Osteoarthritis (OA) is a painful, perhaps even debilitating, irreversible condition. You probably already know that, hence why you're asking: Can physical therapy help with osteoarthritis? While there is currently no cure for OA, one of the most pragmatic ways to manage and delay the progression of this disease is through physical therapy. So, yes, PT does help. Tremendously, in fact, as I will discuss below. 

What are the goals of physical therapy for osteoarthritis?

Examine symptom severity and activity difficulties

The moment you enter the doors to the physical therapy clinic, the first thing your PT will do is do a thorough examination. This includes the severity of your symptoms, what movements your job and/or hobbies require, which of those movements or activities you have trouble with, and what your own goals are.

Create a program specific to your needs

From the examination, your physical therapist will then formulate an entire program that's tailor-made to your own specific needs. To put things in better perspective, an athlete with osteoarthritis will have a very different program relative to someone who spends most of his/her time sitting in front of a computer. This program not only includes activities and modalities that you will be exposed to while in physical therapy, but also those that you can (and should) do at home.

Promote movement to improve fitness and mobility

This is done through exercises that are gradually and safely progressed. These exercises are also aimed at pain relief and to slow down the progression of the disease. Different modalities under thermotherapy, electrotherapy, manual therapy, and other types of therapy for arthritis will also be used to make exercises more painless.

Suggest modifications at home, at work, and in leisure

Along with exercise, the use of modalities, and a thorough assessment, physical therapists will also suggest environmental and activity modifications.

• For work, this may include ergonomic adjustments with monitor risers, standing desks, or better chairs.
• At home, this could be involve the use of knee wraps, pillows, and mattresses.
• In your leisure time, this could be with knee sleeves or knee braces, shoe inserts, assistive devices, and other products that take pressure off of your joints.

Suggested modifications are not limited to those that I mentioned. Your physical therapist may or may not make more suggestions depending on his/her assessment.

Educate you about your disease

Of the several goals I just listed, this may be the most important. Understanding osteoarthritis as much as you can will be a huge step towards delaying, if not stopping its progression dead in its tracks. If you have any questions about this disease, your sessions with your physical therapist will be the perfect time to ask them. And, should your questions be outside the scope of physical therapy, your PT knows to refer you to someone who's more equipped to give you answers.

6 ways physical therapy can help with osteoarthritis

Moving on from goals, below are several specific ways of how physical therapists can help you live better lives despite OA. 

1. Less pain and controlled inflammation

The American Physical Therapy Association (APTA) describes PTs as leaders in the evolution of pain treatments – and rightfully so. (1)  This is especially true for musculoskeletal conditions which, of course, include osteoarthritis.  First line of treatment includes thermotherapy, electrotherapy, and compression. These methods alter pain signals which make it easier to exercise in the short-term.  Long-term pain relief on your arthritic joints will come with patient education, in-session exercises, and your home treatment plan. And, contrary to what many others believe, exercise is recognized as an effective way to reduce pain. (2) 

2. Preserve or improve range of motion

As stiffness is one of the most prevalent sign of osteoarthritis progression, preserving – if not improving – your range of motion will be crucial to your treatment plan.  Again, this includes exercises and other modalities. But stretching, whether done by your PT or yourself, is also a huge part of it.  This is particularly crucial for your weight bearing joints (i.e. knee osteoarthritis, hip osteoarthritis) as these are commonly where this disease presents itself. Maintaining as much of your ambulatory capabilities relies on preserving joint function. 

3. Strengthen the muscles around your arthritic joints

Needless to say, this comes with strengthening exercises. According to research, these exercises present "strong functional benefits for older adults with OA." (3) There is no specific set of exercises and no specific tools as these will all be under consideration depending on your case. Progression in terms of intensity will also be case to case for safety purposes. 

4. Better posture and body mechanics

Bad posture is a sign of muscle imbalances. These imbalances alter the forces acting on your joints which, in turn, lead to poor mechanics that may trigger, if not worsen joint pain.  Your physical therapist will be trained to see these imbalances and find solutions for them.  Ultimately, better body mechanics can help you lead a better quality of life while living with osteoarthritis. 

5. Improve your balance to reduce risk of falls

According to the Arthritis Foundation, the pain and decreased joint function from hip or knee osteoarthritis can disturb both your balance and mobility. Consequently, this increases your risk for falls and fractures. (4) Physical therapy can help reduce the risk by suggesting modifications to your home, teaching you how to use assistive devices, and training you through exercises that improve both your balance and coordination. 

6. Recommend assistive devices and orthotics

Speaking of using assistive devices, this is a crucial part of your PTs job, too.  These devices and orthotics include canes, walkers, different types of knee braces and supports, shoe inserts, splints, and other things that can take pressure off of your affected joints. Not only that, orthotics and assistive devices can also prevent the need for surgery by boosting your ability to perform daily activities. 

Conclusion

In a nutshell, physical therapy helps with osteoarthritis through a number of different principles – from exercise, thermotherapy, electrotherapy, and others.  Each of these therapeutic principles will be applied to match your specific needs by a qualified therapist with the goal of delaying the progression of the disease, improving joint health, and helping you live a better quality of life in the process. 

Resources:

1. “Rewiring the Brain to Ease Chronic Pain.” APTA, 1 May 2019, www.apta.org/apta-magazine/2019/05/01/rewiring-the-brain-to-ease-chronic-pain.
2. Law, Laura Frey, and Kathleen A Sluka. “How does physical activity modulate pain?.” Pain vol. 158,3 (2017): 369-370. doi:10.1097/j.pain.0000000000000792
3. Latham, Nancy, and Chiung-ju Liu. “Strength training in older adults: the benefits for osteoarthritis.” Clinics in geriatric medicine vol. 26,3 (2010): 445-59. doi:10.1016/j.cger.2010.03.006
4. “Osteoarthritis and Falls | Arthritis Foundation.” Arthritis Foundation, www.arthritis.org/health-wellness/healthy-living/managing-pain/joint-protection/osteoarthritis-and-falls. Accessed 9 May 2022.

About The Author:

Kris Ceniza is a Physiotherapist in the Phillipines who has a special interest in Knees and Arthritis. He is also the manager for Knee Force.com Learn more here: https://kneeforce.com