Therapies... - Massage - Rheumatoid Arthritis (RA)

Rheumatoid Arthritis (RA)

RA is a chronic, systemic, inflammatory, autoimmune disorder. It is characterized by periods of exacerbation (of inflammation) or flare-up followed by periods of remission. Often the presence of rheumatoid factors in the blood aid in the diagnosis of this disease. It presents as bilateral joint pain, stiffness, and reduced joint mobility. The onset is often preceded by fever, fatigue, and malaise. Morning stiffness that does not subside with movement is frequently reported.

For unknown reasons, the body produces antibodies which attack the synovial lining of the joints. Inflammation and pannus (granulation tissue) formation follow. Other than the synovial membrane, the inflammation can affect the articular cartilage and the joint capsule. If severe, the ligaments and tendons crossing the joint can also become involved. This eventually leads to destruction and deformity of the joints. Other manifestations of the disease include arteritis, neuropathy, scleritis, pericarditis, lymphadenopathy and splenomegaly.

You can receive massage during or between flare-ups, however, the treatments may be quite different depending on your presentation that particular day. Your RMT may suggest a treatment of short duration as many people with RA fatigue very quickly.

During a flare-up, your therapist can help to reduce SNS firing, which can help reduce inflammation and pain. Thus, the focus is on relaxation. Hydrotherapy used during a flare-up should be whatever helps. Generally, cold applications will help decrease inflammation and pain. If you cannot tolerate ice, your therapist may try using cool, wet towels to produce the same effect.

During periods of remission, your aims may be to reduce pain, maintain existing joint range of motion and reduce any adhesions that have formed (as long as they do not provide stability to the joint). Addressing muscle spasm and trigger points, along with deep moist heat or parafin wax baths can help reduce pain. The wax bath and joint mobilizations (if the RA is not severe) can help to maintain joint ROM. A contrast bath of hot and cold can help maintain tissue health and promote circulation.

Your therapist can prescribe some gentle movements to help maintain mobility and strength in the joints and muscles. It is important not to overdo it. Many people find that performing exercises in pools with warm water effective -- the heat helps with decreasing pain while the bouyancy provided by the water helps to decrease weight (and thus stress) on your joints. Deep breathing exercises or meditation are also beneficial to help decrease stress.