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Physiotherapy And Hand Therapy Management Of The Rheumatoid Hand
arthritis is a chronic disease characterized primarily by inflammation
of the synovial tissue of the joints and tendon sheaths, with other
systemic complications. This diseases’ course vary from individual to
individual (there is no specific, fixed or constant pathway of
progression), and 20-30% of these patients have complete or partial
resolutions. These patients generally do well, with a variable amount of
Rheumatoid arthritis affecting the
hands are common – mainly the wrist joint, knuckles, the thumb are the
most often affected. The knuckles at the ends of the fingers are not
usually affected though. Because of the involvement of joints more
proximal (further up, nearer the elbow) are more affected, this causes
imbalances and results in deformities where the wrist and fingers slant
towards the ulnar side of the hand. Synovial inflammation weakens joint
structures and cartilage, causing more muscle-tendon imbalance, laxity
and even dislocation. In severe cases, tendon rupture occurs.
Physiotherapy / Hand Therapy Evaluation
is necessary to do an initial assessment of the hand, the disease
progression and challenges before starting any interventions – this is
for the baseline setting, where we can work together with the patient
for a joint cooperation management.
Observation and Palpation
observe and note the (ab)normal postures of the hands, check for any
observable deformities, skin conditions or the presence of atrophy. If
deformities are present, we need to understand when did they start and
how fast they developed. The presence of crepitus (cracking) within the
joints needs to be noted as well, for joint stability and tendon
assessments includes the assessment and evaluation of range of motion
of each joints, pinch and grip strength, dexterity (nimbleness),
engagement and performance of daily living activities (e.g. brushing
teeth, buttoning etc) as other objective tests.
Physiotherapy Or Hand Therapy Treatments
are three (3) stages of rheumatoid arthritis – acute, subacute and
chronic stages; and therapy implications and approaches differ from
stage to stage. Goals are relatively similar across the stages, which
remain as to maintain or increase function, minimize pain and deformity.
In the acute stage, rest if often reinforced to decrease pain, swelling
and inflammation, coupled with proper positioning of the limbs or
joints to prevent joint deformities and contractures, as well as gentle
active range of motion exercises will be prescribed to maintain joint
mobility and integrity. These exercises needs to be done 3-4 times
daily. In the subacute stage, focus will be on increasing tolerance and
participation; joint protection strategies and energy conservation
techniques will be taught. In the chronic stage, focus is on joint
protection, activity participation, energy conservation and daily
exercises to maintain and increase strength and tolerance.
See a list of physiotherapy advice for people with arthritis
physiotherapist or hand therapist may determine if a splint would be
beneficial to protect and preserve your joints, and may prescribe one to
you. They may be custom fabricated, or one that is commonly purchased
at local pharmacies. Resting splints, for whole hands or wrists, are
used when there is swelling and inflammation in the hands or joints.
During the flare-ups, joints and soft tissues are more susceptible to
damage, so splinting protects the joints strongly, as well as reduces
pain and swelling experienced. In many cases, splinting preserves the
normal joint integrity and movement, by preventing deformitizing
Picture courtesy of James Heilman, MD
The best way to reduce joint pain, quite frankly, may simply be to
pursue natural treatment for arthritis with a joint relief supplement
with chondroitin and glucosamine. Multiple
studies demonstrate these two compounds not only reduce joint pain, they may
also protect cartilage and offer greater mobility. That's more that most
arthritis medications offer, and probably safer as well.
Try Joint Relief Solution. A blend of natural ingredients,
including glucosamine and chondroitin, it's also formulated with willow bark
extract. You might be surprised to learn that willow bark has the same active
ingredient as aspirin, and shows dramatic reduction in pain symptoms, with less
reliance on NSAIDs as well.
Where to next?
- Make A Physiotherapy, Hand Therapy or Deep Tissue Release Singapore Appointment
- Arrange A CallBack or Make An E-Enquiry Here
- See the list of physiotherapy conditions we treat
- See the list of orthopedic surgeons we serve in Singapore
- Return to Urbanrehab's Physiotherapy, Hand Therapy and Sports Massage Singapore Home Page from our rheumatoid arthritis page
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Our Physio & Rehab Expertise
Specialist Rehab Group works with specialist physiotherapists and specialist rehab therapists who are highly trained, qualified, experienced and passionate to provide high level of expert care to our patients.
Areas of specialization
- physiotherapy: back and neck (spine), sports, shoulder, hip, knee, ankle
- hand therapy: forearm, wrist, hand and fingers
- podiatrist: leg, calf, ankle, foot and toes
- read more on our specializations here
All our therapists are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCM). See our entire team here by location and specialization.
Initially, our specialist physiotherapists will carry out a thorough
assessment, helping them to select the most appropriate treatment to
help you recover. They then provide
expert treatment for your pain as well as prescribing specific
exercises to reduce your risk of re-injury and giving you a long term
To call for inquiries or appointments, please contact us at:
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We do not rely on advertising - instead, we prefer and appreciate the goodwill and positive reinforcement from patients.
When you have the opportunity, please take the time to tell your family, friends and physicians about the positive results and experience you have had in our clinic.
Thank you so much, and stay healthy!
SPECIALIST REHAB APPOINTMENTS & ENQUIRIES
Please Call/SMS/WhatsApp to xx, thanks!
We are a wholly Singapore Private Limited group of licensed physiotherapists, hand therapists, podiatrists, chiropractors, sports massage therapists, clinical pilates practitioners and TCM physicians practicing in our scope of rehabilitation and its areas of specializations. As listed in our website are the list of services we provide our clients as referred by their medical doctors or by self referrals/word of mouth.
The range of rehabilitation results vary from patients to patients, depending on a variety of factors and reasons such as severity of condition, genetics, gender and age. However, we will still deliver the best evidence-based-practice of physiotherapy, hand therapy, TCM, sports training and deep tissue release therapy that we can deliver.
The information available on this site is for educational purposes only, if you need a full professional advise on physiotherapy, hand therapy and occupational therapy, please schedule an appointment with us by contacting our staff by Call/SMS/WhatsApp at xx, thanks!