Arthritis is a term used to describe many diseases, the two most common being osteoarthritis (OA) and rheumatoid arthritis (RA). OA affects more than 20 million Americans and is a degenerative joint problem. RA is an autoimmune disorder that affects the joints as well as breathing and circulation of 2 million Americans.
Differences between Osteoarthritis and Rheumatoid Arthritis include:
OA: Caused by mechanical wear and tear RA: Autoimmune disease
Asymmetric swelling in individual joints Symmetrical Swelling in paired joints
Usually in older patients Can occur at any age
Affects only joints Affects entire body
Stiffness after awakening or inactivity Stiffness all day
Slow onset, over a period of years Rapid onset, over weeks to months
No systemic symptoms Frequent Flu-like symptoms
Initial diagnosis of RA is difficult in that it mimics other diseases. Medications have changed over the years, two of the newer ones being Humira and Remicade. These meds can help reduce the inflammatory process, but if the affected joint isn't rehabilitated by regaining range of motion and strength, one will continue to have disability. Three decades ago the treatment was bed rest, but current research shows that people who exercise have fewer swollen and tender joints. Treatment depends upon the stage of flare of the RA. If it is in an acute stage, the joint is hot and swollen the patient can gently stretch and range their joints as far as they'll go. In a subacute phase the inflammation is beginning to subside and the joint is settling down. At this point one can begin strengthening exercises to prevent weakness. In the chronic state the patient can exercise more frequently and can add aerobic exercise to the stretching and strengthening. The take home message here is that patients with RA should be encouraged to exercise whenever the course of the disease allows. Exercise will lower blood pressure, decrease depression, increase function and is cheaper than drugs. I like to think, "Exercise is Medicine".
Free 15-minute consultation regarding injury, by appointment.
Julie Endreson, MS, ATC
Information taken from the April issue, "Today in PT".