Rheumatoid arthritis (RA), the autoimmune disease that affects the synovial tissues around the joints, causes chronic swelling and pain that can eventually result in bone erosion and joint deformity. Reports suggest that around 1.3 million Americans have RA. This disorder is also reported to be about two-and-a-half times more common in women than in men.
The main symptoms associated with the condition include joint swelling, fatigue, low grade fever, weight loss, pain and stiffness. Early RA may typically affect your smaller joints first. As the disease progresses, symptoms may spread to the wrists, elbows, ankles, knees and hips. In most cases, symptoms can occur in the same joints on both sides of your body. The symptoms of this disease may vary in severity and often come and go.
Physical Therapy for RA – The Nondrug Approach
While medication can help relieve symptoms and reduce joint damage, nondrug approaches such as physical and occupational therapy are necessary to help reduce pain, improve range of motion, increase strength, and protect joints in RA patients, according to a recent Harvard Health publication. These treatments are provided by specially trained clinicians such as a physical therapist or occupational therapist.
While a physical therapist helps patients ease their pain and maintain their mobility, an occupational therapist educates people on how to perform day-to-day tasks without putting pressure on the joints and causing further injury. For instance, when your joints are particularly tender occupational therapists show patients on how to use assistive devices like splints, braces, slings, elastic bandages, or canes to make activities easier and less stressful for the joints and muscles.
Physical therapists perform an evaluation of the patient’s condition and design a customized treatment program. They may develop an individualized workout program to help in better pain management and preserve joint flexibility. Here are some workout programs prescribed to build muscle strength to support the affected joints:
Range-of-motion exercises – Also called stretching or flexibility exercises, these help maintain normal joint function by maintaining mobility and flexibility. These help to gently stretch the joints and bend them in a controlled manner until normal or near-normal range is achieved and maintained. There are three types of range-of-motion exercises
- Active exercise – This program is mainly for people who can work out a muscle without help.
- Active-assistive exercise – This program is designed for people who can move their muscles or joints but feel pain when they do. A therapist helps them to move their joints by hand or with bands or other equipment.
- Passive exercise – This program is meant for people who cannot actively participate in physical activity. A therapist moves joints for them.
Strengthening exercises – These programs aim to build and increase muscle strength. Isometric exercises tighten and strengthen the muscles without moving the joint and are useful when joints are painful. They may include weight training, sit-ups, crunches, leg raises and hyper-extensions.
Hydrotherapy (aqua therapy) – Aqua therapy involves exercising in a pool (usually a warm water pool) to relieve aches and relax muscles.
Aerobic exercises – Aerobic or endurance workouts include activities that use the large muscles of the body in a repetitive manner. They help improve heart, lung and muscle function. They also help people with arthritis maintain body weight, mood, sleep and general health. The workout programs include walking, aerobic dance, bicycling or exercising on equipment such as stationary bikes, treadmills or elliptical trainers.
Multi-specialty healthcare centers have an experienced team of clinicians including physical therapists and neurologists. These experts work together to provide comprehensive physical therapy programs that include exercise and modalities such as ice and heat application, non-steroidal anti-inflammatory drugs (NSAIDs), Myofascial Release Therapy, massage therapy, ultrasound, Transcutaneous Electrical Nerve Stimulation (TENS) and Traction to better manage the symptoms of RA. In addition, at these centers, patients benefit from rehabilitation and injury prevention education to help manage existing pain and prevent future injuries.