Arthritis is a chronic condition that causes inflammation of the joints. It can cause pain, stiffness, and swelling. The hips, knees, hands, and spine are the most commonly affected joints. It is not a single disease but an umbrella term that includes a variety of different types. Some of the more common examples are osteoarthritis, rheumatoid arthritis, gout, psoriatic arthritis, and ankylosing spondylitis. While physical therapy might not be the first treatment you think of for arthritis, it probably should be.

A lot of people choose to use medication to manage their pain, stop activities that hurt, and wait for things to get bad enough to have a joint replacement. But this isn’t a great plan. All medications have side effects, even over the counter ones. Reducing activity leads to muscle atrophy and even stiffer joints. Even though joint replacement surgery usually has good outcomes, it does come with its own set of risks and a painful recovery.

Physical Therapy Intervention for Arthritis

Physical therapy has been extensively researched as a treatment for arthritis and demonstrates good outcomes. A PT will typically start with exercise as the base for treatment. Exercise helps to regain lost joint motion, decrease feelings of stiffness, and strengthen muscles surrounding the affected joint. These benefits are all somewhat obvious. What surprises many people, is that exercise has been shown to be as effective as medication for pain relief in many types of arthritis. And it has no side effects!

Physical therapy has more to offer people than just exercise though. Education helps people understand their condition, what to expect, and how to manage it. As experts in human movement, physical therapists are especially good at helping people modify the way they perform certain tasks or activities to reduce strain on joints affected by arthritis. They can also suggest ways to modify the environment at work or home to reduce pain and improve function. They may also suggest things like braces, orthotics, or other devices that can help maintain mobility and reduce pain. On top of all of that, PT is also a cost effective treatment option.

With so many techniques that are effective in helping people, physical therapy is a recommended first line treatment for many types of arthritis. Now that you have a better understanding of what PT can do, hopefully you’ll think of PT first when you think of arthritis too.

References

1. Research (peer-reviewed)
   1. PT for juvenile RA – https://pubmed.ncbi.nlm.nih.gov/1946625/
   2. PT for hip and knee OA – https://pubmed.ncbi.nlm.nih.gov/33034560/
   3. Systematic Review for Juvenile RA – https://pubmed.ncbi.nlm.nih.gov/28729171/
2. Articles and Content
   1. Effectiveness and Cost-Effectiveness of Physical Therapy for Knee Osteoarthritis-  https://www.rheumatology.org/About-Us/Newsroom/Press-Releases/ID/718
   2. Can physical therapy reduce arthritis pain? – https://www.medicalnewstoday.com/articles/physical-therapy-for-arthritis

As we head toward the end of summer, the weather is hot! For the nearly 5 million people in the United States with fibromyalgia, they might experience a different kind of heat – the burning pain that typically comes along with this diagnosis.

What is Fibromyalgia?

Fibromyalgia is a chronic condition that can cause a wide range of symptoms throughout the body. It’s usually diagnosed between the ages of 30 and 50, and 80% to 90% of the people affected are women. One of the most common and debilitating symptoms is burning pain.

Other common symptoms are:

• Chronic pain all over the body
• Fatigue
• Memory problems
• Sleep disturbances
• Depression and/or anxiety

How Does Physical Therapy Help?

Because of the wide range of symptoms, fibromyalgia can be a debilitating condition. It is not uncommon for people to begin avoiding activities altogether because of pain and fatigue. This begins a cycle of deconditioning that not only impacts the person’s overall health, but also makes the symptoms of fibromyalgia worse. The cause of fibromyalgia is currently unknown and there is no cure, so physical therapy treatments are designed to reduce and manage the symptoms. This requires a multi-pronged approach.

Physical therapists work to help people with fibromyalgia using several different methods. Despite there still being no cure, when patients work with their medical team and physical therapist, they find relief from symptoms.

Firstly though, it’s important to have a thorough medical exam to rule out other conditions that might be causing or contributing to the symptoms like an infection, Lyme disease, thyroid problems, metabolic disease, or side effects from medication. Therefore, a specialist like rheumatologist can help people with fibromyalgia with medications.

Common Fibromyalgia Treatments Include:

Education

The first step in treating fibromyalgia is often helping people understand what’s going on, and what they can do about it. Research has shown that people who are knowledgeable about their condition have better outcomes, more confidence, and cope better.

Decrease Pain and Improve Range of Motion

Also, physical therapists are movement experts. They use a lot of tools and techniques to help with the pain and stiffness caused by fibromyalgia. A PT might use gentle manual therapy or massage, prescribe specific stretches, or a simple yoga routine. They might also use modalities like electrical stimulation, biofeedback or in states where it is allowed, dry needling.

Exercise

Once patients understand the condition and are able to move a little better with less pain, exercise often enters the treatment picture. Research has shown that low to moderate intensity aerobic exercise like walking, biking, or swimming is important in managing fibromyalgia symptoms. It can help with pain, fatigue, sleep disturbances, depression, and more. Additionally, physical therapists and patients work together to find the right type of exercise and the right intensity to best manage fibromyalgia. However, they often have to start slow, and make adjustments along the way.

Each physical therapy session is tailored to the needs of the patient. Treatment will vary depending on the severity of their symptoms. Despite there still being no cure for fibromyalgia, physical therapists can help. They will help with pain management, strength, mobility, fatigue and function to help patients find relief from their symptoms.

The Matthew Effect follows the well-known adage of the rich get richer and the poor get poorer. As it applies to reading, good readers gain a significant advantage over time because they are better readers. A strong reader enjoys reading and thus reads more. By reading more, they further develop better reading skills. In turn, this encourages them to read more and become even stronger readers. A cycle of success is established. By contrast, weak readers read less because reading is not enjoyable. They become less skilled and remain less skilled. Because of this loop, a skill gap between strong and weak readers exists and widens over time.

Unfortunately, reading less also results in reduced vocabulary, reading fluency, world knowledge, and comprehension. Whereas, fluent frequent reading builds vocabulary, knowledge, and understanding. There appears to be a mutual relationship between reading and vocabulary development. A large vocabulary helps readers understand stories better and comprehension of stories builds vocabulary; a mutually beneficial relationship. Likewise, a reduced vocabulary makes it difficult to understand stories, and limited understanding slows vocabulary development – unfortunately a lose-lose situation.  

There are treatment strategies to reduce this Matthew Effect. A primary strategy is to increase a struggling reader’s phonemic awareness. That is, their ability to hear and manipulate speech sounds in words. Kids will then apply this skill to reading and spelling. At MOSAIC Health & Rehab, we provide direct explicit instruction in phonemic knowledge upon which we build reading and writing skills. Call today to schedule an appointment for your child.

Maintaining good posture throughout pregnancy is challenging, but your body will thank you if you do. Good posture can help limit common side effects in pregnancy such as headaches, pelvic girdle pain, shoulder pain, as well as improve respiratory capacity.

During pregnancy, a woman’s body weight increases by 15 to 25 percent; increasing the demand on tendons, ligaments, and joints. Additionally, hormones, such as relaxin and estrogen, loosen the ligaments and increase risk of injury. As the uterus and breasts grow, the body’s center of gravity shifts towards the front. The pelvis is tilted simultaneously, and the lower back curvature increases. All these changes require your muscles to adapt. With adequate strength, the body can better stabilize your posture and reduce risk of pain and injury with daily activities.

Tips to Help You Maintain Good Posture Throughout Pregnancy

• Look forward, elongate your neck, and tuck your chin slightly.
• Pull your shoulders down and back.
• Engage your core by lifting your belly button.
• Slightly bend your knees whenever standing to promote neutral pelvic alignment and reduce knee pain.
• See a women’s health Physical Therapist and/or prenatal exercise specialist.

Your body’s innate wisdom will carry you through, but specific strength training can go a long way in limiting discomforts associated with pregnancy. For more specific ideas about how to maintain your posture throughout your pregnancy, click here.

Most families practice a morning routine, as it helps to get your family moving and out the door on time. However, evenings tend to be more relaxed. But, would your family benefit from ENDING the day with an evening routine? Ending your day with a routine can be helpful for children to gain independence, regulate energy levels, and develop important skills. In general, having routines help build executive functioning skills in children.

Executive functioning is a precise blend of motor, sensory, and communication skills that are very critical to our daily decision making skills and our behaviors. Memory, mental flexibility, and control are the powerhouse behind executive functioning, and we can begin learning these skill sets at a very young age.

In addition to refining executive functioning skills, evening routines can help in other ways.

How an Evening Routine Helps

• Promote self-control – balancing activities and utilizing time efficiently.
• Reducing anxiety – each day will have some predictability.
• Increase confidence and independence – kids learn to manage tasks on their own.
• Regulate energy levels – helps in winding down after a busy day.

So, if an evening routine is something you would like to initiate within your home, there are some things to think about.

Things to Keep in Mind

• Think about what each child needs to do every night, and remember that routines vary from person to person or child to child. Therefore, it is very important to find what works for each individual person and stick to it.
• Make time for activities of daily living. A successful routine will incorporate and prioritize what MUST be done every night. Consider such things as snack, chores, homework, and bedtimes.
• Include hobbies and preferences. Hobbies and preferences are essential for development and assist in creating a foundation for healthy habits. Some activities to consider include: brushing teeth, dance class, baseball, etc.
• Always be positive and encouraging. Make sure that there is plenty of time for fun, otherwise motivation to engage and participate is limited. Make sure to include play time outside.
• Pay attention to how your child responds. Make sure that your child is successful with the routine. Don’t dwell on what wasn’t completed. Make adjustments as needed until you have found a routine that works. Also, provide praise for accomplishments.
• Be open to change. If your child seems overwhelmed or disengaged, then talk to them about what is happening in their daily schedules. Make sure that your child is enjoying the activities that they are participating in.

Starting something new always comes with its challenges and difficulties, but it is extremely important to keep in mind the long term benefits. Be patient. The routine that works for your child may not be the routine you envisioned. And that is perfectly OK! Establishing a new routine or habit takes time, consistency, and patience. The long term effects will be worth all of the hard work in the end and for years to come.  

Orthostatic hypotension (OH), also known as postural hypertension, is a type of low blood pressure that occurs when standing after sitting or lying down. Symptoms can be mild and brief or more severe and chronic. Symptoms vary from the sensation of dizziness or lightheadedness to loss of consciousness, depending on the severity. Mild periodic symptoms can usually be attributed to dehydration or a period of bed rest, and are easily treated. More severe symptoms should be evaluated by your doctor as persistent OH can be a symptom of an underlying medical condition.

Symptoms of Orthostatic Hypotension

Dizziness or lightheadedness is the most common symptom of OH. Symptoms that are more concerning include blurry vision, weakness, fainting or losing consciousness, and confusion upon standing. Keeping track of when and how often symptoms occur is important. Mild periodic lightheadedness, for example, may be of less concern to your physician than feeling faint while driving. Talking with your physician is important because complications from OH can be serious, especially for the geriatric population. The most common is injury from a fall due to dizziness or fainting. Additional complications include stroke due to reduced blood flow to the brain and irregular heartbeat.

OH occurs because of a drop in blood pressure when standing. Gravity allows blood to collect in our legs or abdomen resulting in less blood flowing back to the heart. When this occurs our body signals our brain to make our heart pump faster which stabilizes our blood pressure. When this process is interrupted, OH occurs.

Conditions that may Cause OH

Dehydration. Dehydration reduces blood volume, and thus, blood pressure. Drinking an insufficient amount of fluids, fever, vomiting, severe diarrhea, and excessive sweating all lead to dehydration.

Eating meals. Some, not all, older adults have lower blood pressure after eating a meal.

Cardiac problems. Very low heart rate, heart valve problems, and heart attack prevent the body from pumping more blood upon standing.

Neurological problems. Neurological disorders such as Parkinson’s disease, Lewy body dementia, and multiple system atrophy may interrupt the body’s ability to regulate blood pressure.

Endocrine problems. Thyroid problems, Addison’s disease, and hypoglycemia can cause OH. Diabetes can damage the nerves that send signals to the brain and thus interfere with the body’s ability to regulate blood pressure.

Medications. Medications used to treat high blood pressure can cause OH. These include diuretics, beta blockers, alpha blockers, etc.  Medication used to treat Parkinson’s disease, some antidepressants, some antipsychotics, muscle relaxants, and narcotics may increase risk for OH.

Your physician can assess these conditions and related symptoms and devise a treatment plan with you. Because OH can result in serious injury, it is important to discuss any increase in frequency of occurrence or prolonged duration of symptoms with your physician.