Physiotherapy

Understanding how arthritis affects you

A physiotherapist can help you understand what happens to your joints and muscles when you have arthritis, which in turn helps to manage the effects of arthritis.

Helping you to manage your pain

Medications will help with your pain, but there are other strategies for coping with pain, which a physiotherapist can advise you about:

• Pacing yourself – Sometimes over-activity or not doing enough can make your pain increase. The physiotherapist can advise you on increasing your activity level at a rate you can cope with and on finding the right balance between rest and activity.
• Regular exercise – This will help to strengthen your muscles and joints and increase your fitness. Improving your general fitness and stamina will help you to increase your level of activity without increasing your pain. Regular exercise will also stimulate production of your body's own natural pain-relieving chemicals such as endorphins. Read more about specific exercises and general advice that will help you keep active.

A physiotherapist may also recommend various pain relief treatments.

• TENS (transcutaneous electrical nerve stimulation) works by blocking pain messages to the brain and modifying your perception of pain. A TENS machine is a small electronic device that sends pulses to the nerve endings via pads placed on the skin.
• Massage can help the muscles relax and make joint movement more comfortable.
• Acupuncture can stimulate the brain to produce natural pain-relieving chemicals – it should be used only by a qualified clinician with appropriate training. Some physiotherapists are trained to give acupuncture.
• Splinting of swollen or painful joints may be helpful, for example during a flare-up of rheumatoid arthritis. Your physiotherapist (or an occupational therapist) may provide temporary splints for you.
• Ice packs or heat packs can be used to soothe hot, swollen joints or ease tense, tired muscles.

Improving your fitness

Exercise can improve your general fitness, maintain your weight, help your general mobility, and make you feel better in yourself. The important thing is to find a form of exercise you enjoy, so that you do it on a regular basis – think about this and discuss it with your physiotherapist. S/he can help you plan a programme if exercise is new to you, and advise on any special equipment or training you will need.

Some physiotherapists have access to a hydrotherapy pool. This allows people to perform exercises in a warm-water pool. Many people find it easier to move in water – the warmth and weightlessness helps to relax the joints and muscles.

Teaching you mobilising, stretching and strengthening exercises

Arthritis can cause joint stiffness and muscle weakness, and this can affect your day-to-day activities. Your physiotherapist will assess your muscle strength and the range of movement in your joints, and advise on techniques and exercises to maintain the best possible function.

• You can be referred by your GP or your consultant to your local or hospital physiotherapy department.
• You can make your own arrangements to see a physiotherapist without a doctor's referral. Check with your GP whether you have an NHS physiotherapy department in your area that will accept self-referrals.
• If you wish to be seen privately you can self-refer to a private physiotherapy practice.

It's very important to give a full medical history to the physiotherapist when you self-refer.

Some physiotherapy departments now offer a telephone assessment and advice service so, depending on your condition, you may be able to receive all or part of the advice you need over the phone.