level of fitness.used in the presence of neck instability.
Cold and hot modalities are the most commonly usedPatients using compression gloves have reported
physical treatments in arthritis therapy. Cold applicationreduced joint swelling and pain but there is no hard
is mostly used in acute stages whereas hot is used inevidence that they improve grip strength or hand
chronic stages of RA.function. Improvement may be provided by using
Heat works because it induces analgesia, relievescompression gloves both during the day as well as at
muscle spasm, and improves flexibility. Heat can benight in patients with inflammation in their hands or
used before exercise to help loosen muscles andfingers.
joints. Heat treatment may be applied as a hot-pack,Occupational therapy interventions such as assistive
infrared radiation, diathermy, paraffin, or hydrotherapy.devices and adaptive equipments have beneficial
Applications are recommended for 10-20 minutes onceeffects on joint protection and energy conservation in
or twice a day. Caution should be exercised in patientsarthritic patients. Assistive devices are used in order to
with nerve damage, impaired circulation, or diabetes,improve functioning, reduce pain, and keep patients self
since there is a risk of thermal injury.sufficient.
Cold therapy is preferred in active joints whereLoading over the hip joint may be reduced by about
inflammation is uncontrolled. Cold packs, ice, nitrogen50% by using a cane. Elevated toilet seats, widened
spray, and cryotherapy are different ways of applyinggripping handles, bathroom adjustments all help improve
cold-therapy.activities of daily living.
Cartilage-destroying enzymes such as collagenase,Massage is used to improve general well being and
elastase, hyaluronidase, and protease are produced inhelp diminish swelling of inflamed joints. Massage can
the inflamed joints of patients with RA. Levels of thesehelp with depression, anxiety, mood, and pain.
enzymes are affected by the temperature withinMuscle weakness in patients with RA occurs as a
joints. Increasing temperature inside the joint leads toresult of immobilization or reduction in activities of daily
an increase in collagenase activity and cartilageliving. Maintenance of normal muscle strength is
damage.important not only for physical function but also for
Electrostimulation is used in patients with RA to relievestabilization of the joints and prophylaxis of traumatic
pain. Transcutaneous electrical nerve stimulationinjuries. Exercise therapy has beneficial effects on RA
(TENS) therapy is the most commonly used method.by improving endurance and enhancing fitness.
TENS is a short-acting therapy and it also has a highThings to consider before launching an exercise
placebo effect.program include: whether the involvement of the joints
Water therapy, also known as hydrotherapy oris local or systemic, disease stage, patient age, and
"balneotherapy" has been used for arthritis sincepatient compliance.
ancient times.Range of motion exercises, stretching, strengthening,
Objectives of hydrotherapy are to increase range ofaerobic conditioning exercises, and routine daily
motion, strengthen muscles, relieve painful muscleactivities all should be included in a comprehensive
spasms, and improve a patient's well-being.exercise program.
There have been studies showing beneficial effects ofEvery joint should be moved in full range of motion at
hydrotherapy with pain reduction and improvement inleast once per day in order to prevent contracture. In
grip strength. Because of buoyancy, water therapythe case of acutely inflamed joints, isometric exercises
allows patients to perform exercise without undue jointprovide muscle tone without worsening disease
stress. Some studies have shown that hydrotherapyactivity.
leads to muscle, tendon, and ligament relaxation and aIf the disease activity is minor, then isotonic exercises
feeling of well-being. Endorphin release may alsoshould be performed by using very low weights. If pain
contribute to improved pain control.persists more than 2 hours or too much fatigue, loss of
Some have suggested that water therapy may havestrength, or increase in joint swelling occurs after an
beneficial immune system benefits with reduction inexercise program, then the program should be made
pro-inflammatory cytokines.less intense. Walking can aggravate knee pain in
Physical and occupational therapists educate patientspatients with active inflammation. Therefore, patients
in joint protection strategies, use of assistive devices,with active RA should avoid activities such as climbing
and performance of therapeutic exercises.stairs or weight lifting. Producing excessive stress over
Joints should be put at rest during the acute phase ofthe tendons during the stretching exercises should be
the disease. Bed rest relieves the pain in cases ofavoided.
extensive joint involvement. It is critical, at this stage, toWhen arthritis is controlled medically, conditioning
put the joints into rest at a functional position.exercises such as swimming, walking, using an elliptical
Fortunately, bed rest is not needed as much as it oncetrainer, and cycling with adequate resting periods are
was. Splints are used to keep involved joints in arecommended. They increase muscle endurance and
functional position. Splints help to mitigate pain andaerobic capacity and improve function of the patient,
inflammation, prevent development of deformities,and they also make the patient feel better.