There are over 100 types of arthritis and other rheumatic diseases. These diseases may cause pain, stiffness, and swelling in joints and other supporting structures of the body such as muscles, tendons, ligaments, and bones. Some forms can also affect other parts of the body, including various internal organs.
Many people use the word “arthritis” to refer to all rheumatic diseases. However, the word literally means joint inflammation, or swelling, redness, heat, and pain caused by tissue injury or disease in the joint. The many different kinds of arthritis as a group is just one portion of the group of rheumatic diseases. Some are described as connective tissue diseases because they affect the body’s connective tissue, the supporting framework of the body and its internal organs. Others are known as autoimmune diseases because they are caused by a problem in which the immune system harms the body’s own healthy tissues.
Sometimes an assistive device can help a person with rheumatic disease move better, manage pain or avoid fatigue. Such devices include:
- Orthoses or braces (e.g. back braces)
- Grab bars in showers and tubs
- Shoe inserts and insoles
- Tools and gadgets that help maintain active, independent living without joint strain, such as reaching aids
- Mobility and rehabilitation products, such as luggage or grocery carts
Appropriately recommended and used, an assistive device can help reduce pain and improve function. For example, a lumbar support can reduce lower back pain, which makes moving easier and improves the person’s condition.
On the other hand, many rheumatologists may not recommend orthoses, splinting or bracing for fingers and wrists because it can result in stiffness or less range of motion. Sleeves supporting the knee, ankle or elbow may be less restrictive. Sometimes taping can be effective for fingers, knees, shoulders and elbows to reduce pain and swelling. A rehabilitation physician or physiotherapist can teach the best way to tape a joint.
A Rehabilitation Physician or physiotherapist can recommend safe assistive devices for walking or getting around. They can recommend safe assistive devices, such as reachers, grippers or home modifications that can make getting around at home easier.
Regular exercise, which helps maintain a proper weight, strengthens muscles and makes joints more flexible, can be very helpful in managing rheumatic diseases. In addition, movement helps to
- increase the range of motion
- enhance strength,
- reduce the amount of muscle spasms
- increase blood flow to muscles and joints, promoting healing.
When balanced with rest, exercise can help reduce pain and stiffness and reduce stress. Consult your doctor before beginning an exercise program.
A Rehabilitation Physician or physiotherapist may guide you in creating a safe program. A full structural analysis of your bones and muscles, including muscle flexibility, strength, balance, posture and gait will be done. The program they develop will take into consideration your personal body condition and needs. These programs are safe, individualized and will include a home stretching-and-strengthening program, as well as guidance in appropriate group exercises (such as yoga, tai chi or pool classes), Pilates, cardiovascular exercises or gym training on machines (such as elliptical trainers and bikes).
The best exercise is one that does not increase symptoms or cause pain. When starting an exercise program, start with what you can do now and then increase it by about 10 percent each week. Always pay attention to how you feel. If you have more pain, cut back your exercise by about 10 percent.
Good exercises include brisk walking, biking, tai chi, swimming and water aerobics. Exercises done in water can help relieve the pressure of gravity on joints while giving you aerobic exercise and stretching tight, sore muscles.
Exercise combined with physiotherapy and occupational therapy can also help persons with rheumatic diseases prevent disability.
It is important to listen to your body. Avoid exercising if your joints are tender, injured or severely inflamed. If you feel a pain that you have not had before, stop exercising. New pain that lasts more than two hours after exercise usually means that you have overdone it. Be sure to stand up straight while exercising.
Children who have rheumatic conditions, such as juvenile arthritis, should be encouraged to participate in regular school activities, co-curricular activities and family responsibilities as much as possible.
Medical rehabilitation, including physiotherapy and occupational therapy, can help you do daily activities while managing a rheumatic condition. A rehabilitation program tailored to your condition and needs lets you improve your strength and flexibility and the movement of your joints and muscles – all with less pain and stiffness. Such a program will not cure a rheumatic condition, but can help you become more independent and able to function.
Anyone who experiences pain, spasms, swelling or stiffness that reduces the range of motion, strength or endurance, or the ability to function should consult a rehabilitation therapist. Seeing a physical or occupational therapist with special training in treating rheumatic diseases can be particularly helpful.
An appropriate rehabilitation program is essential for almost all persons with rheumatic diseases. It is most effective for conditions that involve the muscles or joints. A consultation with a Rehabilitation Physician or therapist usually begins with an examination that will include:
- Touching or manipulating muscles that are having spasms
- Assessing range of movement, flexibility and strength
- Analyzing movement and gait
In the first stage of rehabilitation, tender areas of the body are treated with massage, stretching or other approaches as needed. This will be followed with a specific, individualized home program consisting of stretching, strength building, movement re-education and self-management of pain and swelling. You will also learn how to maintain good posture and use your body safely. Group programs can help you cope physically, emotionally and mentally with your condition, giving you a better sense of control and more confidence in your ability to function and lead a full, active life.
Occupational therapy can help you do daily activities without putting unnecessary strain on joints or causing you to become tired.
Physical therapy can help you maintain your strength and flexibility, help reduce pain and keep your mobility at its maximum. Physiotherapy can also help reduce stiffness in joints. In some cases, physiotherapy may involve splinting an area to keep it stable, applying moist heat or ice to reduce swelling and tenderness or exercise to strengthen muscles that protect a joint or enhance your ability to move and do daily activities.
Hydrotherapy may be especially helpful to people who suffer from arthritis. Warm water helps to loosen tight joints and muscles while the resistance of the water improves muscle strength.