Arthritis

Arthritis is a term used for a range of conditions that involve joint damage or destruction. The most common are Rheumatoid Arthritis (RA) and Osteoarthritis (OA)

RA is inflammation of the synovial membrane of the joint (the lining of the joint capsule). It results in damage to the bone, cartilage, ligament, tendon and joint capsule. It is a disease which not only affects the joints making them hot, swollen, stiff and painful but also affects the general health of the individual.

OA is due to “wear and tear” of joints leading to damage of the cartilage. With OA there is usually no inflammation of the joints and the general health is not affected.

What causes Rheumatoid Arthritis?

The cause of RA is not yet fully understood, although doctors do know that an abnormal response of the immune system plays a leading role in the inflammation and joint damage that occurs. No one knows for sure why the immune system attacks itself, but there is scientific evidence that genes, hormones and environmental factors are involved.

Researchers continue to investigate factors that may play a role. These factors include infectious agents such as bacteria or viruses, which may trigger development of the disease in a person whose genes make them more likely to get it.  Female hormones (70 percent of people with RA are women), obesity and the body’s response to stressful events such as physical or emotional trauma can also act as triggers. Research also has indicated that environmental factors may play a role in one’s risk for rheumatoid arthritis. Some include exposure to cigarette smoke, air pollution and insecticides.

What can a doctor do to help?

1. Confirm the diagnoses.
2. Prescribe pain and anti-inflammatory medication.
3. May prescribe disease modifying anti-rheumatic drugs (DMARDs) if appropriate to your case.
4. Prescribe hsand therapy and/or a custom prescription splint.
5. The last resort is to perform surgery to fuse/replace the joint in order to relieve pain and prevent dysfunction.

What can a therapist do to help?

• A hand therapist can provide a variety of hand splints to support and protect the affected joint in the hand, in order to reduce pain and prevent further deformity.
• Massage, heat, ice and other treatments aimed at making the area more comfortable.
• The hand therapist can provide you with exercises to improve your hand function.
  • Range of movement exercises helps prevent stiffness that is associated with arthritis in the hand.
  • Strengthening the muscles and ligaments surrounding the joints, making the joints stronger and reducing the stress on the joints of the hand.
• A hand therapist can provide advice on ‘living with arthritis”. They can give helpful information on how to live one’s life without aggravating or accelerating the damage caused by arthritis. This is often referred to as “joint protection principles“.
• Therapists can also provide some special tools to assist people whose hands have been affected by arthritis perform routine daily activities, namely “assistive devices“.
  • These assistive devices, includes devices like bottle openers, tap turners, tin openers; built-up grips, button hook (for dressing); plug adaptations etc.
• If surgery is required, therapy after surgery is very important. Custom splints may need to be made and maintained by a skilled hand therapist.