Physiotherapy in Osteo Arthritis

Role of Physiotherapy in Arthritis

The word 'Arthritis' literally means joint inflammation. The warning signs of arthritis are pain, swelling, joint stiffness, difficulty in moving one or more joints. Arthritis can be a life changing event which can affect your personal, social and work life unless it is well understood and treated in time.

There are 127 different kind of arthritis. The most common types are Osteoarthritis and Rheumatoid arthritis. Osteoarthritis is degenerative joint disease. It may be due to chronic wear and tear or due to injury.

Rheumatoid arthritis is an autoimmune disease in which ones own immune system attacks cells in the joint capsule and associated chronic inflammation destroys cartilage, bone and ligaments, leading to deformity and disability. Physiotherapy plays a major role in treating both Osteo & Rheumatoid arthritis along with medicine or by itself.

Even though many other factors contribute the development of Osteo arthritis, the root cause may be deviation of normal body mechanics. By correcting the body mechanics the percentage of wear and tear can considerably reduced. Obesity, muscle wasting, poor muscle strength, prolonged standing and internal derangement of knee like ligament injury can also contribute to Osteo arthritis. Physiotherapist can assess these basic causes and helps to correct the pre disposing factors. If it is found and corrected early, Osteo arthritis can be controlled to a great extend. Some patients may need medicine along with Physiotherapy.

Major symptoms seen with Osteo arthritis are pain, restricted range of motion, swelling etc. Pain and swelling can be relieved with the use of hot packs or cold packs, Ultrasound therapy, laser therapy, use of TENS or interferential therapy, taping techniques etc. Range of motion and strengthening exercises can be given to achieve maximum functional independence at home and at work place.

Type of Exercise useful for Arthritic patients

1. Range of motion exercises: It helps to maintain normal joint movements and relieve stiffness. These are gentle stretching exercises which move each joint as far as possible in all directions. Normal daily house work or office work may not help to improve joint range of motion and are not a substitute for ROM exercise.

2. Strengthening Exercises: It helps to keep or increase the muscle strength, provide stability, support and protection to the joint, helps the joint to move more easily with less pain and helps to prevent deformity. Isometric, isotonic or isokinetic exercises can be used according to the condition of the patient. Isometric exercises involves tightening of muscle without joint movement which maintains muscle tone, prevents muscle wasting when joint range is impaired.

3. Endurance exercises: This helps to maintain cardiac fitness, ROM, to increase physical strength, to control body weight and to improve arthritic symptoms. Aerobic exercises like graded walking, use of bicycle or treadmill initially with the supervision of the physiotherapist may help to prevent complication.

How often people with arthritis should do Exercises?

ROM exercises can be done daily many times and should be done at least every other day. Strengthening exercises should be done every day unless you have severe pain or swelling in your joint and repeated daily.

Endurance exercises should be done 20 to 30 minutes at least 3 times a week unless you have severe pain or swelling in your joint. Before starting endurance exercises it is better to have a medical consultation to assess your medical fitness.

In case of rheumatoid arthritis prolonged medical treatment is required. Here Physiotherapy helps to maintain ROM, muscle strength and to prevent joint deformity. Once joint deformity is established the patient may develop severe ambulation problem. This can be prevented with medication and timely physiotherapy.

'Think positive about arthritis, Physiotherapist can guide you to lead a pain-free independent life'.

Acupuncture And Massage Therapies For Arthritis

Affecting an approximately seventy million Americans, arthritis is the leading cause of disability in the United States. Arthritis is complex disease that can hit at any virtually any age and featuring more than one hundred various conditions. Of the multitude of arthritis disorders, osteoarthritis and rheumatoid arthritis are the two most common. For this reason the idea of acupuncture and massage therapies for arthritis treatment has suddenly become quite popular.

Osteoarthritis: Osteoarthritis is the most common form of the disease in the United States. Stricking a record twenty-one million Americans, osteoarthritis is a systematic shutdown of the joint cartiledge that ultimately leads to severe pain and stiffness. The hips, knees, fingers, and spine are the most common comfort zones for osteoarthritis, with the wrists, elbows, shoulders, and ankles less commonly affected. When the disease deviates into a uncommon area of affliction it is typically due to an pre-existing injury. Work related injuries are frequent causes of the development of osteoarthritis. For example, professions where bending, kneeling, and squatting is the main attraction feature an elevated risk of osteoarthritis of the knee.

Rheumatoid Arthritis: In contrast to osteoarthritis, rheumatoid arthritis can actually affect various joint and some patients feel the disease's effects in other parts of the body, including the blood, the lungs, the tissue of the skin, as well as the heart. Rheumatoid arthritis, which can be long-term, is characterized by an inflammation of the joints called synovium, the inflammation causes joint swelling, stiffness, warmth, and redness. The affected joints may lose their shape, thus losing the ability to move normally.

Acupuncture and Massage Therapies for Arthritis Treatment

In recent years, the use of acupuncture and massage therapies for arthritis treatment have pointed to the therapies' potential as effective alternatives to mainstream medicines. And that's not all that the use of acupuncture and massage therapies for arthritis treatments have in common, both alternative treatments have beginnings that are deeply rooted in the mystical world of ancient medicine. Just take a look at acupuncture.

Acupuncture For Arthritis Treatment: Acupuncture, and other types of oriental medicines, have been wildly successful in treating the pain and inflammation affiliated with various types of arthritis. Ancient Chinese medicine custom fits acupuncture treatment according to the individual arthritis symptoms of patients with a unique combo of acupuncture therapy, Chinese herbs, body work, and lifestyle changes. Even dietary changes and energentic exercises are a big part of treating arthritis through acupuncture.

The acupuncture points used to treat arthritis aren't just located over the throbbing area, but rather in different areas located over the entire body. You may just find those tiny acupuncture needles placed in every area from your legs to your arms right on down to your baby toe! Don't let the needles frighten you, some people take their acupuncture session as an opportunity to catch up on a few Z's. Session last between five minutes and a half an hour, but arthritis patients may require multiple trips to their acupuncturist depending on the severity of the disease.

As a follow-up to your visit, your acupuncturist may also provide you with prescribed Chinese herbal formulas specifically designed to alleviate the symptoms of arthritis. Chinese herbs used to treat arthritis as a part of acupuncture therapy are:

Juan Bi Tang

Cinnamon Twig

Peony

Anjelica Pubescens

A Scadanavian study of thirty-two hip replacement/arthritis patients found that twenty-five percent of the patients who received acupuncture therapy experienced such surges in their functionability that they decide they didn't need that hip replaced after all.

Massage Therapy for Arthritis: Both acupuncture and massage therapies for arthritis treatment are used as cutting edge alternatives to contemporary medicine, but did you know that they both got their start in the ancient world? It was the ancient Greek Hippocrates who first suggested that "rubbing" be used as a remedy for loosening a "hard joint-" that was over two thousand years ago. Massage therapy is believed to work in a few ways in combating arthritis:

Improving joint movement

Relaxing tense muscles

Stimulating blood flow to the skin

And if one form of massage therapy doesn't work for you, don't sweat it. There are several very popular massage therapy programs to choose from:

Swedish Massage

Deep Tissue Massage

Trigger Point Therapy

Acupressure

Reflexology

Safeguard Joints That Are Prone to Injury

Many of us take joint health for granted. The strange thing is that you can injure a joint and not even know it. Injury can take place by simply overusing a particular joint or wearing the wrong type of footwear. But once an injury has taken place, it can lead to a gradual degeneration of that joint. The cartilage can begin to tear and bone rubs against bone causing pain and inflammation of surrounding tissues. Joint pain can often manifest after the age of forty and after that the need for joint pain relief can grow more intense. By caring for your joints now, you could avoid pain later.

Which joints require the most care or joint support? Let's take a look at 10 joints that are most prone to injury.

Joint Support for Elbows: Injuries to the elbow joint can occur when playing sports like mountain climbing, racquet sports, baseball, or any sport that involves a throwing or swinging action like golf and volleyball. Elbow injury could also be caused by an occupation that involves repetitive use of the elbow joint.

Joint Support for Ankles: The ankles bear the largest weight. Injuries to the ankle usually occur when we step on uneven surfaces and twist the ankle. Vigorous physical activity such as jumping, landing on a hard or uneven surface can also cause injury to the ankle joint. Joint pain relief becomes vital since it can limit our mobility.

Joint Support for Knees: The knee joint is a weight-bearing joint. Common knee injuries can be due to a blow to the knee by a fall, a sudden stop while running or a twist of the knee, or overuse. Pain can gradually increases with age.

Joint Support for Back joints: Historically the lower back usually incurs more wear and tear. The back bears the weight of the body, but also bears extra stress when we lift heavy objects. Laborers and athletes who do weight training are more susceptible to back aches. Injury can also occur due to poor posture or being overweight. Joint pain relief may be found by massage therapy. Injuries to the back can be difficult to rehabilitate and are more likely to recur.

Joint Support for Shoulders: Being a ball and socket joint, the shoulder joint is flexible and affords wide range of motion. Pain here can arise due to poor posture, wear and tear, overuse, aging, sports such as baseball or tennis, even repetitive household chores that affect the shoulders. Many have found joint pain relief by adopting a proper posture or giving adequate recovery time between sports events.

Joint Support for Neck: A pain in the neck can be due to contact sports, lifting heavy objects or a jerking movement of the neck. It can also be due to poor posture or sitting at your desk for extended periods without stretch breaks. Stretch exercises for the neck can help bring joint pain relief.

Joint Support for Wrist: The most common injury to the wrist is linked to joint impact due to a fall or an accident. The wrist can also suffer injury due to poor positioning of the wrist on a keyboard for prolonged periods. Repetitive use in daily activities can also trigger wrist pain.

Joint Support for Fingers: Wear and tear occurs more easily and shows itself gradually. Simple tasks become difficult such as paring an apple, knitting, or opening the lids of a jar. Joint pain relief may be found by increasing circulation and regular exercise.

Joint Support for Hips: The hips are weight-bearing joints. The cartilage can begin to wear and tear faster especially for those involved in sports like golf, skiing, track, soccer or football. Professional dancers are also prone to hip pain as are those who over-exercise. Many find joint pain relief through low impact exercises.

Joint Support for Toes: Injury here is more common among people who play on artificial turf.. People who wear footwear that does not give support to the forefront joints are also prone to toe injury.

Some of you reading this may think the damage is already done, what can I do? There aren't any ways to bring back time but fortunately there have been scientific breakthroughs that can help restore joint health to some extent.

Duration of Stiffness After Total Knee Replacement

Getting a knee arthroplasty or joint replacement is expected by a lot of people to be a solution to their mobility problems. However, it seems that there is a certain group of people that have not regained the full range of motion that they had expected after surgery. This condition is generally termed as stiffness of the replacement joints. The duration of stiffness after total knee replacement has not been extensively written about, though there are available solutions to correct the condition.

Osteoarthritis and Knee Replacement

An indication that a patient needs knee surgery is when he or she has a developing osteoarthritis. Osteoarthritis is a combination of various conditions that result in the continuous degradation of the joints. The joints are protected by a material called the cartilage, the same material the visible part of the ear is made of. A series of forces contribute to its thinning out, causing the joints to become closer and will eventually cause pain whenever in contact.

This is especially true to the knees, since they have to stand the weight of the entire upper body and the legs. Running, walking, or even standing becomes very difficult to a person with osteoarthritis. If therapy and medication cannot help anymore, the joints are replaced by artificial mechanisms that mimic the function of the knee.

Why Does the Stiffness Happen?

There are several factors that could lead to the stiffness. One is the actual built quality of the artificial replacements. Though the replacements have been rigorously tested prior to shipping in various medical facilities, there is still a big chance that a small portion may not have passed quality control measures.

Another culprit may be the lack of rehabilitation after the surgery. Usually, patients are asked to complete a series of physical exercises to retrain simple tasks such as standing up or bending the knees. At first, they are simply asked to do these exercises while in bed or sitting. Next, a physical therapist and railings or crutches provide assistance until complete motion is revived. If there is serious negligence on the side of a therapist or the lack of cooperation from the patient, stiffness of the knee will eventually occur.

How Long Does the Stiffness Last?

According to a recent study, it was found out that among people who have experienced knee surgery, only 1 percent have felt stiffness in their replacements. Most of them have also reported the issue earlier to their surgeons and they have performed certain corrections. Duration of stiffness after total knee replacement can last as long as the rehabilitation process of the patients. This can mean as long as three months or more, but most patients get full function of the knees by then.

Corrective Procedures

One way to shorten the duration of stiffness after total knee replacement is to massage the knees or have them moved by an expert while the patient is under anesthesia to remove the pain. This is usually part of the rehabilitation process already and ensures that the replacement is working perfectly.

If the stiffness can be discovered early on, surgery can be performed again to adjust the calibration of the joints or have them replaced altogether. According to the same study above, corrective surgery resulted to around 90 percent of patients getting back full motion of the knees.

A strict doctor ordered rehabilitation always follows knee replacement surgery. Unfortunately, this rehab is only enough to give you some mobility and get back part of your life. They don't expect people with knee replacements to have the full abilities like they once did, so they don't even try. With the right exercise and routines, though, you can have that life back, despite what the doctors tell you. Take the time to learn about rehabilitation from knee replacement surgery, and how you can ease your fear of living a sedentary life by taking action.

Treating Sharp Shooting Knee Pain Before it Treats You! Braces For Improved Stability

Having any trouble with your knees lately?

If you have sharp shooting knee pain, chances are, it is the result of an injury to the cartilage or the ligament in the joint. This can be an old injury or even one that just occurred recently. In order to get the right treatment, it is important to consult a doctor and get an accurate diagnosis of the cause and severity of your injury.

Torn vs. Damaged Ligament

There is a difference between a torn or damaged ligament. A torn ligament will not repair itself but a damaged ligament, which is often the case for sharp shooting knee pain, can be repaired. The treatment for both a torn versus a damaged ligament is almost the same, although there will not be as much emphasis on knee surgery for a damaged ligament as opposed to a torn ligament.

Treatment of a Damaged Ligament

A damaged ligament can be treated by wearing a knee brace and keeping the knee elevated for a period of time. The knee brace will not heal you, but it promotes an environment for you to heal yourself - See, when you are walking and moving about, wearing knee braces will help to manage the pain and also help the damaged ligament to heal. The prognosis can be very good for anyone who has sharp shooting knee pain brought on by a damaged knee ligament. Care should be taken to follow the advice of the doctor.

In addition to wearing a knee brace, the knee pain can also be treated with pain medication. Pain medication such as over the counter pain pills can help alleviate the pain you are suffering from. The damaged knee ligament will need to be treated for either weeks or months, depending on the severity of the injury and the intensity of the pain.

Physical therapy is also a good way to treat the damaged ligament. Proper physical therapy, when done in conjunction with wearing a knee brace, can help to heal the damaged knee ligament much faster.

Treatment of a Torn Ligament

A torn ligament is more serious than a damaged ligament. This can also result in very sharp shooting pain in the knee. The torn ligament can be nursed with the help of the same type of treatment that is used for a damaged knee ligament, only here the odds are higher that you may need knee surgery. If you want to stave off knee surgery, wear the knee brace whenever possible and use therapy exercises on your knee.

If you are overweight, you may be able to relieve some of the pressure on the knee by losing some weight. Many people who experience sharp pain in the knee do so because they are overweight. Not only will you be healthier if you lose weight but you will also be giving your knee a welcome break.

If you have to have knee surgery, you will undergo rehabilitation where you will wear a knee brace and practice many of the same exercises that you will perform when you are treating an injured knee.

A sharp shooting knee pain can be very troublesome and can have an adverse effect in all spheres of your life. The best thing you can do for yourself is wear a good pair of knee braces, take steps to lose weight and do the recommended knee exercises regularly.

Knee Arthritis - Hydrotherapy Can Help!

Arthritis in knee joints can be very painful.?People suffering from this problem experience not only pain but stiffness, weak muscles and less confidence in walking and get out and about.?They may walk with a limp and be afraid to use the knee in a normal manner.

What can be done about knee arthritis??The most important thing you can do is exercise to maintain the strength of the knee joint muscles and stretches to maintain the range of movement.?Exercises can be done using weights or resisted bands to increase the strength but in some cause people prefer to perform exercises in water.?
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Hydrotherapy is very useful for people who suffer with arthritis in knee joints.?As a starting point, walking in the water is useful.?You can then walk backwards and sideways.?Other activities to trial in the pool is standing and marching on the spot, stepping up and down onto a small step in the pool and simply floating and kicking your legs.?There are no hard and fast rules with respect to water exercises for arthritis in knee joints.?If you are moving your legs, that is an exercise.?The key is then to repeat that movement and increase the number of repetitions you perform over time.?Because arthritis in the knee is a long term problem the best way to track you progress is?to use?a workbook, write down the exercise type and then monitor the number of exercises.
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Hydrotherapy is a useful therapy that can be used not only for arthritis in knee joints but for arthritis in other joints.?Joints need to keep moving.?If you don't use it or you lose it is a good motto for patients suffering from arthritis.?The important this is to pace the exercises for knee arthritis and overtime you will see a huge benefit.

Knee Pain Most Likely From Muscle Weakness

A person has knee pain and goes to their physician to establish what is causing the pain. An x-ray and MRI are taken as standard protocol. Arthritis is identified; a meniscal tear perhaps, bone-on-bone. These are the typical diagnoses given for pain at the knee. Treatment protocols follow based on these diagnoses. A cortisone shot might be given. This is just a masking agent and clearly can do nothing to resolve a cause. It simply delays the inevitable need to establish what is causing the pain. Surgery is certainly a possible option for a meniscal tear or bone-on-bone.

These are the typical options provided by the medical establishment. Now let's examine the diagnoses and understand why they are not valid and why the described treatment protocols are not valid. Let's start with that diagnosis of a meniscal tear creating pain at the knee. First it would be very important for you to know that a study identified that roughly 63% of people with knee pain have meniscal tears. Shockingly, the same studied identified that roughly 60% of people with no knee pain have meniscal tears. With that understanding it is difficult to correlate meniscal tears with pain. So how can you account for such a large number of people having meniscal tears and no pain. There is only one logical solution.

Regardless of whether you are getting the MRI when you have pain or don't have pain, the positive finding of a meniscal tear is one in which the tear is extremely slow in progression due to degeneration versus a specific traumatic event. The progression of the tear is so slow that it doesn't ignite a pain signal to identify the tear is occurring. Therefore, in most cases the finding of a mensical tear with knee pain is invalid and should not be taken to a legitimate method of identifying the cause of knee pain. Next, look at the diagnosis of bone-on-bone. This diagnosis implies that there is no more cartilage between the femur (thigh bone) and tibia (lower leg bone). Therefore they are bone-on-bone. What is false about this diagnosis is that if the joint is in fact bone-on-bone, there is no space for the bones to glide which is a key to allowing range of motion at the joint to occur. Therefore if you are bone-on-bone you should have no knee range of motion. In the vast majority of patients I have treated with this diagnosis, the person had almost full range of motion of the joint. Therefore they could not be bone-on-bone. They certainly have a decreased joint space but that is it. And that is certainly not a defining characteristic for identifying the cause of knee pain.

Again, studies have shown that almost as many people with no pain can be found to have degenerative joint disease as those with pain. So what is really causing pain at the knee in most cases? The answer lies in a simply understanding that the position of bones at joints is not arbitrary. The position of bones at joints is determined by the pulls of the muscles that attach and pass across the joints. If there is muscle weakness or imbalance of the muscles at a joint, the joint surfaces will become misaligned. This can create irritation and pain. The key to resolving pain at most joints is to determine which muscles are weak or imbalanced creating the misalignment of the joint surfaces. In the case of the knee, there are three main muscular causes of pain. First, the front thigh (quad) muscle is to strong in relationship to the back thigh (hamstring) muscle. This causes the quads to shorten. In doing so, they cause increased upward force on the knee cap which causes it to be compressed excessively in the knee joint.

Resolution in this case comes from strengthening of the hamstrings and glute muscles and stretching of the quads. Next, the quads could be strained causing them to weaken. This causes decreased tone on the knee cap. This allows the knee cap to rise in the knee joint. The knee cap begins to track more to the outside of the joint which causes it to contract the outside border of the knee creating pain. The key to resolution in this case is strengthening of the quad muscles. The third muscular cause of knee pain is straining of the ITB band. This is a band of connective tissue that attaches to the outside border of the knee cap. If this band becomes irritated, it will shorten and pull the knee cap out to the side. The knee cap can then impact the outside border of the knee joint and create pain. Resolution in this case comes from strengthening of the gluteus medius muscle. This is the hip muscle that works with the ITB to create support of the leg at the hip level. Strengthening of the gluteus medius will prevent the ITB from becoming irritated, shortening and creating misalignment of the knee cap.

I hope this gives you a better understanding of what the real potential causes of knee pain are. If you identify the cause of your knee pain as being muscular as I have proven in at least 90% of the cases I have treated, resolution of pain is just a couple of strengthening sessions away.