Physio for RA

I was wondering what physiotherapy modalities would be used on a patient who has RA.

In particular:

What type of Manual Therapy (joint mobilisation/deep transverse frictions/massage/specific soft tissue mobilisations/PNF) should be used?

What type of Exercise Therapy would be used?

It varies so much depending on the activity of the disease, how many joints are affected, the general condition of the patient, and so on and so forth.

Normally during active inflammatory stage the emphasis is on prevention of deformities by resting splints and positioning plus gentle ROM exercises. (Cold therapy may be helpful during this stage)

As the inflammation dies down gentle stretches and graded strengthening exercises are advised. Heat might now be more comfortable to ease stiff joints and muscles.

Pool therapy is often lovely for these patients as the warmth eases moevemnt and water can be used to assist or resist movements.

Hi

Patients with RA should be advised/educated most of all re. pain and the nature and course of RA illness. During flare ups RA patients should be advised to use ice to calm affected areas and to continue to move the affected joint.

RA ultimately causes distortion/deformities of the joint after the inflammation has subsided and gentle exercise (3xreps) even during flare up will not harm the joint, and will preserve ROM. I would not advise manual techniques. Gentle whole body ROM exercises (again 3 reps max during flare up) will not cause harm to the joint and should be encouraged! Hope this helps