By the time you get diagnosed with arthritis you may have a panel of different doctors and nurses who’ve helped you along the way, but there are other medical professionals who can have a big impact on your health and comfort — including occupational therapists, mental health experts, and physical therapists.
Physical therapists are best known for guiding people through exercises to help with rehabilitation and manage pain, but they are so much more than a personal trainer, says Lauren Lobert, a physical therapist and owner of APEX Physical Therapy. A good PT will employ a variety of techniques, including targeted exercises and stretches, manual therapy, and biomechanical analysis among other things. They can help you maintain your health long-term by creating a program that you can use out of their office, giving you the tools to manage arthritis flare-ups and improve your daily quality of life, she says.
We talked to a group of physical therapists for their best advice for people managing arthritis:
The Mental Mindset
1. Don’t forget the reason you’re doing this
Physical therapy can at times be painful, frustrating, or even boring — and that’s understandable as you’re pushing yourself more, says Lia Vann, a physical therapist at Midwest Orthopedics at Rush Chicago. But in those moments it’s important to keep your eye on the prize and remember why you’re doing this in the first place. “The goal of physical therapy is to progressively get stronger in order to be able to not just move more, but to move better,” she explains. A good PT will keep an updated list of your goals and check in with you about your progress.
2. Surgery is not a cure-all
Joint replacement surgery is a necessity for many patients with arthritis. But too many people think it will solve all their mobility problems and their pain will instantly go away, Vann says. Unfortunately the truth is that surgery is not a quick fix. In the initial weeks afterward, things often feels worse before they feel better. One of the best way to help yourself after surgery? Keep your PT appointments, Vann says. “The most positive outcome [from surgery] requires a period of dedicated rehabilitation and we are trained to help you with that,” she says.
3. Ditch the victim mentality
Instead of thinking of yourself as being at the mercy of your arthritis, it’s important to think of your condition as something that can be managed, by you, says Lyndsay Hirst, a physical therapist at Your Pilates Physio. “I tell my clients to imagine they have a tool box and in it are all the things that help their arthritis — things like medication, pain relief, exercise, heat, rest, physical therapy, and so on,” she explains. “Then you feel in control of your illness and can draw out what you need, when you need it.” Need help? A good PT can give you lots of good “tools” for your toolbox, she says.
4. Learn how your joints work
Arthritis patients are often more committed to doing their prescribed physical therapy exercises when they understand how their joints work, says Lauren Peterson, a physical therapist and owner of FYZICALTherapy & Balance Centers. “When your joints move they produce a liquid called synovial fluid, which reduces friction in your joints,” she explains. “This means that your joints might ache a little initially when you start moving the joint, but discomfort should improve with continued movement as you get more fluid to lubricate it.” Your doctor or PT can show you a model or diagram of what your joints look like when they move and how arthritis can change that.
5. You are not your X-rays
Scary-looking scans mean serious pain and disability, right? Not always, Vann says. “I always tell my patients that just because they have osteoarthritis, that does not necessarily mean they are going to have pain,” she explains. “A lot of people get really worried when they are told they have ‘bone on bone’ or have degeneration but just because that is how the joint looks, it does not mean they will have a lot of pain or issues with daily life.” A physical therapist can help you identify any weak spots and give you tips to prevent future pain, she adds. It’s important to talk to your doctor about what your imaging means for your prognosis and whether they indicate any changes in treatment may be needed.
6. Start making changes now
“One of the things I most wish my patients with arthritis understood is that time is of the essence. Arthritis is a progressive and chronic disease,” says Alice Holland, DPT, director of Stride Strong Physical Therapy. Avoiding action or “powering through” can cause further damage to occur. The sooner you start taking steps to deal with and treat your arthritis, the better your prognosis can be.
The Exercise Prescription
7. Motion is lotion
When it comes to soothing painful joints sometimes the best treatment may be the last one you want to do — move it. “Movement is integral in keeping your joints as mobile and limber as possible; stop moving and you’ll see an immediate increase in pain, stiffness, and disability,” says Brittany Ferri, MS, a physical and occupational therapist. “I advise all my clients to keep moving as you normally would, as much as possible, and continue to exercise even through small bouts of pain.” Major pain is a reason to stop, but it’s good to push through a little discomfort, she adds.
8. Learn to love the elliptical machine
When it comes to arthritis, not all exercises are created equal, says Kavita Sharma, of Manhattan Pain & Sports Associates, who specializes in patients with chronic pain. This is especially true if you have osteoarthritis; certain types of exercises can increase the wear and tear on your already damaged joints. “I usually recommend low-impact exercise such as the elliptical machine or swimming, as they are more gentle on your joints,” Sharma explains. “These types of movements are less likely to cause further injury and will maintain or even improve your mobility.”
9. Get pumped
While cardio will keep your joints lubricated and flexible, when it comes to the long-term health of your joints, it’s important to strengthen the muscles that support them, Sharma says. “As you strengthen the muscles that support the joint, you offload the pressure,” she explains. However, it’s important to work with your physical therapist to figure out which exercises are best for your particular type of arthritis. For instance, if your knees are the problem then you’ll want to focus on strengthening your quads, hamstrings, hips, and low back.
10. Strength train without weights
Some people aren’t up to ‘pumping iron’ in the gym and that’s totally fine — there are lots of strengthening exercises you can do just with your body, Hirst says. Pilates is a gentle way to strengthen the muscles that stabilize arthritic joints while improving range of motion and flexibility, she explains. Other options are yoga, tai chi, or bodyweight strength workouts you find online. Just be sure to run it by your PT first so they can make sure they are appropriate for your arthritis, she adds.
11. Do dexterity exercises
Don’t forget your small muscles in your exercises, Holland says. Movement is the best thing you can do for your joints but people often forget that applies to the small joints, like fingers and toes, as well, she says. “If you have arthritis in your hands, do hand dexterity exercises— like opening and closing your hand and picking up small objects — to warm up in the morning,” he says. A PT can help you figure out which dexterity exercises are best for you.
12. Switch up your workouts up
It’s easy to get in a rut with exercise but it’s better for your joints if you can be flexible (ha!) with your workouts, Vann says. “It’s really about finding the right type of exercise and modifying activities so you can keep moving without serious pain,” she explains. That might mean walking one week, swimming the next, and lifting weights in between. Your physical therapist can recommend specific activities that will work best for you at your current pain level, she adds.
13. Don’t overdo it
“Many people with arthritis do too little activity, which can cause their joints to become stiff and painful, but others may be doing too much activity, which can add stress to the joints,” Vann says. (And both things can be true for the same person in different situations!) The whole point of exercising is to help you, so if your activities are so intense that they require hours of recovery afterward or cause major pain flare-ups then it’s time to talk to your PT about making adjustments and cutting back, she says.
14. Get your posture evaluated
Good posture is important for everyone but it’s essential for people with arthritis because poor biomechanics when you sit, walk, or lift can put extra strain and wear and tear on joints, Holland says. “A physical therapist can help to correct your biomechanics,” she explains. “We can help correct your bad habits and postural problems so you wear down your joints less, thereby helping to slow the progression of arthritis and reduce pain.”
The Lifestyle Hacks
15. Spread out your housework
Gone are the days when you can binge-clean your entire house on a Saturday morning, Hirst says. Instead of trying to be superhuman, assign chores to different days and build breaks into your schedule. “I advise my clients to pace their housework, don’t do all your cleaning in one go, do a bit at a time, it’ll still get clean,” she says. Here are more tips for making household chores more manageable.
16. Lower your shelves
Learning to live with arthritis means making adjustments and adaptations to your daily home routine, Ferri says. For instance, moving your shelves down to lower levels so you don’t have to reach over your head, is a simple fix.
17. Get a paraffin wax hand treatment
Moist, hot therapy is the best for painful joints, Holland says. For her patients with arthritis in their hands or feet she recommends a paraffin wax treatment — yes, just like the ones they do in the nail salons. Beyond making your skin silky soft, the wax traps the heat and moisture against your skin where it can do the most good, she explains. It’s also affordable and easy to DIY. You can buy a paraffin wax kit online or at a nail salon, she adds.
18. Slide your furniture
Picking up or pushing heavy furniture is a problem for most people with arthritis. If you have bad form it can injure you or worsen your pain, Ferri says. Thankfully, they make furniture sliders — plastic discs that you put under bed, couch, or table legs — that allow the furniture to glide over your floor. You can buy smooth plastic ones for use on carpeted floors or fuzzy ones for wood or tile floors.
19. Lighten up your grocery list
Another easy adaptation is to consider the size and weight of things you normally buy at the store and consider alternatives, Ferri says. “My patients with arthritis in their hands often have difficulty carrying a gallon of milk, which is heavy and hard to manipulate, so instead I tell them to get two pints,” she says. Another option is to have your groceries delivered. It may be worth the fee to have someone else do the heavy lifting.
20. Turn up the heat, skip the ice
Heat is one of the best tools you have for dealing with painful flare-ups in your joints, yet many patients still primarily use ice, often based on old advice for treating injuries, Lobert says. “For chronic pain, use heat packs to help maintain blood flow and improve flexibility in your joints,” she says. “Ice is better suited for more acute injuries because it can make joints feel more stiff.”
21. Stretch before you get out of bed
Joints stiffen up during the night when they’re not being used. That’s one of the reasons that mornings are often the toughest time of day for people with arthritis, Lobert says. “Stretching is the antidote to morning stiffness,” she explains. “Start with gentle stretches while still lying down and then continue stretching while sitting on the edge of your bed, prior to getting up every morning.”
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