Physiotherapy

Physiotherapy is an important part of treatment for most people with arthritis. Physiotherapists are part of a team of healthcare professionals who help you to resume or maintain an active and independent life both at home and work. They’re experts in assessing movement and can also show you how to protect your joints.

Your physiotherapist will:

• offer advice and reassurance
• help you to feel confident about managing your condition
• address any concerns or uncertainties
• set appropriate goals to keep you as active as possible.

Specialist physiotherapists are trained in diagnosing and treating joint and muscle problems, and your GP may refer you to a specialist physiotherapist rather than to a rheumatologist or orthopaedic surgeon.

It's important that you try to keep active when you have arthritis. Many people worry that exercise will increase their pain or damage their joints. But joints are designed to move, and inactivity weakens the muscles.

A physiotherapist will ask you about your current level of activity and any particular problems you're having. They will also examine your joints to assess your muscle strength and the range of movement in your joints. This will help them tailor a programme of treatments, exercises and activities to meet your individual needs.

The programme may include:

• general advice on increasing your activity level, setting goals and finding the right balance between rest and activity
• helping you avoid exercise-related injuries by advising on any equipment or training you may need if you’re starting a new activity
• a programme of specific graded exercises to improve your fitness, strength, flexibility and mobility – which you can continue to do at home
• a course of aquatic therapy (sometimes called hydrotherapy) – exercises in a warm-water pool
• advice on techniques and treatments to manage pain – including heat or ice packs, massage, and acupuncture
• providing walking aids or splints to help maintain your mobility and independence.

Graded exercise programmes

You can gradually build your strength, stamina, mobility and activity levels by following a graded exercise programme. Your physiotherapist will show you how to start gently and then gradually increase your activity, without straining yourself or adding to your pain.

Your physiotherapist will probably recommend a combination of:

• stretching exercises to help ease aches and pains and get the best movement from your joints
• strengthening exercises to build or maintain strength in the muscles that support your joints
• general fitness exercises, which are important for your general health
• proprioceptive exercises, which improve balance, coordination and agility.

Your physiotherapist will be able to advise on classes which may be available locally such as yoga, t’ai chi or Pilates as well as any walking or sports groups in your area.

Some physiotherapists have access to an aquatic therapy (sometimes called hydrotherapy) pool where you can perform exercises in warm water. Many people find it easier to move in water – the warmth is soothing and the water supports your weight so that you can move your joints and muscles without straining them.

Find out more about exercising with arthritis.

Pain relief treatments

Medications will help but a physiotherapist can tell you about other methods of pain relief that work alongside your medications. You’ll be able to continue with some of these treatments yourself between appointments – for example:

• ice packs to soothe hot, swollen joints
• heat packs to relax tense, tired muscles
• splints to support swollen or painful joints
• TENS (transcutaneous electrical nerve stimulation), which works by altering pain messages to your brain. A TENS machine is a small electronic device that sends pulses to the nerve endings via pads placed on your skin. This causes a tingling sensation that many people find soothing.

Some physiotherapists may have had additional training in other pain relief techniques, such as:

• massage or manipulation to reduce stiffness and pain, relax muscles and help to improve the range of movement in a joint
• acupuncture, which is thought to work by interfering with pain signals to the brain and causing the release of natural painkillers called endorphins
• electrotherapy, where techniques such as ultrasound and low-level laser therapy can help to stimulate the healing process and therefore reduce pain
• steroid injections, which may be helpful if you have a joint that's particularly painful and making it difficult for you to become more active.

Read more about managing your pain.

Where can I get more information?

The Chartered Society of Physiotherapy can offer further information about how physiotherapy can help you if you have arthritis.

There are several ways of getting an appointment to see a physiotherapist:

• You can be referred by your GP or consultant to your local or hospital physiotherapy department.
• You may be able to self-refer to see a physiotherapist. Check with your GP whether you have an NHS physiotherapy department in your area that accepts self-referrals.
• Some physiotherapy departments now offer a telephone assessment and advice service. Depending on your condition you may be able to receive all or part of the advice you need over the phone.
• If you would prefer to go private, you can self-refer to a private physiotherapy practice. Make sure your physiotherapist is registered with the Chartered Society of Physiotherapy.