Go to a random Wikidot site. Combating rheumatoid arthritis normally consists management arthritis rheumatoid medicinal interventions, lifestyle changes, and conservative treatments to manage symptoms and provide pain relief for patients. In more severe cases of rheumatoid arthritis, surgery is indicated. This section will focus on the physical therapy management of rheumatoid arthritis without surgical intervention.
Physical therapy interventions can benefit rheumatoid arthritis patients who suffer from the major problems of the condition. Note: The interventions below are suggested by The Guide for patients presenting under this practical pattern. All interventions may not be appropriate for Rheumatoid arthritis or all patients. With rheumatoid arthritis described as a chronic autoimmune disorder, the consequences to joint surfaces and increased morbidity make patients susceptible to loss of muscle mass, range of motion and diminished aerobic endurance.
An exercise program is essential to prevent joint destruction and combat the symptoms associated with the disease, but comes with a multitude of challenges. Those who are diagnosed with RA may be unsure of beginning an exercise regimen due a lack of confidence in abilities and the pain it may cause. In a review article on the benefits of exercise in this patient population, it is shown that assistance from instructors and social interaction boost motivation for involvement in regular exercise routines. This is where physical therapists play a very important role! Since the marker of this disease is joint destruction, the most important benefit to note is the impact exercise has on improving joint health. During the course of the disease, tendon sheaths, ligaments and cartilage can be affected and exercise can maintain their integrity.
Range of motion and flexibility deficits that hinder a patients productivity can be improved with regular exercise, and combat RA-related fatigue. Progressive resistance training has been shown to improve skeletal muscle size and strength, and is safe for patients with RA. In combination with progressive resistance training, weight-bearing exercises can improve bone mineral density. In terms of finding strategies that offer a patient with rheumatoid arthritis relief, a lot of “evidence” regarding the benefit is individual-specific. The most commonly used physical agents in combating rheumatoid arthritis are thermotherapy and cryotherapy. A cold-pack, ice chips, ice massage or nitrogen spray can be applied to areas where calming inflammation and pain are desired.
It is recommended that these methods be used in conjunction with medical management and exercise programs for patients with rheumatoid arthritis. While the literature on the use of TENS in patients with rheumatoid arthritis is rather conflicting, it can be supported using the modality for this patient population as TENS does not cause any adverse side effects. The ambiguity of the effectiveness of TENS can be related to the type of intensity and frequency administered. Research suggests that TENS for patients with this condition, mainly in treating RA of the hand, provides pain relief when the method is administered, but upon its completion, shows little to no residual benefit. It is safe to say at this time TENS is a short-acting therapy and the beneficial frequency to deliver is 70Hz. This review showed that ultrasound applied to the dorsal and palmar surfaces of hand increased grip strength and to a lesser extent improve wrist flexion and reduce swelling in joints. Patients with rheumatoid arthritis often have joint deformity and severe pain manifesting in the great toe, heel, and lesser toe.
This can impact gait and functional mobility. Patients with RA can be prescribed foot orthoses or specialist footwear to combat these issues, and receive education for care of skin and nails. The use of splints may be able to provide relief for a rheumatoid patient in acute stage of the disease. Splints may allow functional position to give rest to involved joints. Splinting can provide pain relief, reduce inflammation, increase range of motion, and prevent deformities.
Physical therapists can employ the use of assistive devices for patients with RA to improve functional ability and independence in daily activities. Appropriate assistive devices that benefit patients range from work chairs, rolling walkers, canes, and reachers. Research suggests reasons for using assistive devices also reduce amount of load placed on the joint, reduce pain, fatigue and inflammation. Sources such as the Mayo Clinic and the Cleveland Clinic discuss that there are other ways to promote joint health in RA patients. Proper diet is an essential part of maintenance of the disease, as well as adequate rest.