Arthritis is a chronic condition that causes inflammation of the joints. It can cause pain, stiffness, and swelling. The hips, knees, hands, and spine are the most commonly affected joints. Arthritis is not a single disease but an umbrella term that includes a variety of different types. Some of the more common examples are osteoarthritis, rheumatoid arthritis, gout, psoriatic arthritis and ankylosing spondylitis. While physical therapy might not be the first treatment you think of for arthritis, it probably should be.

     A lot of people with arthritis choose to use medication to manage their pain, stop activities that hurt, and wait for things to get bad enough to have a joint replacement. But this isn't a great plan, all medications have side effects, even over the counter ones. Reducing activity leads to muscle atrophy and even stiffer joints. Even though joint replacement surgery usually has good outcomes, it does come with its own set of risks and a painful recovery.

     Physical therapy has been extensively researched as a treatment for arthritis, and demonstrates good outcomes. Physical therapists typically start with exercise as the base for arthritis treatment. Exercise helps to regain lost joint motion, decrease feelings of stiffness, and strengthen muscles surrounding the affected joint. These benefits are all somewhat obvious. What surprises many people is that exercise has been shown to be as effective as medication for pain relief in many types of arthritis, without the side effects.

     Physical therapy has more to offer people with arthritis than just exercise though. Education helps people understand their condition, what to expect, and how to manage it. As experts in human movement, physical therapists are especially good at helping people modify the way they perform certain tasks or activities to reduce strain on joints affected by arthritis. They can also suggest ways to modify the environment at work or home to reduce pain and improve function. They may also suggest things like braces, orthotics, or other devices that can help maintain mobility and reduce pain.

     On top of all of that, PT has been proven to be a cost effective treatment, too. With so many techniques that are proven effective in helping people with arthritis, physical therapy is a recommended first line treatment for many types of arthritis. Now that you have a better understanding of what PT can do, hopefully you'll think of PT first when you think of arthritis too.

References: 1. Research (peer-reviewed) a. PT for juvenile RA - https://pubmed.ncbi.nlm.nih.gov/1946625/ b. PT for hip and knee OA - https://pubmed.ncbi.nlm.nih.gov/33034560/ c. Systematic Review for Juvenile RA - https://pubmed.ncbi.nlm.nih.gov/28729171/  2. Articles and Content a. Effectiveness and Cost-Effectiveness of Physical Therapy for Knee Osteoarthritis-  https://www.rheumatology.org/About-Us/Newsroom/PressReleases/ID/718 b. Can physical therapy reduce arthritis pain? - https://www.medicalnewstoday.com/articles/physical-therapy-for-arthritis 

Many people are focused on fitness so it's worth taking a look at what fitness really means. The dictionary defines fit as "sound physically and mentally, healthy." Using that definition, many "fitness" routines fall short of the goal. If you don't enjoy running and dread every workout, you're probably falling short of the "sound mentally" portion. Exercise should be enjoyable, reduce stress, and leave you feeling better, not worse.

No Pain no Gain?

Exercise should also leave you feeling better physically. If you can run a good time in a 5k, but have aches and pains for days after, you're not "sound physically." If you are increasing your PR in the squat rack, but your joint pain is increasing right along with it, you're not "sound physically" either. Sure, some muscle soreness and fatigue after a hard workout is normal. But if you're having pain that doesn't go away, sore joints, or trouble moving after exercise, you're probably developing movement dysfunction along with your fitness.

Movement Dysfunction

Go back to the dictionary and you'll find that dysfunction is "impaired or abnormal functioning." So movement dysfunction is impaired or abnormal movement. When someone has a movement problem like a sore joint, limited range of motion, or strength loss the brain finds a way to get the body to do what it wants. That usually means moving in a way that is less than optimal. For a while, it works. But eventually it leads to injury. As a concrete example, think of someone who has trouble bending one knee doing squats. When one knee bends further than the other, it will cause one side of the pelvis to drop lower than the other. Now that the pelvis isn't level, the spine bends towards the high side to stay balanced. When that one side of the pelvis drops lower than the other one, it also usually rotates. Now the spine has to bend to the side and twist to keep you upright. This works for a while, but as weight gets added to the squat, and the repetitions add up so does the risk for a back injury.

Preventative Medicine

Pain during workouts, or pain and soreness that don't go away after can be warning signs of a movement dysfunction. If you're experiencing any of these, your physical therapist is a movement expert who can help. We are trained to analyze movement, and figure out the root cause of problems. We can then design a program to treat the cause and correct the abnormal pattern. There is no need to wait until you're injured to see your physical therapist. In fact, it's preferable not to.

Getting minor problems fixed early means fewer visits to the PT, less pain, and not having your workouts put on hold by injury.