Over 350 million people in the world have some form of arthritis. And that number is expected to grow in the coming years. There are many factors, obesity being an important one, that are contributing to the growing number of patients.
If you’re one of the 350 million people who suffer from arthritis, then you should know how it’s treated with physical therapy. That’s exactly what we’ll cover in this article.
What Happens to Your Body When You Have Arthritis?
Arthritis is of two main types: Osteoarthritis (OA) and Rheumatoid arthritis (RA).
In OA, your joint cartilage disintegrates and the joint space decreases. As a result, the joint surfaces come in contact and cause pain when you put load on the joint.
The bones of a joint are covered by hyaline cartilage which acts as a cushion while loading the joint and allows bones to smoothly slide during movement. This cartilage is destroyed in arthritis.
OA affects the bigger joints such as the hip, knee, spine, etc. and the symptoms include pain during movement or rest, inflammation, warmth, and a change in the walking pattern if arthritis is in the lower limb joints.
In rheumatoid arthritis, there is dysregulated inflammation and autoantibody production which attack the synovial membrane of joints and damage the surrounding bones.
RA mostly attacks the smaller joints such as those of the fingers, wrist, or toes. It causes intense pain and significantly restricts the mobility of the involved region.
What’s Included in Physiotherapy Treatment for Arthritis?
The four key components of physiotherapy for arthritis include:
- Education
- Exercise
- Self-management
- Activity modifications. (Reference)
Patient Education
Patient education is a crucial part of the physical therapy treatment for arthritis. That’s because patient compliance plays a major role in the effectiveness of the treatment regimen.
Education includes talking to you about the risk factors, aggravating factors, self-management tips, the importance of exercise and movement, disease progression, and its symptoms.
Exercises for Arthritis
All physical therapy exercises for arthritis have the same goal, which is to strengthen the muscles enough to decrease the load on the joints.
These exercises include stretching, strengthening exercises with body weight and resistance bands, hydrotherapy to allow buoyancy to reduce the body weight on joints, and bracing the knee from different sides depending on the area you need to offload.
Self-Management of Arthritis
Self-management is key to dealing with arthritis and flare-ups. Physical therapists use joint mobilizations and massage therapy for temporary pain relief during these episodes.
You can do the same to ease the pain and also perform low-intensity exercises to activate muscles and take some load off the joint. Medications, especially anti-inflammatory NSAIDs, are helpful during flare-ups.
Activity Modifications for Arthritis Patients
One of our goals of arthritis management with physiotherapy is to keep you active. So we help you adjust your movement patterns and modify your home environment to make it more conducive to your recovery.
Additional Physiotherapy Treatments for Arthritis
We also provide supplementary treatments on top of the exercises. These include modalities (ultrasound and TENS for pain relief), unloader brace, lateral wedge insoles, etc.
These are suitable for a small percentage of patients and are not the go-to physiotherapy treatment for arthritis.
Weight loss is a goal of physiotherapy for arthritis as well but only for people who are overweight.
Fall prevention strategies, teaching you to use assistive devices for walking, and flexibility drills also fall under the physiotherapy treatment umbrella.
Preventing Arthritis Before the Onset of Symptoms
Since the causes of arthritis are not known, it’s difficult to develop a prevention program that works for everyone.
But we do know some of the factors that contribute to arthritis such as age, activity level, diet, and body weight and that’s what we work on here. (Reference)
Controlling the modifiable risk factors can decrease the chances of developing arthritis later in life. That’s why the primary prevention of arthritis involves maintaining:
- Healthy body weight
- Muscle strength
- Bone strength
- High physical activity level
Physical therapists can design an arthritis prevention program for you based on the current state of your health and your risk profile.
Common Physical Therapy Exercises for Arthritis
Here are some of the exercises you can do for the three major categories of arthritis.
All treatment sessions begin with a good warm-up and general ROM exercises.
● Exercises for Osteoarthritis of the Knee
Exercises to treat the osteoarthritis of the knee include
Static Quads (Isometric Knee Extensions)
These are meant to increase the strength of your quadricep muscles so they can contribute towards taking some of the load from the knee joint.
To perform, sit while extending your leg with the osteoarthritic knee. Place a towel or roll under the knee and press down on it by clenching your thigh muscles. It activates the muscles without having them move too much.
Muscle Stretching
This includes stretching your calf, thigh, and hamstring muscles. The goal is to maintain their maximum length so your joint can move through its full range of motion.
You can perform these stretches in standing, sitting, or lying. There isn’t one correct way to do these, so following whichever stretch is the most comfortable for you as long as it gets the job done. (Reference)
Strength Training
This includes leg press, partial squats, toe standing, heel standing, etc. The purpose of strength training is to ensure correct joint alignment, which often suffers when the knee becomes osteoarthritic.
Other Exercises
Low-intensity aerobic exercises for weight loss are also a part of the physical therapy treatment for knee OA. Reducing your body weight by just 10 pounds can offload nearly 30 pounds of weight from your knees.
Ultrasound, manual therapy, and bracing are used along with an elaborate exercise program.
● Exercises for Arthritis of the Back and Neck
We prescribe core strengthening exercises for patients with arthritis of the spine. It strengthens the muscles of your abdomen and back, which takes the load off the joints in your spine.
These exercises include pelvic tilts, lying march, plank, etc.
For strengthening the neck muscles, you should move your neck through its full range of motion and have someone apply resistance to your activity.
The goal is to have your muscles work harder to complete the ROM against additional external load, which should improve their strength and take some of the load off the joints of the neck.
Traction can help if there’s nerve compression. For that, you can lock your knees in one place and ask someone to pull you from your shoulders in the opposite direction of your feet.
Try sitting on a couch with your legs hanging. Lay down from your hip up. This position will lock your knees in place and isolate the traction force to the joints of your spine.
Don’t apply traction to the neck because there are a lot of sensitive structures there so that’s a job for professionals only.
Stretchings of your neck and low back muscles can be pain-relieving and can improve your mobility. For the low back, lie on your back with your knees bent and feet flat on the floor. Move your knees from one side to the other such that you twist your low back.
For the neck stretches, sit up straight and move your neck to the extremes (only to the point where you don’t feel pain) of side bending, forward bending, and rotation. Feel free to apply overpressure with your hands if you don’t have pain while doing that.
● Rheumatoid Arthritis
The exercises we use for treating rheumatoid arthritis are aimed at increasing your mobility and functional activities.
These exercises include:
Aerobic Exercises
Endurance training, although doesn’t directly improve RA, helps to improve your overall health. Patients who suffer from rheumatoid arthritis take a cocktail of medications, some of which affect the cardiovascular system.
Aerobic exercises ensure that you have the stamina you need to perform activities of daily living.
Strength and Resistance Training
Stronger muscles can support the joints with RA much better than weaker ones. Since RA affects the small joints first, the dynamic strengthening exercises are targeted at the fingers, wrist, and forearm in the upper limb. And the toes, ankle, and calf in the lower limb. (Reference)
Joint Flexibility Exercises to Improve ADLs
Flexibility drills include stretching the muscles and moving your joints through their full ROM. You can do these throughout the day whenever you have the time. It’s also best to include flexibility exercises in your warm-up before beginning aerobic or strength training exercises. (Reference)
Can Arthritis Be Cured With Physiotherapy?
No, there’s no treatment as of yet that can completely cure arthritis.
It’s a debilitating disease. PT helps manage your symptoms and improve your mobility so you can carry out your regular activities but it can’t cure arthritis.
Research shows that physiotherapy is effective for
- Increasing the range of motion of the arthritic joint
- Improving function
- Improving muscle strength
- Temporarily decreasing pain intensity
The earlier you reach out to us the better. The muscles begin to lose strength and the joints lose their mobility quite rapidly once the inflammation starts.
Starting physical therapy in the early stages of arthritis can preserve your functional levels and delay joint and bone degradation. That decreases the extent of the disease and damage as well. (Reference)
The Takeaway
The treatment of arthritis for each patient is different. Some require a strengthening focused program while others benefit from a functional program.
Your physiotherapist can be the best judge of which treatment program will suit you. Feel free to contact us for personalized physiotherapy treatment of arthritis based on your current functional status, goals, and activity level.
Disclaimer: This article is for informative purposes only. We provide well-researched and authentic information. Do not consider this personalized health advice. Please contact a licensed healthcare professional for medical issues and health concerns.