Rheumatic disease is a group name for multiple disorders that affect the bones, joints, muscles and nerves in your body, it is also known as autoimmune diseases. Some rheumatic diseases can affect other structures/organs too. Rheumatic diseases include: rheumatoid arthritis, osteoarthritis, systemic lupus erythematosus, psoriatic arthritis and osteoporosis. A rheumatologist can identify, diagnose and assist with the most appropriate intervention plan for you. Physiotherapists are one of the multi-disciplinary team members that work with you to create an individualised management plan. Exercise will always form an integral basis of your management plan. Should your physiotherapist suspect a rheumatic disease, they will refer you to the appropriate rheumatologist or specialist.
At IR Physiotherapy we work in a team with our patient, an orthopaedic surgeon, rheumatologist and other health practitioners to aid the patient to achieve and maintain their highest level of function. We often see patients before and after joint replacement surgery. The recovery or rehabilitation process can be long but is vital for long term success after an operation.
Rheumatoid Arthritis is a complex inflammatory condition that affects more than just joints. One would typically experience pain in the small joints of the hands and feet, but could be all over the body and the intensity of the condition varies by patient. Other organs that can be affected include the skin, lungs, eyes or blood vessels. Rheumatoid arthritis should be managed within a multi-disciplinary team including at least the rheumatologist. It is important that the patient has a clear understanding of the condition and the choices to be made regarding goals and treatment options. The aim of multi-disciplinary team includes management of pain, prevention of complications or progression of the disease. Assisting the patient to keep optimal joint stability, strength and function is one of the aims of physiotherapy. As a team, problem solving to find ways to protect the “at risk” joints and associated structures are often discussed. This may include interventions and surgeries to assist patients to improve quality of life and function.
Osteoarthritis has been explained as pain in a joint as a result of ‘wear and tear’ of the affected joint. Recently we know much more about the complexities of osteoarthritis and ‘wear and tear’ is a misnomer. Osteoarthritis can occur in any synovial joint in the body, this can commonly be experienced in the hip and knee joints but can include the shoulder, hand, feet, back and neck. This can be managed through a maintenance program which we give to our patients to follow at home. Furthermore intermittent physiotherapy, a specific exercise program, analgesic and anti-inflammatory medication and splinting/bracing can help. Having osteoarthritis doesn’t need to be the end of your function and your physiotherapist will be able to assess and treat the condition as well as indicate if referral to a surgeon or rheumatologist, or further investigation is necessary. It is best to manage osteoarthritis as a healthcare team.
Systemic Lupus Erythematosus (SLE) or Lupus
SLE is just one of the rheumatic diseases. This is what is called an autoimmune disease, which means your own body mistakenly attacks its own health tissue. This affects the entire body, including bones, joints, muscle, nerves, skin and organs. Close management by a rheumatologist is needed, and your physiotherapist can assist with pain management, an appropriate exercise program and lifestyle modification methods.