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Rheumatoid Arthritis | Symptoms and Treatment

What is it?

Rheumatoid arthritis is a type of arthritis classified as an autoimmune disease. Autoimmune disorders are conditions where the immune system of the body mistakenly attacks healthy tissues. This process of inflammation, the bodies defence system against injury and infection can damage joints and cause deformity over a long period of time. Unlike osteoarthritis, which usually affects larger joints that are involved in weight bearing, rheumatoid arthritis can affect many joints at the same time, with smaller and larger joints affected equally.

What are the symptoms?

Rheumatoid arthritis is a chronic disease, characterised by periods of remissions and flare-ups. During a flare-up, joints might become red, hot, swollen and painful. During a remission a patient might have few symptoms, however over many years, these flare-ups can degrade and deform joints, causing them to lose function and the muscles around them to weaken.

The symptoms of rheumatoid arthritis vary from mild to severe and as mentioned, can fluctuate significantly over time. As movement can help to reduce swelling caused by inflammation, pain can actually increase as joints are rested. A person with rheumatoid arthritis may complain of pain and stiffness that is worst when waking and may take 1-2 hours to subside.

What are the causes?

While rheumatoid arthritis is known to be a process of autoimmune dysfunction, the trigger that causes the immune system attack healthy tissues is unknown. In some cases, a virus may trigger the onset of the disease. There is evidence that women have a stronger immune system than men, and a downside of this is that they are more prone to autoimmune disorders, as is the case with Rheumatoid Arthritis.

Other risk factors associated with rheumatoid arthritis include a family history of rheumatoid arthritis, obesity and smoking.

How can physiotherapy help?

While there is no cure at present for the disease process that causes rheumatoid arthritis, there are treatments that can improve the patient’s quality of life and help to manage the symptoms. The first line of treatment for rheumatoid arthritis is medication particularly, anti-inflammatory medications. Change in lifestyle and diet are also advised.
The objectives of physiotherapy treatment for rheumatoid arthritis are to improve joint mobility, increase strength, restore the function of the affected joints and to maintain the level of activity of the patient. Physiotherapy treatments include heat or cold therapy, hydrotherapy, therapeutic exercises, pain management, manual techniques and patient education. Splinting may be done to protect joints from further damage. Patient education is an important part of the treatment so that the patient is knowledgeable about his/her disease, what to do and not to do.

All of these treatments can help reduce the potential long-term disabilities caused by rheumatoid arthritis. Speak to your physiotherapist for more information.

 

The information in this article is not a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.

Caboolture Physical Therapy Centre - serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.

When will my injury heal?

When injury strikes, the first thing that most of us want to know is ‘how long will this take to heal?’

Unfortunately, the answer to this can be complicated and requires at least a little understanding of how the different tissues of the body heal. Each of the tissues of the body, including muscles, tendons, ligaments and bone, heal at different speeds and each individual will have some variation on those times as a result of their individual health history and circumstances.

Understanding the type of tissue injured and their different healing times is an important part of how your physiotherapist approaches treatment and setting goals for rehabilitation. On an individual level, a patient’s age, the location and severity of the injury and the way the injury was managed in the first 48 hours all affect the healing times of an injury. Unfortunately, as we age, injuries do tend to heal more slowly than when we are young. Any medical condition that reduces blood flow to an area, such as peripheral vascular disease, can also reduce the body’s ability to heal at its usual rate.

There are some guidelines that can be followed when predicting how long an injury will take to heal based on the tissue type affected. Muscles are full of small capillaries, giving them a rich blood supply, and as such, they have a comparatively fast healing time with 2-4 weeks for minor tears. This time will be extended for larger tears and more complicated presentations.

Ligaments and tendons have less access to blood supply and tears to these tissues generally take longer to heal. Larger or complete tears of all soft tissues, may not be able to heal themselves and in rare cases, surgery may be required for complete healing to occur. Similarly, cartilage, the flexible connective tissue that lines the surface of joints is avascular, which means it has little or no blood supply. To heal, nutrients are supplied to the cartilage from the joint fluid that surrounds and lubricates the joint.

While the different tissues of the body all have different healing times, they do follow a similar process of healing with three main stages, the acute inflammatory phase, the proliferative stage and finally the remodelling stage.

The inflammatory stage occurs immediately after an injury and is the body’s primary defence against injury. This stage is identifiable by heat, redness, swelling and pain around the injured area. During this phase, the body sends white blood cells to remove damaged tissue and reduce any further damage. This stage usually lasts for 3-5 days.

The proliferation stage is the phase where the body starts to produce new cells. Swelling and pain subside and scar tissue is formed that eventually becomes new tissue. This stage usually occurs around days 7-14 following an injury.

The final stage, known as the remodelling stage is when the body completes healing with the reorganization of scar tissue and the laying down of mature tissue. This stage usually occurs roughly two weeks after the initial injury is sustained.

At each stage of the healing process, a different treatment approach is required and your physiotherapist can help to guide you through your recovery. Ask one of our physios at Caboolture Physical Therapy Centre to explain how your injury can be managed best and what to expect in your recovery process.

Caboolture Physical Therapy Centre - serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.

Rotator Cuff Tears

What is a Rotator Cuff Tear?

A rotator cuff is a group of four small muscles that surround the shoulder joint. Their tendons attach to the humerus, close to the joint line and act as a cuff that provides support and control to the shoulder. They also play a primary role in creating rotational movements of the shoulder.

Rotator cuff tears are common injuries and can occur in any of the four muscles, usually at their weakest point, which is the junction between the muscle and tendinous tissue. These tears are common in racket and throwing sports and are one of the leading causes of shoulder pain. The prevalence of rotator cuff tears increases as we age due to age related degenerative changes in the tissues.

What are the symptoms?

Many people have rotator cuff tears with no symptoms at all, and are unaware of the injury. However, for others, these tears can be very painful and lead to difficulty moving the shoulder, particularly with overhead activities. They may find their range of movement is restricted and the arm feels weak. They often experience pain that radiates down to the arm and pain at night, which can cause sleep disturbances.

It is interesting to note that the size of a tear is not necessarily related to the amount of pain and dysfunction experienced, with small tears sometimes creating large problems and large tears going unnoticed.

What are the causes?

Movements that create a rapid twisting motion or over-stretching of the shoulder often cause rotator cuff tears. The most common mechanism of injury is a fall onto an outstretched hand. These tears can be acute or chronic, developing over a period of time or related to degenerative changes, where tendon tissue is damaged by everyday activities due to reduced strength and elasticity.

Other causes of rotator cuff tears include overuse, lifting or carrying heavy objects and repetitive overhead activities. Poor biomechanics can cause weakening of the shoulder’s tendons with insufficient blood supply to the rotator cuff over a long period of time. This can leave the tendon more susceptible to injury as is a significant contributing factor to the development of tears and the outcomes of recovery.

How can physiotherapy help?

The primary objectives of physiotherapy treatment are to reduce pain, increase the range of motion and strength and improve shoulder function. Your physiotherapist will work with you to help set goals assist to reach them with a targeted rehabilitation program, manual therapy and education on how to achieve the most from your recovery.

While severe tears are often repaired surgically, research is increasingly showing that even in severe tears, a comprehensive rehabilitation program under a physiotherapist leads to similar outcomes to surgery. For this reason, a conservative approach guided by a physiotherapist is often recommended to patients as the first option for treatment. The exact time frame of treatment and recovery will vary from person to person and is affected by a variety of factors including if surgical repair was chosen, the severity of the injury and function prior to injury.

This information is not a replacement for proper medical advice. Please get in touch with Caboolture Physical Therapy Centre for advice on your individual injury.

Caboolture Physical Therapy Centre - serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.

Osteoporosis – What is it and how can your Physiotherapist help?

Osteoporosis is a condition characterised by very low bone mass or density. Low bone mass can occur when the body loses too much bone, doesn’t make enough – or both. Osteoporotic bones become weak and fragile and can break from small forces that would normally be harmless.

 

 

But as well as loss of bone density and mass, osteoporotic bones may also be affected by abnormal changes to the structure of the bone matrix, which further contributes to weakness.

Osteoporosis is an extremely common bone disease, and women are more affected than men. As it is a progressive disorder that worsens with age, while the disease process might begin earlier, the effects are usually only noticed and diagnosed in people who are 50 years and older.

What are the Signs and Symptoms?

Often called a silent disease, many people will have no idea that they have the disease, as there are no obvious symptoms. In fact, sometimes the first sign that an individual has osteoporosis is when the first bone breaks. Along with fractures, which are the most serious signs of this disease, osteoporosis can cause the upper back to become excessively hunched (itself often a result of spinal wedge fractures) and there may be widespread pain as bony tissue is increasingly unable to withstand normal forces.

Fractures are a serious problem, especially in seniors. Bone breaks due to osteoporosis occur most frequently in the wrist, spine or hip. When the spine is affected by osteoporosis, people may develop a hunched or stooped posture. This can lead to respiratory issues and place pressure on the internal organs. Osteoporosis can severely impact a person’s mobility and independence, which can have an enormous impact on quality of life.

What Causes It?

As this is primarily a metabolic disorder, there are a variety of things that can cause osteoporosis if they either interfere with the body’s ability to either produce bone tissue or encourage excessive breakdown. This can be anything from gastrointestinal conditions that prevent absorption of calcium, lack of dietary calcium or low levels vitamin D, which is essential for absorption of calcium.

Certain medications may also cause bone loss especially if they are taken for a long time or in high doses. A good example is the long-term use of steroids. Although steroids are used to treat various conditions, it has been proven that steroids can cause bone loss and eventually, osteoporosis.

As bones respond to force and weight bearing by building more bone, having a sedentary lifestyle or doing activities with low impact (i.e. swimming, cycling) can also lead to osteoporosis.

How Can Physiotherapy Help?

Physiotherapy can help you avoid or recover from fractures and improve your overall bone health. Physiotherapy exercises can direct you to safely increase your weight bearing, which can help build bone mass. Balance training is also an important factor as this can reduce the risk of falls. Your physiotherapist can also educate you on how to adjust your lifestyle, at home or at work, to protect your bones and improve your posture.

This information is not a replacement for proper medical advice. Always see a medical professional for advice on your individual condition.

Caboolture Physical Therapy Centre - serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.

The Hidden Risks Of A Sedentary Lifestyle

By now it should come as no surprise that prolonged periods of inactivity are bad for your health. It seems that the science is in, and the bad news is that long periods of sitting or inactivity is a risk factor for many diseases, independent of other factors such as obesity.

What does this mean?

This means that if you are hitting the gym for an hour a day, but are sitting down for long periods during the rest of the day without moving, you may not be avoiding the health risks that come with sitting.

So why is sitting so bad?

There is evidence that shows that when sitting for long periods, our bodies show unhealthy changes in blood pressure and blood sugar levels that over long periods of time can lead to increased risk of diabetes, dementia and obesity. How much sitting is considered too much and how long it takes for these changes to take place is up for debate. What we do know is that regularly breaking up your periods of sitting is a healthy lifestyle choice you can make for yourself in the same way that drinking water, regular cardio exercise and eating vegetables are.

The insidiousness of the issue is that it’s likely that you are sitting much more than you used to without even realising it. Car commutes to work are getting longer, working days are often spent at a desk and with the rise of online T.V, you might be guilty of three or more hours stuck in one spot catching up with your favourite characters before you know it.

I have an office job, what can I do?

The first step to changing this habit is to start being aware of exactly how long you are sitting for an uninterrupted period of more than 20 minutes. Once you start noticing your daily patterns you can identify moments where changes can be made. We’ve heard of incidental exercise, but we’ll call this ‘incidental standing’. Consider standing on the train instead of sitting or standing when you have a document to read.

Here are a few other tips to get you moving;

  • Set an alarm to go off every half an hour that reminds you to get up and get a drink (this might also help to keep you hydrated)
  • Try out a standing desk
  • Stand up to take phone calls or get up to go ask a colleague a question instead of calling them
  • Take a walking lunch break

Speak to your physiotherapist for more ideas tailored to suit your individual lifestyle.

Caboolture Physical Therapy Centre - serving people in need from the following areas: Caboolture, Morayfield, Elimbah, Wamuran, Beerburrum, Beerwah, Glasshouse Mountains, Toorbul, Donnybrook, Ningi, Woodford, Kilcoy, Bribie Island, Goodwin Beach, Sandstone Point, Banksia Beach, Bongaree, Bellar, Woorim, Burpengary & Beachmere.