Rheumatological Conditions

A physiotherapist can help you understand what happens to your joints when you have arthritis. There are different types of arthritis and it can affect your muscles and joints in many ways. It is important that you understand how the arthritis affects you individually.

How does it work?

The team gives advice and treatment covering all aspects of education, pain management and rehabilitation.

You’ll be assessed individually to identify problems and then a treatment plan is agreed to address the issues raised.

Learning about arthritis

Education about living with arthritis is very important and involves such things as strategies for coping with a variable condition and adjusting the balance of activity and rest. We’ll give you advice on coping with a ‘flare’, and how to increase activities and exercise to restore function as the disease settles down. All of this will help you to manage the impact of arthritis on your life.

We use many techniques to help including acupuncture, manual therapy, exercise, aromatherapy, hydrotherapy and counselling. We liaise with other members of the Rheumatology Multi Disciplinary team (MDT), such as doctors, occupational therapists and orthotists, in order to give you the best service.

We encourage you to develop a long term plan to keep active. Whenever possible we’d encourage you to continue with suitable sports if necessary with some adjustments.

How can you manage your pain?

Arthritis can cause widespread joint or muscle pain, or pain that is more localised (occurring in only one place). Managing your day-to-day pain is very important and you should discuss with your doctor what medication is suitable for you.

In addition to medication there are many other ways that you can manage your pain, a physiotherapist can advise you about these.
Pacing is a good example. Sometimes over-activity or not doing enough activity can make your pain increase. Working with the physiotherapist you can discover the right balance between rest and activity. This does not mean you have to do less, but if you plan your activities so you are always comfortable it will help you enjoy the things you want to do.

Regular exercise will help strengthen your muscles and joints and increase your day to day fitness. Being physically fit will help your level of activity without necessarily increasing your pain. It will also stimulate the production of your own natural pain–relieving chemical such as endorphins.

Some tips for dealing with pain

• Applying an ice pack over a hot and swollen joint can relieve pain. Always wrap the ice in a tea towel and only use it for 5-10 minutes. Check the skin to ensure that the ice is not burning your skin. Never use ice on an area of skin where you have no sensation.
• Applying a heat pack over a tense and tired muscle will help the muscle relax. Always follow the instructions and never use it over an area where you have no sensation.

Patients with Raynaud’s disease or heart problems should not use heat or ice treatments.

• Taking time out and relaxing will reduce body and mind tension and make you feel better in yourself.
• Splinting your swollen painful joints may be helpful, for example during a flare of Rheumatoid arthritis. Your Physiotherapist/Occupational Therapist may provide temporary splints for you.
• A TENS machine works by blocking pain messages to the brain and altering your perception of pain. It is a small electronic device that you use by placing pads on the surface of your skin. These send small pulses to nerve endings. This may help pain in some cases – the response varies between individuals.
• Massage can help muscles relax and make joint movement more comfortable.
• Acupuncture can stimulate the brain to produce natural pain- relieving chemicals – it should be used only by a qualified clinician who has had appropriate training. Some physiotherapists are trained to give acupuncture

You should discuss with your physiotherapist which of the above methods may work best for you.

Improving your fitness

Keeping active is very important when you have arthritis. Exercise can improve your general fitness, maintain your weight (or reduce your weight if overweight), will help your general mobility, and make you feel better in yourself. There are many different ways you can exercise, the important point is that you do it on a regular basis, that you find a type of exercise that is suited to you, and that you enjoy it.

Activities like swimming, walking, T’ai chi and dancing can be a good start. Talk to friends and family and find out what facilities are available in your area or contact your local council and see what activity programmes are offered in your area. With this information you and your physiotherapist can decide what would be the best option for you. Exercising may be a new experience for you and your physiotherapist will support and encourage you through this process.

Hydrotherapy allows people to perform exercise in a specially heated pool. Many people find it easier to move in water – the warmth and weightlessness enables them to move with less effort and to relax their joints and muscles.

Arthritis can cause joint inflammation that leads to joint stiffness and muscle weakness. Your physiotherapist will assess the range of movement of your joints and your muscle strength.

Using manual techniques and exercises, you and your physiotherapist can work towards your full potential and best functional outcome.

Please note that this information was taken from the ARC leaflet “Physiotherapy and Arthritis”