How occupational therapy can help those living with rheumatoid arthritis
Rheumatoid arthritis (RA) is an autoimmune, chronic inflammatory condition that primarily affects the joints of the body. The best management of RA is a holistic approach - including both medical and therapeutic interventions.
The primary goal of occupational therapy is to help you to participate in activities of everyday life. Occupational therapists can help by assisting you to engage in valued occupations by modifying the occupation, the environment or both. RA often effects your hands and occupational therapists can help you manage even if your hands are impacted by RA. This involves assessing of the effect of RA on your bones, muscles, tendons and ligaments of the hand; specific function of the hand; and your overall engagement in valued activities.
Once an assessment is completed, a treatment plan will be developed with you that is aimed at preventing further joint deformity, minimising pain, minimising swelling, and further destruction of the joint surfaces, whilst maintaining strength and joint movement. This involved education on ways to protect joints and conserve energy – making everyday activities easier. The occupational therapist may also provide you with splints to help you continue to do what you want such as cooking, making sushi or playing cards with your friends or children.
Joint protection and energy conservation strategies are one of the best ways to help reduce the overall impact that RA has on your joints. Altering the way a task is completed (by using specific techniques) has been clinically proven to reduce pain during activity, reduce forces on joints, reduce inflammation and subsequent strain on soft tissue, reduce fatigue and help preserve the joint surface - all of which improve or maintain function.
Some of these strategies include breaking down the activities that worsen symptoms into smaller tasks. These smaller tasks are then spread out over a longer period of time, to allow the body to rest and recoup between each smaller task. As a result, less energy is used at once and the level of stress on joints is reduced as the body has a chance to recover. This strategy often requires pre-planning to allow for the increased time it will take to complete a task - however the overall benefit for your body is well worth taking it slow and steady! Your occupational therapists can help you learn how to pace yourself.
Using equipment that can help place less stress on joints is also really useful in managing your RA. There are plenty of products available for purchase for a small cost that can make a huge difference in the day-to-day tasks at home. Some of these aids can be purchased online. Another provider of information and advice on assistive technology is Life Tec. Visit their website or call 1300 885 886.
Orthoses (splints) for the hand and wrist are another great option for helping manage the pain and swelling resulting in increased function. They also have the benefit of maintaining the correct alignment of joints and help in the prevention of joint deformity by counteracting destructive forces, and providing support. Splints are either custom-made by specially trained therapists for individual fit and comfort or prefabricated based on generic sizes.
It is always recommended to see a qualified occupational therapist with specialist training in hand and upper limb rehabilitation to get advice on which is the best orthosis option for you. There are a number of factors that impact the decision and the occupational therapist will conduct a thorough assessment and provide recommendations on the best choice based on your individual needs and occupational limitations. If it is required, they will be able to make you a custom-fit splint and provide specialist advice tailored to your needs. You do not require a referral from your GP to make an appointment, however they may be able to point you in the right direction to find the closest one. Appointment costs from registered occupational therapists are eligible for Private Health Insurance rebates, depending on your level of cover.
Living with RA can be challenging. There is however a few small things that can be done that can significantly improve the quality of life for those living with RA. Breaking down tasks and spreading them out over the day, using the bigger joints in the hand instead of small joints to complete tasks and employing orthoses where appropriate, can help make the day to day a little easier. If you are living with RA and you would like further information about how an occupational therapist can help, speak with your GP or Rheumatologist.