Physiotherapy and Arthritis
An Information Sheet
What is in this leaflet?
This leaflet contains information about the role of physiotherapy in helping you with your arthritis. Having arthritis can be a life-changing event that can affect your personal, social and work life. It can take time to accept and adjust to a diagnosis of arthritis and this can be an emotional and difficult process, through which you will need support. Your family, friends, arthritis support groups and a team of health professionals will be able to offer you that support. A physiotherapist is part of that large team which will help you manage your arthritis.
What does a physiotherapist do?
Physiotherapists are health care professionals who help people resume an active and independent life both at home and at work. They are experts in assessing movement, addressing individual needs, helping to improve function, and managing pain. Some physiotherapists specialise in treating people with arthritis, which affects people in different ways. They can provide you with appropriate aids, such as a walking stick, and teach you how to use these. They also teach you how to protect your joints. Some specialist physiotherapists have been trained to diagnose and treat people with joint and muscle pain – therefore when you are referred by your GP for specialist treatment, in some places you may be seen by a specialist physiotherapist rather than by a rheumatologist or an orthopaedic surgeon.
Where does a physiotherapist work?
Physiotherapists work in both the National Health Service (NHS) and the private sector. They work in a variety of settings, including hospitals, primary care services, GP practices, health centres, workplaces and schools, and visit people at home.
How can I be referred to a physiotherapist?
Your access to physiotherapy services depends on where you live and what services are available in your area. There are two routes you can take to see a physiotherapist:
- You can be referred by your GP or your consultant to your local or hospital physiotherapy department.
- The second route is self-referral, in other words making your
own arrangements to see a physiotherapist without a doctor's referral.
This is a new practice that has been implemented in some parts
of the UK. Check with your GP and find out if you have an NHS
physiotherapy department in your area that will accept self-referrals.
If you wish to be seen privately you can self-refer to a private
physiotherapy practice.
It is very important to give a full medical history to the physiotherapist when you self-refer.
How can physiotherapy help me?
1. Helping you to understand how arthritis affects you
A physiotherapist can help you understand what happens to your joints and muscles when you have arthritis. There are different types of arthritis and it can affect your muscles and joints in many ways. It is important that you understand how the arthritis affects you individually. The information you are given by health professionals, leaflets and the internet will help you manage the effects of arthritis.
2. Helping you to manage your pain
Arthritis can cause widespread joint or muscle pain, or pain that is more localised (occurring in only one place). Managing your day-to-day pain is very important and you should discuss with your doctor what medication is suitable for you.
In addition to medication there are many other strategies that you can use to manage your pain, and a physiotherapist can advise you about these.
Pacing is one of these strategies. Sometimes over-activity or not doing enough can make your pain increase. Working with the physiotherapist you can discover the right balance between rest and activity. This does not mean you have to do less, but planning your activities so you are always comfortable will enable you to enjoy the things you want to do.
Regular exercise will help you strengthen your muscles and joints and increase your day-to-day fitness. Being physically fit will help you increase your level of activity without necessarily increasing your pain. It will also stimulate the production of your own natural pain-relieving chemicals such as endorphins.
There are some other simple strategies you can use. Applying an ice pack over a hot and swollen joint can relieve pain. Applying a heat pack over a tensed and tired muscle will help the muscle relax. Taking time out and relaxing will reduce body and mind tension and make you feel better in yourself. Splinting of swollen or painful joints may be helpful, for example during a flare of rheumatoid arthritis. Your physiotherapist or occupational therapist may therefore make or provide temporary splints for you.
Other methods that may be used by physiotherapists (and which may be found in settings outside a physiotherapy department) include transcutaneous electrical nerve stimulation (TENS), massage and acupuncture.
- TENS works by blocking pain messages to the brain and modifying your perception of pain. It is a small electronic device that you use by placing small pads on your skin surface. These then send small pulses to nerve endings. This may help pain in some cases – the response varies between individuals.
- Massage can help the muscles relax and make joint movement more comfortable.
- Acupuncture can stimulate the brain to produce natural pain-relieving chemicals – it should be used only by a qualified clinician who has had the appropriate training. Some physiotherapists are trained to give acupuncture.
You should discuss with your physiotherapist which methods may work best for you.
3. Improving your fitness
Keeping active is very important when you have arthritis. Exercise can improve your general fitness, maintain your weight, help your general mobility, and make you feel better in yourself. There are many different ways you can exercise. The important point is that you do it on a regular basis, that you find a type of exercise that is suited to you, and that you enjoy it.
Activities like swimming, walking, t'ai chi and dancing can be a good start. Talk to friends and family and find out what facilities are available in your area. Contact your local council and see what activity or exercise programmes are offered in your area. With this information you and your physiotherapist can decide what would be the best exercise option for you. Exercising may be a new experience for you and your physiotherapist will support and encourage you through this process.
Some physiotherapists have access to hydrotherapy (see arc leaflet 'Hydrotherapy and Arthritis'). This allows people to perform exercises in a hydrotherapy pool, which is heated to a higher temperature than a normal swimming pool. Many people find it easier to move in water – the warmth and weightlessness enables them to move with less effort and to relax their joints and muscles.
4. Teaching you mobilising, stretching and strengthening exercises
Arthritis can cause joint inflammation that leads to joint stiffness and muscle weakness. This can affect your day-to-day activities, from something as simple as sitting to your ability to work and exercise. Your physiotherapist will assess the range of movement of your joints and your muscle strength. Using manual techniques and exercises, you and your physiotherapist can work towards achieving your full potential and best functional outcome. Each person will be individually assessed and advised.
Further information
The Chartered Society of Physiotherapy website has a section that explains what physiotherapy is and how it can help people with different conditions. You can find this information at www.csp.org.uk under the heading 'Physiotherapy explained'.
