Know your arthritis

Colleen Lebanna | Tuesday July 12, 2022 06:00

For some with arthritis, this may not be a pleasant time as the cold weather slows blood circulation and heightens pain sensitivity.

Our joints can detect and respond to changes in barometric pressure, and a drop can cause muscles and tendons to expand, which may put more stress on an already crowded arthritic joint. Joints may get stiffer or more painful than usual (what we call a flare up of arthritis).

But do not despair, if this is you or someone you know, there are ways of managing the aches and pains, and well, knowledge and understanding go a long way in helping one cope. So, what is arthritis? There are two major types of arthritis. Rheumatoid arthritis (RA) and Osteoarthritis (OA). RA is autoimmune, while OA comes because of wear and tear of the joint.

They are diagnosed differently as RA does not only rely on the physical signs and symptoms but often a definitive diagnosis is given when specific inflammatory markers are found in blood tests. OA on the other hand does not require blood testing, as a subjective history may suffice, and in some cases, bone damage or loss of joint integrity will show up on x-rays. Typically, in osteoarthritis, one may experience pains in one joint, often the hands, knees, hips, and spine.

The cause may be due to aging or as a result from previous injury (e.g. fracture or car accident) or a job that repetitively puts pressure on your joints (e.g. runners). If it is because of previous injury, we often refer to it as post traumatic arthritis, and if it is the degeneration of the spinal joints, then we refer to it as spondylosis. In addition to these, being overweight is also a risk factor.

One may experience pain and stiffness on waking/morning stiffness, that eases out with movement Pain on movement after prolonged sitting or static activity Weakness of the muscles surrounding the joint Crepitus on movement, a crunchy-like sound as if bone is rubbing against bone Decreased movement of the joint, sometimes mild swelling may occur. RA on the other hand is an inflammatory and autoimmune disorder that typically affects more than one joint at a time, usually hands, feet, ankles, on both sides and the same time.

This happens when your immune system mistakenly attacks itself, causing inflammation in the affected parts. Some people with RA also experience symptoms that don’t involve joints such as the skin, eyes, mouth, lungs, and heart. Basically, RA is systemic while OA is localised. The actual cause is not certain, but it may have a genetic component that makes one susceptible to reacting to an environmental factor that may trigger it. One is more at risk if they are female, with a family history of RA, smoker, and being overweight.

One may experience swelling and warmth of joints Joint deformity and instability over time Painful and tender joints Morning stiffness that lasts longer than in the case of OA Fatigue and low-grade fever All these combined may affect function and limit daily activities, depending on the site and extend. One may experience good days (remission) when the symptoms are well controlled and not bothersome, but flare-ups are inevitable.

As damage to joints cannot be reversed, staying active, maintaining a healthy weight and being aware of own triggers can go a long way. Depending on severity, a multidisciplinary approach will often be the case so one may expect to encounter a physiotherapist, a dietician, a general practitioner, a pharmacist, radiologist, a rheumatologist, an orthopaedic surgeon, amongst others, all depending on severity and need, if they have either OA or RA. Physiotherapy approach involves a non-pharmaceutical pain management strategy, restoration or improvement of function and movement, and maintaining joint and muscle integrity. Education and promotion of self-care is at the forefront.

Self-care tips include but not limited to advice regarding: Balancing activity and rest (e.g. dance at that wedding, but don’t dance all day!) Use of home warm and cold packs (warmth for stiffness, cold for mild swelling) Increasing physical activity (use the stairs, don’t ignore the far-off parking spot) Awareness of your triggers (Don’t sit for longer than you must) If you must come in for a physiotherapy assessment and treatment, a rehabilitation programme will usually be specific to your need and on objective findings.

Modalities used will often include: Electrotherapy Soft tissue mobilisation Joint manipulations and mobilisations Strengthening and flexibility (stretching) exercises Proprioception/balance and stability exercises Hydrotherapy and of course thermotherapy. So keep warm, keep moving, like seasons, flare ups don’t last forever!

Grace Physiotherapy (Gaborone)

Colleen Lebanna Physiotherapy Hons Degree UCD (Ireland) Master of Public Health UP (South Africa)