THE “JOINT” EFFORT!

Centers for Disease Control and Prevention (CDC) describes “Arthritis” as inflammation (-itis) of one or more joints (arthros). There could be various conditions affecting the joints and eventually the tissues around it, causing an array of symptoms from pain, swelling to stiffness, amongst others.

There are more than 200 diseases identified, which affect the joints. According to the statistics provided by an Indian Rheumatologist, the prevalence of arthritis is around 15% (approximately 180 million people in India), much higher than diabetes or cancer. Ministry of health and family welfare quotes Osteoarthritis as the most frequent joint disease, with a prevalence of 22-39% in India.

Types of arthritis:

Risk factors:

These risk factors may eventually cause arthritis if not managed at the right time.

Symptoms:

Diagnosis:

Management:

1. Lifestyle modification:

  • Diet, nutrition, hydration, regular exercise and good sleep on a regular basis is an important part of management of arthritis.
  1. Medical Management
  • Painkillers, anti-inflammatory medications, drugs used to modify immune response, topical ointments, creams, gels and steroids form a major part of the medical management. Only over the counter drugs can be consumed as needed. Other medications should be consumed only as when prescribed by a doctor.
  1. Physical therapy and exercise:
  • This is one of the most important part of management at all stages, especially the early stage, where prevention of progression is of utmost importance. Physical therapy helps in pain control, improvement of range of motion, strengthening and eventually better function. This applies to all types, except infectious arthritis, where physiotherapy for the concerned joint is directly avoided or done in consultation with the orthopedic.

Physiotherapy management can be broadly classified into:

Patient education: explanation about the disease, its nature, course and prognosis is very important for the patient to have acceptance and understanding of the disease and treatment given.

Manual therapy: various techniques/equipments, like cupping, dry needling, myofascial release, neural mobilization, joint mobilization, taping and others, may be used to work on the joints or muscles to eventually decrease pain and aid function.

Manual therapy

-Electrotherapy: various electrical modalities like TENS, Ultrasound, IFT, LASER and others, are used to majorly manage pain during the flare phase of the inflammation. Dependency on these modalities should be avoided as exercise is eventually the only means of rehabilitation.

Electrotherapy

Exercise: Graded strengthening, range of motion exercises, stretching exercises forms the basis of management. Aquatic exercises are also quite helpful, especially when weight bearing joints are inflamed and painful. These are often well tolerated and beneficial according to a lot of researches.

– Bracing and splinting: From various splints and belts used for joint protection to dynamic splints which aid in function, there are a wide variety of orthoses prescribed only as and when required.

Relaxation: various different forms of relaxation techniques, breathing exercises, energy conservation techniques, positions and activity pacing is taught to the patient to give a more holistic approach to the management while focusing on the overall health, psychological state of mind and fatigue levels.

Relaxation technique

4. Surgical management:

Joint repair: where surfaces are smoothened or realigned. Often done arthroscopically.

Joint replacement: damaged joint replaced with an artificial one.

Joint fusion: generally used for smaller joints of hands and feet or even spine, where both the ends of the joints are fused into one unit.

Thus arthritis forms a major part of the economic burden in every country. On this World Arthritis Day (12th October), let’s all make it a “joint” effort to work towards being aware of our bodies and report early, so as to prevent worsening of symptoms. Early diagnosis and treatment helps to reduce symptoms, improve chances of remission and prevent disability! Kindly always consult an expert and not self-diagnose or self-treat, for better outcomes. Wishing you all happy and healthy joints!!

Authored by-
Dr Kinjal Atul Mehta
Masters in Musculoskeletal Physiotherapy

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