If I have arthritis – how can physio help me? Surely if there is wear in the joint no amount of physio will help me? Not true. Research is in plentiful supply regarding the benefits of physiotherapy in arthritic conditions.
I like to use the analogy of a pie chart with my patients. There are always components to any problems. For example – let us assume there is an arthritic change occurring – wear on the bony surface of the joint. There will be inflammation of the joint capsule and swelling will ensue. This causes a reflex inhibition of the muscles supporting the joint – the body trying to tell you to stop using that body part. There will be a loss of proprioception (positional sense awareness) around that joint. This weakness and pain will cause altered movements to offload the joint. This may weaken certain muscles and tighten other muscles and connective tissues even more. This alters the stresses, loading and support for the already troubled joint so clearly this aggravates the arthritis and so a vicious circle is created.
Physiotherapy can work on the “reversible” elements of the problem and this is often enough to make the pain stop and improve function. Arthritis does not come on overnight so why is it that one day it starts to hurt? The above scenario explains it. It is the straw which breaks the camels back idea – the cumulative effect rather than just the wear on the joint surface.
The same is true for many complaints such as disc prolapses, facet joint wear in the spine, spondylosis in the neck or back. So just because we might see something like arthritis or a disc prolapse on a scan does not mean that surgery is inevitable or that things have gone beyond the point where physio might help.