Rheumatoid Arthritis (RA) is an autoimmune disease in which your immune system attacks the lining of your joints or synovial tissue. Tissue cells produce inflammatory chemicals that can damage your joint and surrounding tissue. RA signs and symptoms include Pain, Stiffness, Swelling and limited Range of Motion, Reduced Flexibility and ultimately loss of Functions. RA can affect any joint in our body, it affects the small joints of hands and feet aggressively as a result of which it becomes difficult to perform functions of daily living like dressing, eating, walking etc.
As RA is a chronic disease, early and aggressive treatment at the right time helps to delay the progression of disease and maintains the available functioning. Treating RA should be a team effort with combined interventions by the Rheumatologists, Physiotherapist, Occupational Therapist, Dietician and the Patient himself. This team effort will help the patient manage symptoms and prevent joint damage.
Physiotherapy Treatment of RA plays an important role in Pain relief, prevention of deformities and disability, Increase in functional capacity and Improving Quality of Life. Along with exercise program and enabling functional independence, patient and caregiver education plays the core of physiotherapy management in RA.
Physiotherapy Management Includes:
1. Pain Relief:
It is Important to protect the joint and hence it is important to Rest, Apply Ice to combat Inflammation and make use of Splints when require. Respecting Pain will help to Relieve Pain.
2. Maintaining /Improving Mobility:
Depending on your RA stage and severity of your symptoms, exercises are planned which help to maintain and improve joint Range of Motion. Mobility Exercises are important for all joints and spine.
3. Maintaining / Improving Flexibility:
As RA leads to joint stiffness which if not taken care of can cause deformities, it is important to maintain the flexibility by a few stretching exercises. These exercises performed once a day will help maintain the flexibility and prevent stiffness.
4. Treating Small Joints:
Hands are the most important assets for performing activities of daily living. It is important to exercise the small joints of hands as RA commonly affects hands making it difficult to perform basic functions.
Along with the exercises it is also very important to follow the joint protection and energy conservation principles in order to have a healthy and pain relief functioning.
JOINT PROTECTION AND ENERGY CONSERVATION PRINCIPLES:
1. Respect Pain: While exercising, if you feel pain, you need to stop and rest your join.
2. Balance Activity & Rest: It is important to not overdo your exercises and take proper Rest in between exercises or even in between your activities of daily activities. Taking Rest will give you more energy to continue.
3. Plan your Day: As RA causes fatigue with multiple tasks of the day, it is important to plan your activities and perform the important activities in your peak energy hours. Prioritize important activities.
4. Use Large Joints: As RA predominately affects small joints, it is advised to make use of proximal/large joints like shoulder and hip and protect the smaller joints.
5. Avoid one position for long time: Keep changing your position, stretch and relax your joints.
6. Maintain Good Joint Alignment: Reduce unwanted stress on joints by taking care of your posture.
7. Maintain your Weight: Maintain a diet plan and stay fit. Overweight can cause more stress on weight bearing joints.
IT IS COMPLETELY OKAY TO USE SPLINTS AND PROTECT YOUR JOINTS WHEN REQUIRED.
By……
Dr Chhaya Verma. PT, PhD
&
Dr Tanvee Vora. MPTh ( Musculoskeletal Specialty)