Physical Therapy Treatment for Arthritis

Did you know that there are over 100 types of arthritis and related conditions? In fact, the Arthritis Foundation lists arthritis as the leading cause of disability among Americans. People of all ages may be affected by this condition to varying degrees, even children, and while its effects may be merely an annoyance to some, to others it can interfere greatly with everyday tasks. As arthritis progresses simple things like getting out of bed, opening a tight jar, or going up stairs can become more difficult.

So what is arthritis? The term arthritis is an umbrella term for conditions involving inflammation and pain in the joints. Osteoarthritis is the most common type of arthritis. It causes degeneration of cartilage lining the joint and most often affects weight bearing joints such as the hips and knees. This type of arthritis is often associated with “wear and tear” as a person ages. Other types of arthritis with different underlying causes exist as well. Arthritic conditions can typically be classified as degenerative, inflammatory, infectious or metabolic. Rheumatoid arthritis, juvenile arthritis, psoriatic arthritis, lupus and gout are examples of other types of arthritis

WHAT ARE THE SYMPTOMS OF ARTHRITIS?

Joint pain, swelling, stiffness and decreased range of motion are common symptoms of arthritis. In mild osteoarthritis joint pain and swelling typically occur in response to activity and improve with rest. As joint surfaces degenerate further pain, stiffness, and inflammation may persist even at rest and be worse, for instance, when first getting up in the morning or after sitting for a long time. 

Inflammatory arthritis such as rheumatoid arthritis is caused by an autoimmune response leading to inflammation in the joints. Similar to osteoarthritis, swelling, joint pain, and stiffness are common. Inflammatory conditions, however, can also affect other connective tissues such as lungs, heart, eyes and other organs. Heat and tenderness to touch around the joint line is also very common. The small joints of the hands and feet are often involved and in many cases multiple joints throughout the body are affected. Because this type of arthritis is caused by an overactive immune response, a specialist such as a Rheumatologist will often be involved in treating and managing the underlying condition. 

HOW IS ARTHRITIS DIAGNOSED?

If your physical therapist suspects arthritis, they will interview you on what symptoms you are experiencing, what aggravates and eases your symptoms and where they are located. They will gently move your joints to assess their mobility, palpate (feel) the joints and surrounding tissue for any inflammation, heat or tenderness, and assess your movement during functional activities such as standing, walking or squatting. They may also perform specific tests to the joints themselves to rule out other conditions involving the muscles, tendons and ligaments.

In some cases your physical therapist or physician may recommend imaging such as an X-ray, CT scan or MRI to evaluate the joint surfaces for any cartilage breakdown, signs of inflammation or deformities. As arthritis progresses the congruency of the joint surfaces decreases which can further exacerbate pain and result in a need to change the way you stand, walk or move. If you, yourself have arthritis, you are probably familiar with the creative ways people often adapt to arthritis pain. 

HOW CAN A PHYSICAL THERAPIST TREAT MY ARTHRITIS?

While physical therapy cannot reverse the effects of arthritis on joint tissues, research shows that physical therapy is an effective tool to reduce pain and improve function. When physical activity worsens pain, it is common for persons with arthritis to begin self-limiting activity. First you may cut back on how many miles you run then you move into a single story house to avoid the stairs. Soon you find yourself walking with a cane or walker and saying no to invitations to attend baseball games and trips to the mall. 

Though it may seem counterintuitive, less motion is often not the answer to arthritis pain. This is where a physical therapist can help. After interviewing and examining you, your PT at Evolve will work with you to understand your goals and develop a plan to help you get there. 

Pain Reduction: Joint pain may be mild, moderate or severe but physical therapy can help to address your pain symptoms. Modalities such as heat, ice or electrical stimulation may be prescribed by your PT to reduce inflammation and provide pain relief. They may also apply gentle hands-on techniques such as passive range of motion, soft tissue or joint mobilization, myofascial release techniques, or taping to improve the mobility and health of the joint and soft tissues that are affected. 

Restore Joint Motion: Joint stiffness and loss of range of motion are common with arthritis. Restoring normal joint motion is an important step in getting you back to your favorite activities. If mobility is restricted in the connective tissue structures around the joint itself, joint mobilization techniques may be utilized to improve that motion. Active range of motion might be prescribed initially to reintroduce motion to the joint and later on stretching may be prescribed to help lengthen chronically shortened tissues. 

Address Biomechanical Impairments: While the surfaces of the joint may no longer be pristine, how the joint moves and how much stress is applied across an arthritic joint can play a large role in how much pain you experience and how much you have to limit your activities. Proper strength and flexibility in the muscles surrounding the joint can optimize the movement of the joint and may reduce some of the rubbing that occurs between uneven joint surfaces. Your physical therapist will test your muscles to identify areas that need work and can guide you through a progressive program of exercises to address these issues.

 As muscles get stronger and tissues regain their proper length and flexibility, learning to activate muscles at the right time and in the right order during a specific activity is essential. For example, proper firing of foot, ankle, and hip musculature is essential for good biomechanics with running and stair climbing. Even if your muscles are strong, the motor control of these muscles may not be adequate to properly perform a movement without putting excessive stress across a certain joint. As you learn to control and fire your muscles while performing a motion such as hitting a tennis ball, you will likely experience less pain in your shoulder joint. 

Getting Back to Activities

The ultimate goal of a physical therapy program is to help you get back to the activities you love and need to do throughout your life. At Evolve, your PT will help you get back to activities in the safest, most effective and quickest way possible. They will always strive to help get you back to these activities but in cases where that is not possible without some modification, your PT is there to help advise you on adaptations you can make to help control your symptoms.

While arthritis pain may have been in the driver’s seat for some time, there is something you can do about it. Schedule an evaluation with a physical therapist at Evolve to learn more about your condition and begin taking steps to regain control over your arthritis pain.

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About EvolveNY-

Brooklyn’s Premier Holistic Physical Therapy Clinics-

There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better! First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

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