Physical and Occupational Therapy for Arthritis

The goal of physical therapy is to get a person back to the point where he or she can perform normal, everyday activities without difficulty.

Preserving good range of motion is key to maintain the ability to perform daily activities. Therefore, increasing the range of motion of a joint is the primary focus of physical therapy. Building strength in the involved muscles surrounding the joint also is extremely important, since stronger muscles can better stabilize a weakened joint.

Physical therapists provide exercises designed to preserve the strength and use of your joints. They can show you the best way to move from one position to another and can also teach you how to use walking aids such as crutches, a walker or a cane, if necessary.

If you have arthritis, there are many benefits to participating in a physical and occupational therapy program, including:

• You gain education about your type of arthritis, so that you can be well informed.
• If you are overweight, a dietary plan can be created to reduce the stress of excess weight on supporting joints of the back, legs, and feet. As yet, no specific diet -- other than a diet designed for weight loss -- has proved helpful for arthritis.
• You gain foot-care advice, including choice of well-fitting shoes with shock-absorbing outer soles and sculptured (orthotic) insoles molded exactly to the contour of each foot.
• You will learn therapeutic methods to relieve discomfort and improve performance through various physical techniques and activity modifications.

You'll learn several techniques, including:

• Rest. Bed rest helps reduce both joint inflammation and pain, and is especially useful when multiple joints are affected and fatigue is a major problem. Individual joint rest is most helpful when arthritis involves one or only a few joints. Custom splints can be made to rest and support inflamed joints and a soft collar can support the neck while you are sitting or standing.
• Thermal modalities. Applying ice packs or heating pads, as well as deep heat provided by ultrasound and hot packs, can help relieve local pain. Heat also relaxes muscle spasm around inflamed joints. Heating joints and muscles with a warm bath or shower before exercising may help you exercise more easily.
• Exercise. Exercise is an important part of arthritis treatment that is most effective when done properly every day. Your doctor and therapist will prescribe a program for you that may vary as your needs change.

Preoperative programs of education and exercise, started before joint replacement surgery, are continued at home. They may be changed in the hospital after surgery to fit new needs during the rehabilitation period. These exercises may be added to your usual exercise regimen, and you may find your ability to exercise has improved after surgery.

There are ways to reduce the stress on joints affected by arthritis while participating in daily activities. Some of these include:

• Controlling your weight to avoid putting extra stress on weight-bearing joints such as the back, hips, knees, and feet.
• Being aware of body position, using good posture to protect your back and the joints of your legs and feet. When possible, sit down to do a job instead of standing. Change position often since staying in one position for a long time tends to increase stiffness and pain.
• Conserving energy by allowing for rest periods, both during the workday and during an activity.
• Respecting pain. It is your body's way of telling you something is wrong. Don't try an activity that puts strain on joints that are already painful or stiff.

An occupational therapist can show you ways to do everyday tasks without worsening pain or causing joint damage. Some joint protection techniques include:

• Using proper body mechanics for getting in and out of a car, chair or tub, as well as for lifting objects.
• Using your strongest joints and muscles to reduce the stress on smaller joints. For example, carrying a purse or briefcase with a shoulder strap rather than with your hand.
• Distributing pressure to minimize stress on any one joint. Lifting dishes with both palms rather than with your fingers and carrying heavy loads in your arms instead of with your hands.
• If your hands are affected by arthritis, avoid tight gripping, pinching, squeezing, and twisting. Ways to accomplish the same tasks with alternate methods or tools can usually be found.

If you have arthritis, many assistive devices have been developed to make activities easier and less stressful for the joints and muscles. Your therapist can suggest devices that will be helpful for tasks you may find difficult at home or at work.

A few examples of helpful devices include a bath stool for use in the shower or tub, grab bars around the toilet or tub, and long-handled shoehorns or sock grippers. Your therapist can show you catalogs that have a wide variety of assistive devices.

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