Occupational Therapy for Arthritis Management

Did you know that nearly 25% of American adults suffer from arthritis? That’s approximately 54 million Americans! Luckily, you don’t have to resign yourself to a life of constant pain. Occupational therapy is a particularly powerful tool for arthritis management. But, before we examine why, let’s take a closer look at this broad class of joint disorders.

What is Arthritis?

Arthritis refers to a group of more than 100 medical conditions that cause accelerated joint breakdown and irritation. Specifically, an arthrosis refers to the meeting point of two bones for the purpose of movement, whereas the suffix -itis indicates inflammation. Hence, arthritis is a term that refers to joint dysfunction, pain, and tenderness.

Technically, arthritis specialists divide the disorder into both inflammatory and noninflammatory subtypes based on the mechanism of the disease. Yet, all forms of arthritis can result in inflammation. Let’s examine the two most common types of arthritis to discover why:

  • Rheumatoid Arthritis (RA): RA, or inflammatory arthritis, occurs when the immune system misidentifies its own tissues as foreign pathogens and mounts a defense. In a healthy immune system, inflammation serves an important function in healing. It signals the immune system to dispatch healing agents to the site of an injury or infection. In an immune system that has gone awry, however, uncontrolled inflammation can lead to adverse consequences, such as joint deterioration. As you can see, in this case, inflammation causes the disease; it is not a byproduct of the condition itself.
  • Osteoarthritis (OA): OA, also known as noninflammatory or degenerative arthritis, occurs when our joints wear down over time as the result of overuse or mechanical injury. More specifically, our joints are lined with lubricated cartilage to minimize friction during movement. As this cartilage begins to erode away from constant use, symptoms such as inflammation, pain, and swelling can occur. By far the most common type of arthritis, OA affects 32.5 million Americans each year.

Other Common Causes of Arthritis

Aside from these two primary agents, other common causes of arthritis include:

  • Juvenile Idiopathic Arthritis (JA): A childhood form of arthritis that arises from an underlying autoimmune disorder
  • Systemic Lupus Erythematosus (SLE): An inflammatory autoimmune disease that can attack any part of the body, including your joints
  • Gout: A form of metabolic arthritis in which the body struggles to remove excess uric acid from the blood, leading to painful urate crystal formation in the joints
  • Ankylosing Spondylitis (AS): At least partially genetic in origin, an inflammatory disease leading to fusion of the spinal vertebrae, aka, bamboo spine
  • Psoriatic Arthritis (PsA): An arthritic condition that occurs in conjunction with psoriasis, a scaly red rash with peeling white patches
  • Reactive Arthritis: A type of arthritis that develops in response to an infection elsewhere in the body, often affecting the knees, ankles, eyes, and urethra
  • Septic Arthritis: Refers to joint inflammation that results from a diffuse bacterial infection in the bloodstream (i.e. sepsis) which introduces pathogens directly into the joint

A Brief Note on Fibromyalgia

You may now be wondering… But, what about fibromyalgia?

Fibromyalgia results in symptoms of widespread pain that mimic arthritis in presentation. However, fibromyalgia is caused by defects in our brain’s pain processing center. These misfirings amplify minor sensations of discomfort into more severe signals of pain. Although not technically classified as a form of arthritis, fibromyalgia is best addressed by an expert in pain management. For more information about cutting-edge treatments for fibromyalgia, contact one of our pain management specialists today!

Recognizing the Symptoms of Arthritis

With over 100 different conditions contributing to arthritis, needless to say, symptoms can vary quite extensively from patient to patient. So too can the joints affected. Osteoarthritis, for example, most commonly affects the joints of the spine, knees, hips, and fingers. Rheumatoid arthritis, on the other hand, frequently attacks the smaller joints of the wrists, hands, and feet.

Generally speaking, however, the symptoms of arthritis may include:

  • A dull, aching pain in the affected joint(s)
  • Swelling (also known as joint effusion) of the soft tissues supporting the joint
  • Joint stiffness that worsens after periods of inactivity (e.g. upon first waking up in the morning)
  • Redness at the site of joint inflammation
  • Reduced endurance or tolerance for pain-provoking activities
  • Loss of ability to participate in certain activities of daily living (e.g. climbing stairs, sitting for prolonged periods of time without experiencing pain)
  • Crepitus, the grinding or crackling sensation created by bone-on-bone contact
  • The formation of bone spurs, the bony equivalent of a callus, around the joint
  • Evidence of visible bone deformities (e.g. nodules that form around the finger joints)

In addition, certain types of arthritis, such as RA or lupus, may be accompanied by fever or fatigue. As your condition worsens, you may find yourself unable to perform many of the activities of daily living that you once took for granted. For example, an individual with severe arthritis in the hands may lose the dexterity required to button a shirt.

When it comes to relearning activities such as these, this is precisely where an occupational therapist becomes indispensable.

What is an Occupational Therapist?

Occupational therapists equip patients with adaptive strategies that enable a successful return to the activities of daily living (or ADLs). In OT speak, ADLs are alternatively referred to as occupations, because these tasks reflect how we occupy our time.

Whereas physical therapists may focus on restoring movement in a particular joint, occupational therapists endeavor to restore a patient’s quality of life. Often, this means supporting a patient to come to terms with a particular injury/disease and devising strategies to help that patient lead a fulfilling life.

Let’s consider a recent spinal cord injury as an example. When a patient sustains a spinal cord injury, many aspects of his or her life change overnight. With limited use of the arms, for example, the patient may need to relearn certain activities, such as feeding or dressing.

But, what about the things that really make life worth living? The hobbies and activities that the patient finds personally meaningful? OTs assist patients to identify these meaningful activities and then implement a series of techniques to optimize the experience. These techniques may include the use of one-on-one training, environmental modifications, adaptive equipment, social and emotional support networks, and/or patient advocacy.

Needless to say, occupational therapists are masters at adaptation. Especially when it comes to learning how to manage a disease such as arthritis.

Goals of Occupational Therapy for Arthritis Management

So, you’ve been referred to an occupational therapist for arthritis management. What comes next?

Your OT will likely perform an initial assessment to establish your baseline levels of pain, range of motion, strength, and activity tolerance. In addition, your OT will endeavor to discover the activities at which you excel (despite your arthritis) as well as the tasks which seem particularly challenging.

During this initial assessment, hold back nothing. If you struggle with essential tasks, such as bathing or achieving a good night’s sleep, let your OT know. But, don’t forget to mention the things you love doing—like gardening or surfing the web—that you’ve found limiting due to your arthritis.

Also, don’t be surprised if your OT wants to know about how your condition affects other aspects of your life, such as your social relationships or mental health. Your OT will want to address your arthritis from a holistic perspective. This means examining not only the activities that allow us to achieve independence, but also the essential support systems that allow us to truly flourish.

All of this crucial information will enable your OT to create a profile of your unique treatment goals. Although the goals of each individual will vary, you can expect to see some basic overlap in specific treatment techniques.

Specific OT Treatment Strategies for Arthritis Management

Remember: Arthritis is caused by over 100 different medical conditions that manifest in similar but different ways. And, each patient has a specific set of goals that he or she hopes to achieve in order to live a meaningful life. Therefore, an effective OT treatment plan for arthritis must be highly individualized.

Nevertheless, common OT treatment strategies for arthritis management include:

  • Introduction of heat & ice therapy to reduce pain, alleviate joint stiffness, prime muscles for future exercise, and relax muscle spasms.
  • Inflammation control methods (e.g. RICE = Rest of an affected limb via immobilization techniques like splinting, Ice application, Compression, & Elevation of the affected joint to reduce swelling).
  • Specific exercises designed to increase functional independence during the activities of daily living and leisure. These exercises may focus on building strength, enhancing flexibility and range of motion, increasing activity endurance, and improving fine and gross motor control, etc.
  • Custom-made orthotics for hands and feet
  • Introduction of assistive devices, such as easy-grip utensils, buttoning aids, handrails, grab bars, reachers, etc.
  • Ergonomic evaluation of work and home environments with appropriate modifications
  • Activity adaptations to facilitate participation in beloved leisure activities
  • Exploration of community supports for individuals with arthritis or chronic illness

Your Arthritis Relief Journey Begins NOW

Arthritis is a common outcome of aging. But, being diagnosed with arthritis doesn’t mean that you’re resigned to a life of chronic pain.

At the Injury Care Center, our pain management physicians collaborate with a team of allied professionals, including physical, occupational, and massage therapists. Working collaboratively, we ensure that every patient in our care receives a treatment plan suited to his or her specific needs. This means going the extra mile to suss out your treatment goals and empower you with the tools to achieve them. With over 30 years of experience, discover why the Injury Care Center is consistently rated the best in the biz!