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Diseases & Conditions

Occupational & Physical Therapy for Arthritis

How is arthritis treated?

"Arthritis" means inflammation of the joints, and it might cause pain, swelling, and limited motion of one or many joints in the body. More than 100 different illnesses can cause arthritis.

Treatment begins after diagnosis by a doctor, who might prescribe medicine to reduce inflammation, pain, swelling, and loss of motion. As part of a comprehensive plan for arthritis treatment, your doctor might also prescribe occupational and physical therapy, which can provide additional help in your recovery.

How can occupational therapists help?

Occupational therapists can teach you how to reduce strain on your joints during daily activities. They can show you how to modify your home and workplace environments to reduce motions that might aggravate arthritis. Occupational therapists might also provide splints for your hands or wrists, and might recommend assistive devices to aid in driving, bathing, dressing, housekeeping, and other tasks.

How can physical therapists help?

Physical therapists can provide you exercises designed to preserve the mobility, strength, and use of your joints. Physical therapists can also teach you the proper body mechanics to move from one position to another and the proper mechanics during the performance of household activities. They can also teach you proper posture, such as while sitting, to protect the integrity of the joints. They can also educate you on the use of walking aids such as crutches, a walker, or a cane when needed.

What are the goals of treatment?

Your physical therapist will tailor a program to your specific needs, whether your arthritic problems are widespread or confined to one joint or body area.

The goals of treatment are to:

  • Prevent loss of use of the joints
  • Restore abilities that may have been lost
  • Help you adapt to new activity levels
  • Maintain your fitness
  • Maintain your ability to take part in the activities you choose with minimal help from others

Therapy should be started early in order to reduce painful symptoms of inflammation, prevent deformity and permanent joint stiffness, and maintain strength in the surrounding muscles. When pain and swelling are better controlled, treatment plans may include exercises to increase range of motion, and to improve muscle strength and endurance.

What are some benefits of occupational and physical therapy programs?

Physical therapy programs may provide:

  • Exercises aimed at restoring normal joint mobility or flexibility
  • Exercises aimed at restoring normal strength
  • Education on whether you are safe to walk with or without an assistive device
  • Postural education and activity modifications to relieve discomfort and improve performance

What are some therapeutic methods?

  1. Exercise — This is an important part of arthritis treatment that is most effective when done properly every day. Your therapist will prescribe a program for you that will vary as your needs change.
    • Range of motion exercises. Gentle movements of specific joints through their normal range of motion will help relieve stiffness, improve and maintain joint movement, and increase flexibility.  Your therapist will provide you with exercises that are specific for your needs.
    • Strengthening exercises. Strengthening exercises are aimed at preserving or increasing muscle strength. Isometric exercises tighten and strengthen the muscle without moving the joint and are most useful when joints are painful. Isotonic exercises strengthen the muscle by using it to move a weight.
    • Water exercise. Warm water helps relieve pain and relax muscles. Swimming is not necessary, as water exercises may be done while standing in shoulder-high water. Support by the water decreases body weight applied to the joints of the spine, legs, and feet. Water support of the arms and legs also helps joints move through range of motion exercises more easily.
  2. Thermal modalities — Applying ice packs or heating pads can help relieve pain locally. Heat can help relax muscle spasms or taking a warm bath or shower before exercising might help you exercise more easily.
  3. Therapy for joint surgery patients — Preoperative programs of education and exercise, started before surgery in the outpatient therapy department, are continued at home. They might be changed in the hospital after surgery to fit new needs in the rehabilitation period. These exercises might be added to your usual exercise regimen, and you might find your ability to exercise has improved after surgery.
  4. Joint protection techniques — There are ways to reduce the stress on joints affected by arthritis while participating in daily activities. Some of these ways include:
    • Control your weight to avoid putting extra stress on weight-bearing joints such as your back, hips, knees, and feet.
    • Be aware of body position, using good posture to protect your back and the joints of your legs and feet. Change positions often, since staying in one position for a long time tends to increase stiffness and pain.
    • Conserve energy by allowing for rest periods, both during the day and during an activity.
    • Respect pain. It is a body signal that is telling you something is wrong. Don't try an activity that puts strain on joints that are already painful or stiff.

    A therapist can show you ways to do everyday tasks without worsening pain or producing joint damage. Some joint protection techniques include:

    • Use proper body mechanics to get in and out of a car, chair or tub, as well as for lifting objects.
    • Use your strongest joints and muscles to reduce the stress on smaller joints. For example, carry a purse or briefcase with a shoulder strap rather than in your hand.
    • Distribute pressure to minimize stress on any one joint. Lift dishes with both palms rather than with your fingers, and carry heavy loads in your arms instead of with your hands.
    • If your hands are affected by arthritis, avoid tight gripping, pinching, squeezing, and twisting. Ways to accomplish the same tasks with alternate methods or tools can usually be found.
  5. Assistive devices — Many assistive devices have been developed to make activities easier and less stressful for the joints and muscles. Your therapist will suggest devices that will be helpful for tasks you might have found difficult at home or work.

    A few examples of helpful devices include a bath stool in the shower or tub; grab bars around the toilet or tub; and long-handled shoehorns and sock grippers. Your therapist can show you catalogs that have a wide variety of assistive devices you may order.

Summary

As the central member of your treatment team, you are the person responsible for following through with your therapy program. This includes continuing daily exercises and other suggestions made by your therapist. You should discuss questions and problems with your therapist as they come up so that the program can be adjusted to best meet your needs.

A positive attitude, patience, and persistence will help you to get the greatest benefit from your occupational and physical therapy activities, which are so important in meeting the challenges of arthritis.

References:

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 9/17/2012...#4266

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