How can physiotherapy help?

Physiotherapy treatment has a large part to play in the overall management of arthritis. The physiotherapist, as a member of your management team, is trained to understand and treat the physical aspects of the human body.

Physiotherapy for people with arthritis is aimed at:

• reducing pain
• improving movement
• strengthening muscle power
• assisting a person to be independent and functioning as well as is possible.

The range of therapies which may be used include pain relief methods and treatments to relieve pain and stiffness.

Pain relief methods

• Thermal (heat treatments)
  These treatments produce heat within your body tissues. The application can be directed towards superficial or deeper parts of the body. The most common types of treatment used are infra-red radiation (heat lamps), wax baths and hot packs for superficial treatments, and microwave diathermy and shortwave diathermy for deep heating treatment.
• Electrical treatments (electrotherapy)
  These treatments produce electrical stimulation of your body tissues. They may be extremely useful in the treatment of both acute and chronic arthritis, where pain, swelling and muscle spasms are present.
• Physical treatments
  These treatments include the use of ultrasonic sound waves, ice therapy and traction.

Treatments to relieve pain and stiffness

Exercise
A balanced programme of rest and exercise, and careful attention to joint posture is an important part of pain management, joint protection and maintenance of your joint function.

Controlled exercise helps lessen pain and stiffness and improves the strength of muscles and ligaments, so helping to stabilise joints. This is essential in all aspects of self care and particularly important before and after joint surgery.

Manual therapy
Mobilisation and manipulation techniques are passive movements applied to a joint or soft tissue by the therapist in a specific manner to help restore full movement to a joint that is painful and restricted.

With increased understanding of the structure and movement of the spine and peripheral joints, the usefulness of manipulation in the treatment of arthritis has become much clearer. Manual therapy is often useful in the chronic forms of arthritis and is often successful when other methods such as heat and exercises have given little or no relief.

Hydrotherapy
Hydrotherapy or pool therapy is a very useful means of exercising arthritic joints using the buoyancy of water to assist or resist movement. The warmth of the water increases the circulation and helps reduce muscle spasms, producing more effective movement. Joint mobility, muscle strength and general fitness can be improved with hydrotherapy.

In New Zealand, a physiotherapist will also assess you for equipment, such as: splints to protect your joints, crutches, walking frames and wheelchairs. They will be able to advise you on their availability through your local hospital. Access to a public hospital physiotherapist can be arranged through your doctor or rheumatologist.

Occupational therapy

The occupational therapist provides services to people with arthritis whose abilities to cope with activities of daily living are threatened or impaired. The primary aim of occupational therapy is to help you develop the skills and capacity to be able to master the tasks essential to you at home, work or leisure. The therapist can provide advice on how to make life simpler and conserve energy as well as protecting your joints. They can:

• Provide advice about alterations to your home which will help you manage your care more effectively. These could range from small items such as the placement of handrails to house alterations, location of switches to hoists, etc. They will also be able to refer to other agencies such as Equipment Management Services (EMS) who follow through on your assessment and entitlement to funding for the provision of these support services.
• Recommend equipment and aids to assist you in tasks around the home, including in the kitchen, bathroom and bedroom. They can also provide advice and assistance in personal care equipment to help with dressing and hygiene, etc. Again, they will be able to assess you for funding of these aids from your local hospital.
• Provide assessment for other assistance such as home help or referral to other agencies for this.
  

Access to a public hospital occupational therapist can be arranged through your doctor or rheumatologist.

Original material provided by Arthritis New Zealand. Edited by everybody, July 2005.