Our rheumatology clinic has under its wings one of the best osteoarthritis rehabilitation and rheumatoid arthritis rehabilitation.
These are a group of conditions that affects your musculoskeletal system (muscles, tendons, ligaments, capsule and bone) as well as other organ systems (such as respiratory, cardiac, hematological system, etc.). Some of the common rheumatologic conditions include
- Rheumatoid Arthritis – It is a chronic autoimmune (your immune system malfunctions and attacks your own body) inflammatory disorder affecting multiple organ systems. However, it primarily affects the joints, especially small joints of the hands and has a tendency to erode it
- Systemic lupus erythematosus – This is also a chronic autoimmune inflammatory condition affecting multiple organ systems but it has less predilection to affect your joints compared to rheumatoid arthritis
- Osteoarthritis – It is a progressive degenerative disorder of your joint cartilage causing pain and inflammation in your joints. It is not an autoimmune condition
- Spondyloarthropathies such as ankylosing spondylitis, reactive arthritis, and psoriatic arthritis are a group of inflammatory conditions that affect multiple organ systems but has a predilection to the musculoskeletal system
- Sjogren’s syndrome – It is an autoimmune condition that affects various organ systems including the musculoskeletal system but has a predilection to your exocrine glands causing dryness of the eyes, mouth, skin, etc.
- Mixed connective tissue disorders – It is a condition which has characteristics of several other autoimmune disorders discussed here.
- Scleroderma – It is an autoimmune condition, which affects multiple organ systems including the musculoskeletal system. Thickening of the organ system due to collagen deposition is the hallmark of this condition.
- Polymyositis and Dermatomyositis – These are autoimmune conditions that predominantly affect your muscles causing weakness especially in the shoulder and hips as well as rash in the skin.
- Infectious or reactive arthritis – virus, bacteria, fungi, and other organisms can affect your joints causing prolonged pain, generalized muscle weakness and fatigue
- Crystal-induced Arthropathies such as gout, pseudogout – This condition occurs as a result of crystal deposition in your joints
- Neuropathic Arthropathy such as Charcot joints – This condition causes progressive destruction of the joints and it occurs predominantly in the ankle joints of individuals who have decreased sensation due to nerve damage
- Fibromyalgia – This is a condition, which causes diffuse weakness, stiffness, tender points and muscle aches all over the body. Usually diagnosed when all other conditions discussed above have been ruled out.
Symptoms
Collectively, individuals affected by these conditions can have a number of symptoms such as
- Joint pain and stiffness including deformities. This can also be localized to 1-2 joints
- Diffuse muscle aches
- Fatigue
- Muscle weakness in multiple muscles. Sometimes it can occur in some muscle groups more than the other.
- Depression
- Swallowing can be affected in some conditions
- Poor endurance
- These symptoms can affect someone’s ability to walk and perform activities of daily living independently which can significantly worsen their quality of life
Our comprehensive, interdisciplinary team approach (i.e. care being provided by various disciplines in a coordinated fashion) with Physician (Physiatrist), Physiotherapist, Occupational Therapist, Speech and Language Therapist, Neuropsychologist, Nutritionist and a Rehabilitation Nurse can help reduce your symptoms directly related to the illness and prevent medical complications that occur as a result of impaired mobility such as blood clots in the veins of the arms and legs, blood clot in the lungs and pressure ulcers. Our treatment is not a substitution for medication such as steroids, immunosuppressants etc. but a supplementation to such treatments to maximize your recovery. Therefore, you should continue seeing a Rheumatologist for diagnosis and treatment of the underlying problem (when such treatments are available). Not all patients will require all services and usually, a combination of these services is required for an individual patient. You will be evaluated at the initial visit to determine what services you require and a tailored treatment plan will be initiated.
Patients will be evaluated by the Physician first to determine the severity of the condition and it’s impact on the patient and then formulate a treatment plan that best suits them. Depending on the patient’s symptoms, the treatment plan will include training of various exercises and treatment modalities, which will be executed by the rest of the healthcare team. The physician can also recommend appropriate orthosis if the patient has significant muscle weakness to help walk better or perform daily activities better or to prevent/treat joint deformities. The physician also performs various injections such as trigger point injections, tendon injections and joint injections to help relieve pain and tightness. The physician also prescribes medications to improve bone strength, and decrease pain.
The Physiotherapist trains patients on various physical exercises to improve their walking and balance,strength in the arms and legs, endurance and bone strength. They also use physical modalities to reduce joint pain and stiffness, muscle soreness, increase bone strength and treat and prevent muscle atrophy.
The Occupational Therapist helps patients with severe physical impairment to be independent by training them on various physical activities of daily living such as moving in the bed, transferring from one place to another, eating, dressing, bathing, toileting, and driving.The final phase of treatment involves patient training for successful community integration (education, employment etc).
A Neuropsychologist evaluates patients with depression and anxiety that is commonly seen after any major life-changing illness and guides them through the process of rehabilitation thereby improving the quality of life through motivation and counseling.
As adequate nutrition intake is essential for optimal recovery, the Nutritionist recommends appropriate nutrition intake.
The Rehabilitation Nurse performs and teaches wound care management for patients with wounds due to immobility. The Nurse also trains on bowel and bladder management if incontinence is an issue.
Expectations of Recovery
Treatment duration and prognosis depends on the nature and severity of the condition. Most of these conditions are chronic and cannot be cured but can be treated with medications to control symptoms. However, medications may not be sufficient to control all the symptoms experienced by these individuals and will require additional treatment options that we provide to reduce pain, reduce joint stiffness, treat joint deformities with splints and orthosis, improve muscle strength, reduce fatigue, increase endurance, improve mood, walking and balance thereby facilitating improvement in their daily activities including household activities and employment.