Rheumatoid Arthritis Infographic

Rheumatoid arthritis is a systemic autoimmune disease that affects the soft tissue around joints, causing joint inflammation and limiting joint function. While rheumatoid arthritis (RA) cannot be cured, medications can slow the progression of the disease, and physical therapy and exercise can alleviate symptoms and improve function and quality of life.

Rheumatoid arthritis affects more than 1.3 million people in the United States. Women are more likely to develop rheumatoid arthritis than men and are diagnosed with it three times more than men. The cause of rheumatoid arthritis is not known but is thought to be a combination of genetic and environmental or hormonal factors. Normally, your immune system protects your body from disease. However, with RA, something triggers the immune system to attack your joints.

Symptoms of RA are often symmetrical, affecting both sides of the body. RA initially affects smaller joints like the hands, fingers, and wrists and then progresses to larger joints like the knees and ankles. Symptoms can include stiff joints that feel worse in the morning, bouts of fatigue and general discomfort, a low-grade fever, loss of joint function or range of motion, and redness, warmth, and tenderness in joint areas. Individuals with RA experience painful swollen joints on both sides of the body and can undergo rheumatoid cachexia, which is accelerated loss of muscle mass. If left untreated, RA inflammation can progress to such an extent that the cartilage of joints becomes damaged, causing severe pain and stiffness and even joint deformity.

Physical therapy and exercise can significantly augment medical drug treatment to manage rheumatoid arthritis. A physical therapist can design a custom exercise treatment program to help RA patients maintain fitness, increase strength to support affected joints, improve range of motion, and maintain the ability to do daily activities.

Physical therapy treatment for rheumatoid arthritis can include:

• Use of ice or heat to manage pain and swelling. Ice can ease pain by slowing circulation and reducing swelling, while heat triggers the body’s natural healing process by relaxing joints and muscles and speeding up blood flow to the painful area.

• Passive treatment using ultrasound, which creates gentle heat that increases blood circulation to deep tissues, helping reduce inflammation, stiffness, and pain.

• Low-impact aerobic exercise, such as walking, swimming, or biking to build stamina and endurance without placing unnecessary stress on the joints.

• Active stretching and range of motion exercises to maintain flexibility in arthritic joints and surrounding muscles.

• Targeted strengthening of the muscles around arthritic joints to lengthen and strengthen the muscles and provide greater support to the joints, improving joint movement and stability.

• Body awareness and balance training to improve posture, balance, joint position awareness (proprioception), and coordination.

• Manual therapy soft tissue and joint mobilizations to improve joint range of motion

• Aquatic therapy in a warm water therapy pool, which allows RA patients to exercise more easily without stressing joints while also experiencing swelling and pain relief due to the compressive force of the water on the body.

Research has shown that exercise is effective in reversing the loss of muscle mass common among rheumatoid arthritis patients, reducing fatigue, restoring joint movement, and improving the physical function of RA patients. Long-term studies have shown that even people with inflammatory arthritis such as rheumatoid arthritis (RA) can benefit from moderate-intensity, weight-bearing activity. Other benefits include less bone loss and small-joint damage associated with RA and no increase in pain or disease activity.

A recent 2020 study assessed 66 rheumatoid arthritis patients who were placed into either standard care or a personalized exercise program. The study established that a personalized exercise program is feasible and safe in RA patients, helps to reduce fatigue scores and improve cardiovascular fitness, and has a positive impact on cognition in RA patients. A 2022 meta-analysis of 662 articles evaluating the impact of exercise therapy on patient-reported outcomes in those with rheumatoid arthritis revealed that exercise therapy does improve RA patients’ experience of pain, physical function, and quality of life.

Are you or a loved one experiencing rheumatoid arthritis pain? Work with a physical therapist to manage pain and restore function and mobility!