Wednesday 20 October 2021

 

Arthritis

Arthritis | Its Treatment and Management by Physiotherapy

Are you suffering from Arthritis and are taking painkillers to suppress the pain caused by this condition? Then you should immediately take proper treatment before this condition progresses to a level where it might restrict the movement of the affected joints. Exercising every day and consulting a well-trained physiotherapist is one such step that can be beneficial. Arthritis targets the skin and multiple joints of the body affecting day to day life of an individual. This blog is written to give you a better understanding of arthritis, its types, and its physiotherapy management.

 

Types of Arthritis

Arthritis is the inflammation of the joints, it affects one or multiple joints. The symptoms of this condition may develop over time and are not constant. Arthritis is broadly classified into three categories:

1: Osteoarthritis:

This type of arthritis occurs due to an injury or aging.

2: Rheumatoid arthritis:

Rheumatoid arthritis happens due to the immune system attacking (by accident) the functional cells of the body.

3: Infectious arthritis:

Infectious arthritis spreads to the joint from a different body part.

4: Juvenile arthritis

Juvenile arthritis takes place in children.

5: Psoriatic arthritis

Psoriatic arthritis occurs in people with psoriasis, it affects their skin and joints.

 

Physiotherapy management

Physiotherapy for arthritis is an effective and safe way to help:

  • Decrease pain
  • Reduce discomfort
  • Strengthen the joints and muscles
  • Improve mobility
  • Helps in increasing the range of flexibility and motion.
  • Restore the use of affected joints
  • Prevent further damage to the joints
  • Prevent progression of arthritis
  • Maintain fitness
  • Improve functionality.

 

Physiotherapy intervention

According to the patient's needs, the physiotherapist would tailor the exercises. The physiotherapy treatment program for arthritis includes:


1: Rest and Splinting:

Rest or splinting is recommended if required during the acute stage of the disease. Bed rest relieves extensive joint pain and puts the joints into rest at a functional position. Rest and splinting, diminishes pain and inflammation, to prevent stress, stiffness, and deformities.

 

2: Ultrasound Therapy:

Ultrasound therapy creates warmth and gentle heat that increases blood circulation in deeper tissues thus decreases pain and increases range of motion.

 

3: Transcutaneous electrical stimulations (TENS):

Transcutaneous electrical stimulations are found to be significantly effective in increasing strength. This helps to prevent the progression of the condition that limits movement and functionality in daily life.

 

4: Low-level Laser Therapy (LLLT):

Low-level Laser Therapy is a non-invasive treatment that reduces pain, inflammation and also increases mobility.

 

5: Paraffin Therapy:

Paraffin therapy is extremely beneficial for arthritis. It has a very high capacity for absorbing heat, which helps to improve the patient's performance while exercising.

 

6: Ice therapy:

Use of ice pack or cloth soaked in cold water can be applied to the affected area or by submerging the part in ice-cold water.  Ice packs can be used to reduce pain, swelling, and inflammation. 

 

7: Heat therapy:

Similarly, heat packs can also help decrease stiffness and improves blood circulation.  A heating pad, warm shower, hot water bottle on the affected area can be used. Heat packs can also help decrease stiffness and improves blood circulation.

 

8: Massages:

Moderate pressure massage is given by a trained physiotherapist. Massage therapy is proved to be helpful and soothing for many arthritis sufferers. Regular massages can relieve pain by lowering the production of cortisol (stress hormone) in the human body.

 

9: Acupuncture:

Acupuncture is another treatment that can be used as an intervention by the physiotherapist to stimulate the brain to release endorphins.

 

10: Exercise:

Graded exercises help reduce arthritis pain. These exercises are started slowly and then gently increased when progressed further.  These exercises strengthen the muscles and joints and increase overall fitness. Strengthening, endurance, stretching & stability exercises are a part of the exercise program. The therapist also advises holding correct body posture while carrying out daily activities to relieve pain and prevent further damage.

 

11: Hydrotherapy:

Physiotherapy for arthritis is not limited to simple exercises or the use of modalities only, but also extends to other exercises such as swimming which is a great form of exercise without putting pressure on the joints. Water-based exercises can relieve pressure on the joints, reduce body fat, and improve mood, coordination, and range of motion.

 

12: Assistive devices:

The physiotherapy also recommends assistive devices like wearing braces or walking with a cane.

 

13: Posture correction

Arthritis can also be caused due to bad body posture while sitting and working. Simple exercises at home or at the workplace can help in preventing arthritis. Some simple stretches include neck rotations, head tilts, leg raises, hamstring stretches, finger and thumb bends and wrist rotation to ease the tension in the joints while working on the desk.

 

Physiotherapy has beneficial effects on increasing physical capacity and reduces the activity of the disease. The physiotherapist provides patient education about their condition and makes them aware of the various physiotherapy options that are available to improve the quality of life.

Monday 11 October 2021


 

Joint Mobilization | How does it help in increasing the range of motion?

Are you unable to move your joints after a long period of immobilization, overuse, or trauma?  If yes, then to restore the normal movement of these affected joints you require early treatment.  One such treatment technique used is Joint mobilization. This technique is used by physiotherapists to passively move the joint to increase the range of motion and decrease pain. The treatment enhances movements like gliding, rolling, spinning, etc that take place between the bones after injury.  These are small, involuntary movements that assist the joints to perform to their optimum. In this blog, we will discuss joint mobilization and its benefits.

 

Joint Mobilization

This technique, also known as manual therapy, is performed by well-trained physiotherapists.  Joint mobilization is the application of graded forces to move a joint in the desired direction. The person is placed in a comfortable and relaxed position to allow the free movement of the joint.  Hands are used to localize the joint which is to be mobilized, mobilization is applied at a slow speed, with or without oscillations or a stretch, by using the hands in the appropriate direction. Grades of joint mobilization range from Grades 1 – 5.  Grades 1 – 4 are used to apply partial movement glides to the end range and Grade 5 is the same as manipulation. The treatment is progressed with the application of high-speed mobilizations helping in reducing pain and in restoring joint play.

 

Classification of movements:

  • Medial to Lateral
  • Anterior to Posterior (AP)
  • Oscillations
  • Translation
  • Distraction

 

Grades:

Grade 1: Small-amplitude movement at the beginning range of joint movement.

Grade 2: Large amplitude movement at the mid-range of joint movement.

Grade 3: Large amplitude movement at the end range of joint movement.

Grade 4: Small amplitude movement at the end of the range of joint movement.

Grade 5: Manipulation of high velocity and low amplitude to the anatomical endpoint of a joint.

 

What Happens When a joint has limited motion?

Due to limited joint mobility, the nutrition of cartilage starts to decrease within the joint, and other joints begin to compensate for the joint stiffness and thus move excessively. This overuse of the adjacent joints causes their deterioration due to overuse. Muscles surrounding the stiff joint become tight and lose their ability to contract and relax sufficiently, thus causing overall dysfunction of the joint.

 

Benefits:

  • Decreases pain,
  • Decreases joint tightness,
  • Improves joint mobility
  • Decreases muscle spasms
  • Decreases muscle tension,
  • Induce reflex muscle relaxation,
  • Increases functionality.

 

Indications for Joint Mobilization

The physiotherapist examines the anatomy, arthrokinematics, and the pathology of the neuromusculoskeletal system to recognize when the techniques are indicated. The pathomechanics of the condition is understood first to determine whether joint mobilization is appropriate for the specific musculoskeletal condition.

 Precautions

Joint mobilization is a successful treatment technique used to treat many cases of joint dysfunction, but certain precautions are necessary like in case of:

  • Joint hypermobility
  • Osteoporosis
  • Joint effusion
  • Severe scoliosis
  • Fracture
  • joint ankylosis
  • Spondylolisthesis
  • Rheumatoid arthritis
  • Tuberculosis
  • Paget's disease
  • Malignancy
  • Pregnancy

 Complications of joint mobilization like tendon or muscle injury, nerve damage, dislocation, and fracture should be taken care of.  Therefore, these techniques should be performed by a well-trained physiotherapist to avoid any unnecessary injuries.