Benefits and when to start

Physiotherapy may be beneficial as part of a treatment plan for people with psoriatic arthritis (PA). Knowing when and how to work with a physical therapist can have a positive effect on PA symptoms and disease management.

PSA is a chronic inflammatory joint disease. It causes joint pain, swelling and stiffness and eventually leads to joint degeneration. It often occurs alongside psoriasis, which is an immune-mediated disease that causes inflamed, scaly patches to develop on the skin.

Treatment for PA aims to reduce inflammation and prevent damage to joints, ligaments and tendons. Typically, doctors prescribe medication to people with the condition. These may include NSAIDs in mild cases and biologics in more severe cases.

Complementary therapy options may also be beneficial for people with PsA. For example, physiotherapy can be a useful treatment strategy. People can use physiotherapy alongside medication, but it may be sufficient as a stand-alone treatment if a person has only mild symptoms or cannot tolerate medication.

Physiotherapy for PA may involve guided exercises, stretching, and strength training. These activities can help sufferers manage symptoms that affect their quality of life.

Physical therapy could also help people learn to better cope with flare-ups and find ways to compensate for any changes in their range of motion or abilities as the disease progresses.

However, there is little research on the effect of physical therapy on people with PsA. Most of the information is anecdotal or comes from research on other types of arthritis.

This article explains why physiotherapy might be a good option for people with PsA. It also looks at when to start these treatments and what to expect from them.

Anyone who feels enough pain and stiffness to consider physical therapy should do so as soon as possible. In general, the earlier a person with PsA begins physical therapy, the better.

Some doctors may refer people with PA to a physical therapist even before their symptoms begin to interfere with daily tasks. Early intervention can help people avoid injury. A physical therapist can also teach a person new ways to do their job or tasks so they don’t put stress on their joints.

Joint pain and stiffness caused by PSA can limit movement, making a person more likely to be sedentary. A sedentary lifestyle increases the risk of cardiovascular disease, including coronary heart disease and metabolic syndrome.

Research suggests that as a result of chronic inflammation, people with PsA already have a 43% higher risk of cardiovascular disease than the general population. Specifically, they have increased rates of heart attack, cerebrovascular disease, and heart failure.

However, along with increased movement and exercise, physiotherapy can help reduce these risks while easing the symptoms of PA. As a result, it will likely be beneficial for someone with PA to see a physical therapist for an individualized plan that they can start using when the disease is in its early stages.

Although it may seem counterintuitive to recommend physical activity and exercise for people who have stiff and swollen joints, regular exercise is generally beneficial for people with PsA. Movement helps joints stay mobile and functional.

Physiotherapy can also help people fight conditions that worsen PA symptoms, including obesity and cardiovascular disease.

Potential benefits of physiotherapy for PSA include:

  • improved range of motion and flexibility
  • reduction of symptoms, including joint stiffness and pain
  • individualized fitness plans
  • instructions on how to safely participate in activities such as yoga, cycling, and stretching
  • education about therapies, such as heat and cold therapy
  • instructions on how to use assistive devices for daily activities
  • instruction on movement modifications to make everyday tasks easier and protect the joints

Regular movement and exercise can help a person with PA improve cardiovascular health and conditioning. People with PsA have a increased risk cardiovascular health issues, including heart attacks, strokes, and metabolic syndrome. Exercise can help combat lifestyle factors that contribute to these conditions.

Physiotherapy can help a person find ways to manage the symptoms of the disease.

Physiotherapy can help people manage a variety of symptoms of PA, including:

  • articular pain
  • joint stiffness
  • reduced range of motion
  • fatigue
  • insomnia

Physiotherapy for PSA can take many forms. The best exercises and treatment options for a person will depend on their symptoms, goals, and overall health.

During initial visits, a physical therapist will work with a person to understand what they are currently able to do. From there, they can use one or more types of therapies and techniques.

Types of physical therapy that may be helpful for people with PsA include:

  • gentle exercise
  • elongation
  • strength training
  • joint mobilization
  • soft tissue mobilization
  • use of assistive devices or adapted equipment
  • supports posture
  • braces or splints that can support the joints to reduce damage and pain
  • hydrotherapy, which involves water-based exercises that allow movement without putting weight on the joints

If a person has health insurance, their plan may cover physical therapy for PSA. Insurance companies establish different reimbursement structures and schedules for physiotherapy visits. Each insurance plan will have specific allowances for tours and activities.

A person should call their health insurance company before a first physical therapy appointment. The insurance company should be able to provide an outline of what they will cover and the person’s liability.

Some insurance companies will require that a client be directly referred to a physical therapist by a physician before covering the costs. A person can work with a doctor to get a recommendation and referral for insurance coverage for physical therapy appointments.

People looking to find a physical therapist for PAs should speak with a doctor who treats PAs.

Rheumatologists, or doctors who specialize in inflammatory conditions, frequently consult and refer people to physical therapists. Therefore, they should be able to recommend a suitable physiotherapist in the area.

Alternatively, a person might consider contacting professional organizations such as the American College of Rheumatology, which can provide lists of local physical therapists. These organizations may also know of physiotherapists who specialize in treating the symptoms of PAs.

Psoriatic arthritis is a chronic inflammatory joint disease that can cause joint stiffness, decreased range of motion, and pain, along with other symptoms. The standard treatment is medication that reduces inflammation. Complementary therapies, such as physiotherapy, also play a role.

Physical activity can help relieve symptoms of PA and improve quality of life. It can also help a person improve their cardiovascular health to reduce the risk of heart disease, heart attack, and stroke.

A physical therapist can help people with PA learn to move and exercise safely, which can help them avoid worsening symptoms. Overall, the earlier a person starts working with a physical therapist, the better.

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