Physical and Occupational Therapy for Rheumatoid Arthritis
Rheumatoid arthritis treatment often includes physical therapy and/or occupational therapy.
Healthy joints are the "hinges" that let us move around and allow us to function every day. Many of us take that for granted. But if your joints are affected by rheumatoid arthritis, these simple movements aren't always automatic or easy.
Diagnosing rheumatoid arthritis (RA) in the early stages can be difficult. There is no single test that can clearly identify rheumatoid arthritis. Instead, doctors diagnose rheumatoid arthritis based on factors that are strongly associated with the disease. The American College of Rheumatology uses this list of criteria:
Morning stiffness in and around the joints for at least one hour.
Swelling or fluid around three or more joints simultaneously.
At least one swollen area in the wrist,...
It's possible for joints affected by rheumatoid arthritis to be too painful and damaged to use fully. Your treatment team will include a rheumatologist and others.
Physical therapists focus on helping you be able to keep moving around.
Occupational therapists help you keep doing things you are used to doing every day.
The goals and treatments used by physical therapists and occupational therapists sometimes overlap, but there are some general differences.
Physical Therapy for Rheumatoid Arthritis
Physical therapy has one simple goal: keeping you moving. It will stimulate muscles, bones, and joints through exercise or other methods. The result is more strength, tone, and overall fitness.
Physical therapists help you with joint function, muscle strength, and fitness level. They understand the mechanics of bones, joints, and muscles working together, the problems that can occur, and what to do about them.
Working with a physical therapist is a good idea at any stage or severity of rheumatoid arthritis.
Early in the course of rheumatoid arthritis, your physical therapist can assess and document where you are in terms of function, strength, and fitness. Your exercise plan will be designed to maximize your chances of avoiding joint problems as the disease progresses.
In moderate or advanced rheumatoid arthritis, a physical therapist can help you keep or increase the strength and flexibility you have.
Together, you and your physical therapist will create a road map of improvement for each muscle/joint group, and for your overall fitness. This will become part of the treatment plan for your rheumatoid arthritis. There are a number of strategies your physical therapist can use to reach your treatment goals.
Exercise. This is the cornerstone of any physical therapy plan. Together with you and your doctor, your physical therapist will design an exercise plan that is targeted to your ability and fitness level. A good plan will include stretching/flexibility exercises; strength exercises, and conditioning (or aerobic) exercise.
Heat/Ice. Treating inflamed or painful joints with heat or ice packs helps some people feel better.
Massage. In some patients with chronic pain, therapeutic massage reduces symptoms.
Motivation and encouragement. While "low-tech," it's hard to overestimate the value of having someone in your corner cheering you on-and pushing you to do better.
Occupational Therapy for Rheumatoid Arthritis
Occupational therapists specialize in maximizing your independence. They can assess your ability to perform the activities of daily living. If doing routine things around the house or at work has become harder, an occupational therapist can probably help. They have many tools at their disposal.
Efficiency analysis. Occupational therapists can see where you're wasting energy or time in doing your daily activities, including where you're stressing your joints unnecessarily. Then, they can teach you better or easier ways to accomplish those things.
Assistive devices. If activities like dressing, cooking, or bathing become difficult or painful, occupational therapists can recommend or provide solutions. Assistive devices are products or improvements that make doing what you're used to doing easier.
SOURCES: Arthritis Foundation web site: "The Role of Physical Therapy in Management of Patients with Osteoarthritis and Rheumatoid Arthritis." de Jong, Z., Arthritis and Rheumatism, September 2003; vol 48(9): pp 2393-2395. Frontera W., Essentials of Physical Medicine and Rehabilitation, Hanley & Belfus, 2002. Li, L., Current Opinion in Rheumatology, March 2005; vol 17(2): pp 172-176. Steultjens, E., Cochrane Database of Systematic Reviews, January 2004(1).