Role of physiotherapy in treatment of Rheumatoid Arthritis

Abstract

R arthritis is a systemic auto-immune disease. Symmetrical inflammatory polyarthritis is the primary clinical manifestation. The arthritis usually begins in the small joints of the hands and the feet, spreading later to the larger joints. The inflamed joint lining or synovium extends and then erodes the articular cartilage and bone, causing joint deformity and progressive physical disability. RA is a disease where joints are commonly involved. The hands and wrists are affected in approximately 90% of RA patients, and these joints may show unique changes over time. Early in RA, joint tenderness and subtle swelling are observed, but after months to years the synovitis becomes proliferative and destructive. The tissue within the joint becomes boggy to the touch then typical joint deformities appear. Physiotherapy is can be used in the treatment of RA. These include: 1. Cold/hot applications 2. Electrical stimulation 3. Rest and splinting 4. Massage therapy 5. Therapeutic exercise. Cold/Hot application is well known that cold application is mostly used in acute stages whereas hot is used in chronic stages of RA. By using heat, analgesia is accomplished, muscle spasm relieved. Transcutaneous electrical nerve stimulation (TENS) is a widely used form of electro analgesia. TENS is thought to produce analgesia according to the gate control theory. The electrical stimuli delivered by TENS units can be varied to suit patient tolerance, as well as to produce the best efficacy. Massage Therapy is a commonly used treatment tool that improves flexibility, enhances a feeling of connection with other treatment modalities, improves general well being, and can help to diminish swelling of inflamed joints. Rest and Splinting treatment the joints should be put into rest during the acute stage of the disease. Bed rest relieves the pain in cases of extensive joint involvement. It is critical, at this stage, to put the joints into rest at a functional position. Orthosis and splinting are used to diminish pain and inflammation, to prevent development of deformities. Mitesh Patel, Orthop Muscul Syst 2013, 2:2 http://dx.doi.org/10.4172/2161-0533.S1.012