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Treatment of Rheumatoid Arthritis - Physiotherapy and Medication

written by: Willie Scott • edited by: Diana Cooper • updated: 10/19/2010

Physiotherapy and medication can help when living with rheumatoid arthritis. Physiotherapy although painful is essential to keep the supporting muscles and tendons around an arthritic joint functioning. Medication is administered to defuse the disease and reduce the inflammation and pain.

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    Introduction to Treatment of Rheumatoid Arthritis – Physiotherapy and Medication

    Rheumatoid arthritis is a crippling disease affecting many people of all ages across the world, and is the third most common disease after heart and cancer conditions.

    The pain and immobility caused by rheumatoid arthritis in the joints can be controlled quite effectively by regular physiotherapy to the affected joints and embarking on a course of medication which will assuage the pain and combat the symptoms of rheumatoid arthritis.

    This is an article on living with rheumatoid arthritis. Here we will examine the effect of physiotherapy and medication used to maintain mobility and reduce pain. We begin by examining the physiotherapy methods used to treat rheumatoid arthritis, before moving on to the more common medication practices.

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    Physiotherapy for Rheumatoid Arthritis – Hot and Cold Treatment

    There are numerous hot and cold therapies used by physiotherapists in the treatment of rheumatoid arthritis, depending on the location of the affected joint.

    • Ice Packs

    Ice packs are used to reduce the inflammation around a hot arthritic joint, and promote blood circulation.

    The treatment consists of laying a wet cloth over the affected joint then placing an icepack against the cloth which prevents the ice from burning the skin.

    This treatment normally lasts for 20 minutes.

    • Hot Packs

    Hot packs are used where there is pain but the joint is not hot or inflamed.

    The pack is normally of gel or oats and is heated in a microwave before being placed against the affected joint.

    This has a soothing effect by loosening up tense muscles and tendons, as well as promoting blood flow to the area.

    • Hot Wax

    This treatment is normally used for painful hands, wrists, and fingers. I personally have had great success with this therapy, and am convinced it saved me from having surgery, to these areas.

    The hot wax is held in a steel container under thermostatic control, into which the hand is dipped and removed after several seconds, to let the wax solidify on the hand.

    This is repeated four or five times until the layer of wax is about 1/8” thick, then a towel is wrapped around the wax to prevent heat loss.

    After 20 minutes the wax is removed by peeling it from the hands and fingers, the hands then being washed in hot water.

    Joint muscle and tendon strengthening exercises may be carried out following hot or cold treatment.

    • Hydrotherapy Pool Physiotherapy

    Some physiotherapy clinics have access to a hydrotherapy pool. This is a specially built pool having various disabled appliances to enable most rheumatoid arthritis sufferers access to the pool. The water temperature is maintained at 23°C (73°F) and a combination of this high temperature and buoyancy, allows most joints to be exercised freely and without pain under the supervision of the physiotherapist.

    Reference Webs:

    1. everydayhealth - Hot and Cold treatment for Rheumatoid Arthritis
    2. arthritisabout - Hydrotherapy for Rheumatoid Arthritis
    3. puffinpool - Hydrotherapy Pool

    Please read on to see the type of exercises, therapy and medication used to combat Rheumatoid Arthritis.

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    Rrheumatoid Arthritis DisabilityRheumatoid arthritis can stop one living a full active life - if one allows it to. I have suffered from a rheumatoid arthritis disability for over thirty years and had worked in the Offshore Oil and Gas Industry for over twenty years, before retiring. The things to avoid are jogging or any heavy impact or contact sports. Keep the arthritic joints mobile through exercise, short walks, cycling and swimming. Attending physiotherapy when advised by ones doctor, as well as taking prescribed medication has helped me to lead a nearly normal life, despite having a rheumatoid arthritis disability.
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    Physiotherapy – Exercises for Rheumatoid Arthritis

    Exercise is an important part of physiotherapy in the treatment of rheumatoid arthritis, the various joints require different exercises as follows:

    1. Hips and Knees

    Following a hip and knee replacement and extensive physiotherapy at a clinic, I am using an Ortho-Glide to build these muscles instead of the conventional board and grommet. The Ortho-Glide is also used by physiotherapists to build up muscles and tendons after hot or cold treatment of the joints. It resembles a small plastic dinner plate, with an indent to fit one's heel into, and can be used on most surfaces to exercise the hip and knee joints, in forward and back movements as well as side to side movements.

    2. Shoulders and Elbows

    Here a pulley and rope is used, hung overhead above the patient.

    The two hand grips on the ends of the rope are gripped in each hand by the patient. As the rope is pulled down by the hand grip, the other arm is lifted up so making exercising easy. It is beneficial to apply hot or cold treatment to the affected joint before exercising on the pulley.

    3. Ankles

    • Wobble Board

    This is a circular piece of wood with a half wood ball fitted into the bottom surface, which sits on the floor.

    The patient stands on the board with the feet spread apart, and once balance has been achieved, a see-saw motion is started by bending each knee in turn and this action exercises the ankles. This should be carried out between parallel bars in case balance is impaired.

    4. Neck

    Problems with the neck due to rheumatoid arthritis have to be treated by a physiotherapist after heat treatment. This consists of gentle turning of the head up and down and from side to side (not circling!).

    This is usually followed by a massage to loosen off the tight muscles.

    Reference Webs:

    1. disaboom - Exercises for Rheumatoid Arthritis - mobilizing
    2. rehabilitation - Exercises for Rheumatoid Arthritis - hip and knee
    3. webmd - Exercises for Rheumatoid Arthritis - recommended general exercises
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    Electrotherapy

    Interferential Machines

    These machines use medium frequency currents at two different wavelengths; these are manually set-up on the machine by the Physio, and are directed in such a way as to cross each other causing an interference.

    Over the years I have had interferential treatment to my feet, shoulders and elbows, with good short-term success. Electrodes are connected to opposite sides of the affected joint or to each foot, and through these the machine produces pulses; sharp tingling sensations, much like needles in acupuncture, but more constant.

    This has the effect of lowering pain levels locally by encouraging the body’s defense mechanism to create its natural pain killing endorphins. It also increases muscle stimulation and localized blood flow, and can reduce edema.

    Reference Web: electrotherapy - Interferential Treatment

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    Medication used for Rheumatoid Arthritis

    Medication for rheumatoid arthritis performs two main purposes, to relieve pain and to halt the progress of the rheumatoid arthritis disease.

    There are four main categories of drugs used in treating rheumatoid arthritis.

    • Drugs That Control the Symptoms

    1. Analgesics (Pain killers)

    These are used to reduce pain and are often used in conjunction with other remedies.

    2. Non Steroidal Anti-inflammatory Drugs (NSAIDs)

    These are first line of attack drugs and are used to reduce inflammation and pain in an arthritic joint.

    They are usually taken by mouth and can be coated or slow release as they can affect the stomach lining, so are to be avoided by anyone suffering from stomach ulcers.

    • Drugs That Control the Disease

    3. Disease Modifying Anti Rheumatoid Drugs (DMARG)

    These drugs reduce pain, joint stiffness and swelling around the joint.

    Included in this group of drugs are Immunosuppressants which suppress the immune system.

    Also in this group are the relatively innovative biological drugs that reduce joint inflammation where other drugs have been unsuccessful.

    4. Corticosteroids

    These steroids effectively reduce inflammation and pain, but should only be used as a short-term treatment, for instance to treat a flare-up of rheumatoid arthritis.

    This is due to the serious side effects when taken as a long term remedy; among these are weight gain and bone degrading.

    Reference Web: Hopkins - Medication for Treatment of Rheumatoid Arthritis

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    Image Section - Table Showing Medication for Rheumatoid Arthritis, and Various Physiotherapy Exercises for Rheumatoid Arthritis Effected Joints

    Table of Medications for Rheumatoid ArthritisOrtho-GlideKnee Exercise using Ortho-GlideHip ExerciseKnee ExerciseShoulder and Elbow ExerciseHip ExercisePuffin Hydrotherapy Pool Dingwall Scotland
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    Disclaimer

    Please read this disclaimer regarding the information contained within this article.


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