Physiotherapy for Rheumatoid Arthritis (RA)

Rheumatoid arthritis is a chronic, painful, autoimmune disease from an unknown cause characterized by inflammation of the joints, especially the wrists, hands and feet. The structures around the joint can also be affected, like the tendon sheath, the bursa and tendons. This pathology causes pain, stiffness in the morning and after periods of inactivity, joint swelling and weakness. Without treatment RA can lead to irreversible damage, namely deformity and finally provoke considerable physical functional loss or even permanent disability.

It is fairly more common in women than men and can occur at any age but it usually starts with the age of 40 till 60.

Causes
There is no known cause of RA. Some suspect that genes play a role, however, many people diagnosed with RA didn’t have a family history of RA, nor did they pass it on to their children. It is possible that the joint pain could be from other disorders such as gout, osteoporosis and lupus.

Symptoms
In rheumatoid arthritis, symptoms often develop slowly over a period of weeks or months. Fatigue and stiffness are usually early symptoms. Weight loss and a low-grade fever can also occur. This may be followed by joint pain if it’s not present already.

Rheumatoid nodules (bumps) ranging in size from a pea to a mothball develop in nearly one-third of people who have rheumatoid arthritis. Nodules usually form over pressure points in the body such as the elbows, knuckles, spine, and lower leg bones.

Diagnosis
No single lab test can diagnose rheumatoid arthritis. Instead, doctors look for symptoms and physical signs, and then rule out other diseases that can cause similar symptoms.

A medical history and physical exam are usually done to help find the cause of joint pain. The pattern and nature of joint symptoms are the most important clues to the diagnosis.

Tests such as, Bone density test, to check for bone loss (osteoporosis), complete blood count, eye exam, imaging tests such as magnetic resonance imaging (MRI) or X-rays, joint fluid analysis, kidney function tests, liver and muscle enzyme tests, tissue type tests, help in diagnosis.

Treatment
While at present there are no treatments that can fully cure RA, treatments which help reduce pain are given to patients, this includes medicines, exercises, physical therapies, and so on. Once you start the treatment, it goes on for the rest of your life.

Physiotherapy helps in relieving the symptoms and prevent the disease from getting worse. Your physiotherapist will use any of the following treatments, depending on your case:

• Ice/Heat Application
• Electric stimulation
• Massages
• Hydrotherapy
• Splints
• Exercises that focus on building strength, improving range of motion, flexibility, etc will also be introduced by the physiotherapist.

The course of rheumatoid arthritis is hard to predict. It usually progresses slowly, over months or years. In some people it doesn’t get worse, and symptoms stay about the same. But in rare cases, symptoms come on rapidly, within days. Surgical treatment for rheumatoid arthritis is used to relieve severe pain and improve function of severely deformed joints that don’t respond to medicine and physical therapy. To know more about Rheumatoid Arthritis and treatment, consult your physiotherapist.