Joint Changes in Arthritis are Permanent, but Pain Does Not Have to Be

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Fiona McMahon PT, DPT

May is arthritis awareness month. Arthritis can come in many different forms. It can be a result of wear and tear or it can be a response to an autoimmune condition. There are many different types of arthritis, but the fact remains that in all of these different types of arthritis, once the damage to the joint is done, it is done. Currently, we have no way of repairing the joint outside of joint replacement. You may be thinking, if the damage is done, why bother spending my precious time and money in physical therapy? The reason is that physical therapy and lifestyle management can make a huge difference towards reducing your pain, improving your function, and even preventing the progression of joint break down. Physical therapy has been proven to help reduce pain and increase function, and in many cases, avoid surgery.

Physical therapists are movement experts. It seems obvious that they should be the providers directly involved in restoring function to individuals with diseases of the joints. For both rheumatoid conditions as well as osteoarthritis, physical activity is considered the first line intervention for improving pain and function. This is not to say that exercise will replace disease modifying arthritis drugs (DMARDs) in cases of rheumatoid arthritis. It is saying treatment is not complete until you address the strength, pain, and range of motion problems that occur with arthritis.

Physical therapy will not change the conditions of joints that have been damaged by arthritis; however, physical therapy is paramount to improving the prognosis of arthritis by helping to improve the strength around the joint, range of motion, and stability of the joint to prevent further cartilage and joint break down. Physical therapy can also have a marked effect on the pain and function, and can open up your world to things that were once too painful. In a meta-analysis study conducted by Sampath and colleagues, two common physical therapy techniques, manual therapy (work on the joints) and exercise therapy were examined to assess the efficacy of these techniques on pain and function in individuals with arthritis. The study found strong evidence that exercise therapy and manual therapy were good at reducing pain and improving function in people with arthritis.

Physical therapy is so worth the investment. It is an investment in your comfort, the ability to do the things you love, and commonly helps people stave off needing a joint replacement. Full disclosure, I’m partial to our clinic, Beyond Basics Physical Therapy (understatement of the year, I know). What makes us so special is that we have the manual therapy, exercise and orthopedic experts. We all come from various orthopedic (joint and muscle PT) backgrounds including the Postural Restoration Institute (PRI) and the Institute of Physical Art (IPA) and many of us have earned advance orthopedic certifications such as the Certified Functional Manual Therapist (CFMT), Certified Orthopedic Specialist (OCS), and Postural Restoration Certification (PRC) distinctions. What this means is our therapists have the knowledge and skill set to go above and beyond the basics in our hour long treatments to treat you head to toe, improving the way your body moves and more importantly, how it feels. Click here to read more about the ins and outs of the CFMT certification and how it can take you to the a place of less pain and more function here.

Another thing to keep in mind is your weight. When it comes to management of arthritic conditions, additional pounds put additional stress on your joints and can hasten the progression of joint break down. Losing pounds can be a big task when your joints are not feeling their best. Your physical therapist can guide you through exercises that are efficient for weight loss and do not exacerbate your symptoms. We also can provide a valuable link to get you set up with proper nutritional support to help manage weight.

Once the damage is done by arthritis it is done; however, that does not mean you are condemned to pain, decrease function and continued deterioration. Get physical therapy today for pain relief and to get moving again!

We have two clinics. One in Midtown Manhattan and one Downtown. We also offer Pilates and personal training at our clinics, which can help get you back into an exercise routine.

Give us a call today to find out more:

212-354-2622 (Midtown)

212- 267-0240 (Downtown)

Heidari B, Rheumatoid Arthritis: Early diagnosis and treatment outcomes. J Capsian Internal Med. 2011: 2(1) 161-70

Hootman J, Murphy L, Omura J, et Al. Health care provider counselling for physical activity among adults with arthritis. Morbidity and Mortality Weekly Report. 2018; 66(51-52) 1398-1401

Sampath K, Mani R, Miyamori T, et al. The effect of manual therapy or exercise therapy or both in people with hip osteoarthritis: a systematic review and meta-analysis. Clinical Rehab. 2016; 3-(12) 1141-55

Wang Y, Lombard C, Hussain S, et al.Effect of a low-intensity, self-management lifestyle intervention on knee pain in community- based young to middle-aged rural women: a cluster randomised controlled trial. Arthritis Research & Therapy. 2018; 20(74)

May is Arthritis Awareness Month!

By Riva Preil

Celebrate Arthritis Awareness Month this May with Beyond Basics Physical Therapy!  Arthritis is a musculoskeletal disorder that affects more than 50 million Americans.  It can be sub-categorized into many different diseases, including Osteoarthritis (OA), Rheumatoid Arthritis (RA), and Juvenile Arthritis (JA, an autoimmune disorder among children below age 16).  Some misunderstand the disease and think that it involves minor aging related aches and pains. However, arthritis is not something to take lightly- early diagnosis and symptom management is important to slow down the degenerative process and reduce the effects.

OA is the most common type of arthritis, and it is a progressive joint disease that involves degeneration of the articular cartilage. Cartilage is connective tissue that lines and protects joints. It allows fluid, smooth, pain-free movement and prevents bone from rubbing against bone. Impaired cartilage results in joint pain, stiffness, and decreased range of motion.  The risk factors associated with OA include increased age, joint injury or overuse (ex. work involving repetitive motion, such as baseball pitchers or landscapers), genetics, and obesity.  In fact, for every pound gained, four pounds of pressure are added to the knees.  The added load that the lower extremity joints are forced to withstand contributes to joint breakdown.  The common signs and symptoms of OA include joint soreness, especially after periods of overuse (ex. at the end of the day) OR underuse (ex. during the first thirty minutes of the day), decreased coordination and increased pain with walking, and overall stiffness.

RA affects approximately 1.3 million Americans, and is it considered an inflammatory autoimmune disease.  For some reason, the body attacks its own synovium, the membrane that lines the joints.  This results in a synovial buildup in the joints which causes pain and inflammation throughout the body.  It is much more common amongst females, and it is believed to be caused by a combination of environmental and genetic components.  The common symptoms of RA are joint swelling, warmth, pain, and decreased range of motion throughout the body.  As opposed to OA, which primarily affects the weight bearing and overused joints of the body, RA is a systemic inflammatory process that can affect the entire body. Appropriate exercises under the guidance of a skilled physical therapist, weight control, joint protection strategies, and medications can help alleviate symptoms and decrease further damage.

PT in the News: Jane Brody on Arthritis in The New York Times

At BBPT, one of our specialties is orthopedics, in which we treat musculoskeletal conditions like osteoarthritis. Many Americans, including health writer Jane Brody of The New York Times, suffer from arthritis. This week, Brody wrote about her experience living with the condition and coping with a variety of techniques, including physical therapy. She quotes Dr. Kenneth Brandt:

“You should exercise affected joints,” Dr. Brandt said. “Muscles around the joints can atrophy — use them or lose them — and result in even more pain and stiffness.” He suggested consulting a physical therapist or exercise physiologist to help design “an exercise program that permits loading joints appropriately.”

Do you suffer from arthritis? What are some of your ways of coping? Tell us in the comments below!