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Rheumatoid Arthritis

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Introduction

Physiotherapy in River Heights, Winnipeg for Rheumatoid Arthritis

Welcome to River Heights Physiotherapy’s guide to Rheumatoid arthritis (RA).

RA is a chronic, or long-term, inflammatory form of arthritis. RA is considered an autoimmune disease, in which your immune system attacks the tissues of your own body. In RA, the immune system mostly attacks tissues in the joints, but it can also affect other organs of your body. In some people, RA seems to run its course and does not gradually get worse. In others, RA gets progressively worse and leads to the destruction of joints. RA can greatly affect your ability to move and do normal tasks. RA can appear at any age, but most patients are between the ages of 30 and 50. About two million Americans have RA, and most of them are women. RA can affect children and when it does, it is termed Juvenile RA. Juvenile RA will not be discussed in this patient guide.

This guide will help you understand:

  • how RA develops
  • how your health care professional will diagnose the condition
  • what can be done for RA
  • what River Heights Physiotherapy’s approach to rehabilitation is

Rehabilitation

Although there is no cure for RA, physiotherapy can greatly assist with both the flare-ups as well as the potential long-term joint problems that can occur as a result of the disease. The main goals of our treatment at River Heights Physiotherapy for RA are to relieve symptoms, preserve the function of your joints, prevent structural damage or deformity, and to assist you with maintaining a normal lifestyle.

River Heights Physiotherapy provides services for physiotherapy in River Heights, Winnipeg.

RA is a frustrating and complex disease. At River Heights Physiotherapy we believe that the more you understand about the disease, the more effective our treatment will be. For this reason, education is an important part of our treatment for RA. By understanding the disease, you will also be better able to assist us in treating your own symptoms and preventing or managing flare-ups.  Liaising with others who also have RA can be very insightful so we will assist in directing you to support groups or organizations that focus on living with RA.

As mentioned previously, the synovitis of the joints causes pain and over time can cause structural damage and deformities of the joints. During flare-ups the synovitis is actively occurring and is the source of pain.  Our treatment at River Heights Physiotherapy will therefore firstly focus on decreasing your pain.  Modalities such as heat or cold may be useful as well as other modalities such as transcutaneaous nerve stimulators (TENS.) These TENS machines assist with pain by delivering electrical currents through the painful area and work essentially to override the pain sensations. Your physiotherapist may also suggest that you use hydrotherapy to ease the pain. During hydrotherapy your whole body, or just the affected joints, are immersed in warm water while gentle movements are performed. In many cases, this can significantly reduce the pain associated with an RA flare-up.  Massage can also be very helpful to assist with flare-ups although not all patients with RA enjoy their painful joints being massaged, and this will be entirely respected. Sometimes with RA the most effective treatment during a flare-up is simply to rest the joint. Each joint has a natural resting position where the least amount of stress is placed on the tissues of the joint and therefore causes the least amount of pain. Your physiotherapist at River Heights Physiotherapy can advise you on the most effective resting position for any of your RA affected joints and can also advise you on when it is appropriate to begin exercise again after the rest period.

In addition to our physiotherapy treatment the medication that your doctor has prescribed will be especially important during flare-ups. Your physiotherapist at River Heights Physiotherapy may liaise closely with your doctor while treating you to ensure that all treatments are coinciding to most effectively relieve your pain. By limiting the length and intensity of the flare-ups, the synovitis has less time to cause structural damage to the joints and therefore less chance of causing a long-term deformity.

The next part of our treatment at River Heights Physiotherapy will focus on preventing any deficits or deterioration in range of motion of your affected joints. Your physiotherapist may assist in stretching your muscles while at the clinic and, if necessary, may ‘mobilize’ the joint. This hands-on technique encourages joints to move gradually into their normal range of motion and may also assist with pain relief. We will also prescribe a series of stretching exercises that we will encourage you to do as part of a home exercise program. The daily stretches and range of motion exercises done at home are often the most important part of treating RA as they work to both prevent and stop the progression of long-term deformities in the joint. If your joints have already developed some deformity then we will be particularly specific in teaching you range of motion exercises that take into consideration the abnormal position of the joint. Standard stretching exercises may cause deformities to progress if not adjusted to this consideration. Your physiotherapist at River Heights Physiotherapy will tailor a stretching program specifically for you.

Joints where deformity is likely to occur or that already show some deformation may require bracing or splinting to prevent further decline. Simple braces may be constructed by your physiotherapist at River Heights Physiotherapy but for more complex braces we will refer you to an occupational therapist, orthotist, or chiropodist to ensure a proper individualized brace or orthotic is constructed. Occupational therapists can also provide you with assistive devices, if needed, which make using a joint affected by RA easier and less painful. This in turns prevents the deterioration of the joint.

The muscles surrounding the affected RA joints can lose strength. The strength loss occurs both due to decreased use of the joints when they are painful, and also as a result of the altered pulling on the muscles when there are joint deformities. Similarly to the range of motion deficits, strength deficits will also be addressed during our treatment.  Again, your physiotherapist at River Heights Physiotherapy will prescribe a series of strengthening exercises that we will encourage you to do as part of a home exercise program. These exercises will also be specifically tailored by our physiotherapist to suit the needs of your affected joints.

Maintaining coordination of your RA joints is also an important part of maintaining normal function. Pain, inflammation, and joint deformity can all affect how well a joint works during functional activities such as grasping items or walking. In addition to the range of motion and strengthening exercises prescribed your physiotherapist at River Heights Physiotherapy will encourage coordination and proprioception exercises to ensure the joints do not lose normal function.

As a final component of our treatment, your physiotherapist will discuss the benefits of some gentle aerobic exercise. Aerobic exercise such as swimming, walking or cycling can improve muscle endurance, aerobic capacity and improve your general well-being so is highly encouraged as part of an overall treatment plan for patients suffering with RA. Obviously, during times of flare-ups, aerobic exercise may not be possible, however when able, you should work to include it.

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