ASK YOUR PHARMACIST
Rheumatoid Arthritis from a Physiotherapist’s Perspective
Eamonn Brady is a pharmacist and the owner of Whelehans Pharmacy, Pearse St, Mullingar. If you have any health questions e-mail them to firstname.lastname@example.org
Over the last few weeks in the Westmeath Examiner I discussed Rheumatoid Arthritis. I mentioned how Physiotherapy can help; thus to complete this series on Rheumatoid Arthritis I conclude by discussing its control from a physiotherapist perspective. For this article I acquired the help of Chartered Physiotherapist Sinead Brogan who runs FlexPhysio Physiotherapy Clinic based in private treatment rooms above Whelehans Pharmacy. To contact Sinead for more information or to make an appointment you can call her at 083 1722171.
Rheumatoid arthritis (RA) is a long-term, progressive, unpredictable disease characterised by acute and chronic inflammation of the joints in the body. This results in pain, swelling and stiffness which can subsequently lead to joint damage and associated disability. RA is known as an 'autoimmune disease' because it is caused when the body's immune system, which normally fights infection, starts to attack healthy joints.
The cause of RA is unknown and at present there is no cure. However, understanding about this disease has improved and there is now more information available about effective treatments that can help ease pain and slow down progression of symptoms. It is essential that these treatments are commenced early to minimise damage to the joints.
A multi-disciplinary approach is recommended for the management of RA. In addition to medical and pharmacological input, there is strong evidence for the role of physiotherapeutic intervention for this condition. One of the main goals of physiotherapy to is to avert or limit joint damage in order to safe-guard future function and reduce the rate of disability. A chartered physiotherapist can undertake a thorough musculoskeletal assessment, taking into account hot and inflamed joints, mechanical deformities, fatigue, deconditioning, co-existing conditions and other psychosocial issues. Armed with this information, a specific individually tailored treatment plan can be designed and implemented.
Regular exercise is an important aspect of the management plan and greatly encouraged. Pain and stiffness in those with RA can lead to avoidance of movement. This in turn causes restriction in joint range of motion, development of contractures and muscle wasting (atrophy), all of which can contribute to joint instability and a further increase in fatigue. When in an acute flare up of RA, emphasis is on decreasing pain and swelling and general rest. As this point gentle range of motion exercises are advocated within pain limits to try and maintain soft tissue and joint flexibility. During a flare up, muscle weight, fibre size and strength decreases due to periods of immobilisation. Hence, it is recommended to start exercising again as soon as the acute pain subsides. A chartered physiotherapist can prescribe specific exercises to prevent muscle inhibition and wasting. An exercise program generally involves range of motion exercises, strengthening for the upper and lower limbs and core and some aerobic exercises. The physiotherapist can also provide education and advice regarding the balance between rest and activity and the best way to manage inflamed joints.
For more information on physiotherapy for the management of Rheumatoid Arthritis, come along to the Rheumatoid Arthritis Information Night in the Greville Arms Hotel, Tuesday 28th of April (tonight) where Sinead Brogan, Chartered Physiotherapist will be on hand to answer your questions. Other speakers include pharmacist Eamonn Brady, nutritionist Aisling Murray as well as contribution from those living with arthritis.
Thanks to Chartered Physiotherapist Sinead Brogan of FlexPhysio for help with this article. To contact Sinead for more information or to make an appointment call 083 1722171.