14/08/2022
Arthritis Management and Rehabilitation @ https://pmrpainclinics.com/
Arthritis is a diseased state of joints.
There are mainly three types of arthritis:
- Degenerative OR non-inflammatory arthritis &
- Inflammatory arthritis
- Infective and Reactive arthritis
Degenerative arthritis (wear and tear) is also termed Osteoarthritis. Osteoarthritis may be primary or secondary (occurs after damage due to a primary disease / infection / post-surgery)
It is the most common type of arthritis, mainly due to overuse and ageing, post injury, and due to obesity.
Most common joints involved are those of spine, hip, knee and feet. Osteoarthritis of hands are commonly inherited.
Inflammatory arthritis are many – Rheumatoid arthritis; Psoriatic arthritis; Gouty arthritis; Ankylosing spondylitis; Non-specific inflammatory arthritis etc.
In any arthritis, there is damage to the cartilage, underlying bone below the cartilage, with bony outgrowths, damage to synovial tissue with or without inflammation, and reduction or an increase in joint fluid.
As the arthritis progresses, deformity of the joints happens with wear and tear of the surrounding muscles and ligaments. This is associated with reduced strength, flexibility and endurance of surrounding muscles.
When a joint is involved, the adjacent joints of the kinetic chain are also affected gradually.
Symptoms
• Pain (localized or diffuse)
• Pain increased with movement or with prolonged rest
• Stiffness
• Swelling
• Warmth or cold
• Increased or decreased movement
• Joint deformity
• Joint instability
• Inability to function normally (eg. Difficulty in gripping, combing, buttoning, unbuttoning, sitting, bending forward, walking, running etc)
The involvement of joints may be symmetrical or asymmetrical, depending upon the type of arthritis and underlying condition.
The type and number of joints involved also depends upon the underlying condition and type of arthritis.
Treatment of arthritis
Medications: depending upon the cause. These include NSAIDS, muscle relaxants, anti-inflammatory medications, antibiotics, supplements, bone antiresorptive agents, medications for neuropathic pain, anti-spasticity medications, mood stabilizers, and medications for anxiety & depression.
Rest: in acute injury and inflamed joints.
Ice / heat modalities to reduce swelling and inflammation, and for relaxing tissues.
External aids and braces: to support the joints, prevent unwanted movement, provide normal movement of the joint and to offload the joints
Joint injections: with anti-inflammatory agents, visco-supplements, Platelet rich plasma (PRP) or growth factor therapy, botox injections, and nerve blocks. The injections are done inside the joint around the joint, around the nerves of the joint, inside the bursa, in / around the tendons.
Physiotherapy: Hot and cold therapy; Electrotherapy; Traction and massage; Exercise therapy for strengthening, flexibility and endurance of muscles; Proper positioning and posture.
Occupational Therapy: for improvement in daily functioning (basic and advanced skills)
Lifestyle modification and Counselling
Psychotherapy: Cognitive Behavioral therapy; Hypnotherapy and Relaxation techniques
