Hello and welcome back to the ThreeSpires Physiotherapy blog where we take a look at all things physiotherapy and health related. As our last article covered the extremely common cause of joint pain: Osteoarthritis, I thought in this article we could examine the other less common form of arthritis: Rheumatoid Arthritis which our physiotherapists regularly help patients with. Just to remind anyone reading this blog we are a home visit physiotherapy service based in Lichfield and serving areas such as Sutton Coldfield, Tamworth, Rugeley, Walsall and Cannock.

What is Rheumatoid Arthritis?

Rheumatoid arthritis like osteoarthritis causes sufferers joint pain but whereas osteoarthritis is predominantly a pathology of wear and tear of the cartilage in each joint rheumatoid arthritis is a systemic auto-immune disorder whereby the body's immune system attacks the joints. This problem of the immune system attacking the joints causes large amounts of inflammation and pain in the joints affected and if left untreated can cause joints such as knees to become completely unstable and reduce mobility.

Who is Affected by Rheumatoid Arthritis?

Rheumatoid arthritis can affect anyone at any age but it usually occurs in late middle age with women being much more commonly affected than men.

What are the Symptoms of Rheumatoid Arthritis?

Pain in one or more of the joints is the most common symptom of rheumatoid arthritis with the joints most commonly affected being the wrist and hands and although it predominantly affects the joints other areas such as skin and bodily organs can also be affected. Sometimes if left untreated joints will have become deformed (often the fingers).

How is Rheumatoid Arthritis Diagnosed?

Diagnosis of rheumatoid arthrtis is through a combination of clinical assessment with a rheumatologist, x-ray imaging and blood tests. It is important that if you suspect you have rheumatoid arthritis that you see your GP who will refer you through to rheumatology (if appropriate) for an assessment.

As a physiotherapist when encountering a patient with rheumatoid arthritis several factors will often be apparent: they may have warm, swollen joints and may (if untreated) have lax and unstable joints. This contrasts with a patient with osteoarthritis who will generally have normal joint temperature and their joints will feel hard and clunky.

What Causes Rheumatoid Arthritis?

As with many auto-immune problems the exact cause is still not fully understood and it is thought that there is an error with the auto-immune system which causes it to attack the joint. With rheumatoid arthritis the synovium around the joint will become inflamed as it is attacked by the body's immune system and will cause swelling and pain for the patient. The underlying cause of the disease is thought to involve a combination of genetic factors with environmental triggers although this is still being researched.

Treatment for Rheumatoid Arthritis:

The treatment for rheumatoid arthritis is still an active area of research so, if you have been diagnosed with rheumatoid arthritis this is something you will need to discuss in dteail with your rheumatologist. Howvever, below are some general treatment options:

1. Early Diagnosis: yes I know this sounds like common sense! Obviously you would want to know if you have rheumatoid arthritis, however for many patients it will go untreated and un-diagnosed for many years. It is vital that the diagnosis is made early so that you can understand how best to manage your rheumatoid arthritis and minimise joint damage.

2. Assessment with a Rheumatologist: some patients once the GP has explained that it is very likely they have rheumatoid arthritis will then not bother seeing a rheumatolgist as they will think they have all the information they need. Management of rheumatoid arthritis requires a specialist set of skills and it is important that anyone with rheumatoid arthritis has had a full assessment.

3. Medication: the consensus currently is that early access to medication to manage rheumatoid arthritis and avoid joint damage is the best way. Possibly the most common drug that patients will receive is methotrexate but it is vital that you ahve seen rhuematologist to discuss which medicine would be best for yoru rheumatoid arthritis.

4. Exercise: keeping fit, mobile and strong is a vital part of the management of rheumatoid arthritis. Exercise can be as simple as going for a walk, doing some swimming, joining a keep fit class, going the gym or doing some exercise at home. 

5. Physiotherapy: having a consultation with a physiotherapist after having a diagnosis of rheumatoid arthritis is essential. Your physiotherapist will be able to advise you about the best exercises, how to avoid irritating your joints, the nature of the disease and how generally it is best to manage your rheumatoid arthritis.

6. Walking Aids: sometimes patients with rheumatoid arthritis have severe joint pain that makes it diffiuclt for them to mobilise and walk. In these cases a walking aid such as a frame or rollator can help keep them on their feet. Your physiotherapist will be able to help you with this.

7. Steroid Injections: if you are experiencing severe joint pain that is not well managed with medicine then a steroid injction to reduce inflammation can be helpful for your rheumatoid arthritis.

8. Surgery: finally if all else has failed then surgery (most commonly a joint replacement) may be the best option.

How Can ThreeSpires Physiotherapy Help with My Rheumatoid Arthritis?

So, clearly I am biased here but I really do believe that we can help in a number of ways. Firstly our physiotherapists have a large amount of experience of helping patients with their rheumatoid arthritis right through from the very earliest symptoms (and in fact we have made many referrals to GPs for investigation for Rheumatoid Arthritis) to patients with very severe symptoms needing joint replacements. Our physiotherapists will be able to assess your rheumatoid arthritis, examine how it is affecting you and decide upon the best course of action, including the best exercises to try. An assessment with one of our physiotherapists will help give you all the information you need to best manage your condition and also give you a personalised exercise programme aimed at keeping you mobile, strong and fit. Another important factor (especially for those with mobility problems) is that we provide a home visit physiotherapy service. This means that our physiotherapists will come out to you at yoru home and save you the difficulty of travelling to a physiotherapy clinic. For patients with rheumatoid arthritis who are struggling with mobility and pain this can be extremely helpful. 

Okay, I hope that you have enjoyed reading this article about rheumatoid arthritis. For anyone reading this blog who hasn't come across our site before: we are a home visit physiotherapy service, based in Lichfield but serving anywhere within a 20 minute drive including areas such as Sutton Coldfield, Tamworth, Cannock, Burton and Rugeley. We offer a wide range of services including paediatric physiotherapy, post-operative rehabilitation, neurological physiotherapy and neck and back pain relief. If you need further information or would like to book an appointment we can be contacted on 0788 428 1623 or via enquiries@threespiresphysiotherapy.co.uk