Believe it or not, arthritis joints love to move. Active rehabilitation, or rehabbing the joints to a more functional state through movement, is one of the best forms of treatment. If you are finding yourself in a severe flare-up where general exercise is too painful, a great alternative is to do what is referred to as a passive or active assisted movement. This means using another joint, person, or device to move the affected joint in a supported way. For example, sitting on the floor, looping a belt around your foot, and slowly pulling on the belt to bend and extend your knee without using your knee muscles. Active assisted and passive movements can help loosen up your joints and reduce swelling without putting a great amount of force through them. Lying in bed and repetitively bringing each knee to your chest with your hands is another example.
2. Move the right amount
Get it moving, get it strong. We have heard it before: exercise can help. But if the exercise you are choosing to do leaves you limping and sore, then it might not be the “right” exercise for you. Joints with arthritis pain tend to like low weight bearing activities, such as walking, swimming, and biking. It is also important to find the right dose of exercise. Canadian Physical Activity Guidelines recommend 150 minutes of moderate exercise/week. But, this is can be divided up in whatever way offers you less pain. If walking is something you like to do, but walking for 30 minutes a day gives you pain, try walking for 15 minutes twice a day instead. The benefits will be similar, but the pain may be less.
3. Move securely
Braces can offer some support to joints with arthritis. If you are looking for a brace, it should have a metal hinge in it (not plastic). Keep in mind, there is not much evidence to support simple elastic braces for pain relief (other than the fact that they offer some feedback to the body as to how the joint is moving). A custom brace, which is measured by a professional and ordered specifically for you, can be very beneficial in pain management. Depending on the specific joint, the brace can take pressure off of a certain compartment, and therefore reduce pain significantly. These braces tend not to be a permanent solution, but can offer a few years of relief before more invasive intervention.
4. Move properly
Is the pain in your joint just from arthritis? Arthritis in the low back, hips, and knees can cause changes to the structures around them. Muscles become tighter and weaker, walking patterns change, and the joints no longer move the way they are “supposed to”. Often, when a physiotherapist is assessing a joint with arthritis, they will find other mechanical issues contributing to pain. These issues, if corrected, can reduce pain significantly. Sometimes, a muscle or ligament can be causing the pain completely, and the arthritis is simply what is referred to as an incidental finding (something that happened to show up on an xray, but has nothing to do with the pain).
5. Move…then rest (at the right temperature)
Tale as old as time…”put ice on it”. But, does ice actually help? In fact, ice, or heat, can be very useful in pain management. Ice was traditionally though to reduce inflammation. But, recent studies have suggested it to less beneficial in reducing swelling, and more beneficial in pain modification or “dulling the pain”. Compression, such as that from a tensor wrap, can be combined with ice to help with swelling (use the tensor wrap to fasten the ice in place). A cryocuff is an example of an automated machine that compress the joint while icing it. It has a motor that circulates water to keep the joint extra cold. In terms of the heat vs ice debate; when an injury is new, hot to touch, and visibly swollen, ice tends to be the weapon of choice. Otherwise, it comes down to preference.
Topical creams that offer a numbing sensation may also provide relief, but lack evidence to demonstrate swelling reduction or healing properties.
More and more, experts are pushing for joints to move, or undergo active rehabilitation, before more aggressive measures are taken. Worst case, the joint is in better condition going into a surgery, and rehabilitation afterwards is quicker and more effective.
If you have are suffering from low back, hip, or knee arthritis in the Cornwall and SD,&G area, speak to a physiotherapist about how you can reduce your pain significantly. If you are scheduled for a total knee replacement, hip replacement, or back surgery, talk to a physiotherapist about ways that you can increase your mobility and strength before surgery and get a head start on your active rehabilitation.
Call In-home Therapeutics to have a physiotherapist assess your joints today. If the answer to a pain free lifestyle is out there, let us help you find it. We are Eastern Ontario’s fully mobile Physiotherapy clinic. Let us serve you in the comfort of your own home.
We provide in-home physiotherapy in Eastern Ontario, Including Cornwall, Brockville, Kingston and Ottawa.
Or Call: (343) 370-7393