Physiotherapy / Structure Exercise Programmes

Simple Pain Management Prescription Analgesics


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What is it and why?

  • Meeting with a professional physiotherapist.

  • This will allow for confirmatory diagnosis and the planning of physical therapy and exercise regimes tailored to you and your condition.

  • The goal of physiotherapy will be to improve your ability to do daily activities and increase strength to support the joint.

  • The physiotherapist will teach you proper posture and recommend devices, aids and appropriate exercises. They may also advise on modifications to your home or workplace.


  • Treatment does not involve Home/self-help
    Home/self-help
  • Treatment involves Hospital
    Hospital
  • Treatment involves Daycase procedure
    Daycase procedure
  • Treatment does not involve Inpatient procedure
    Inpatient procedure
  • Treatment does not involve Local anaesthetic
    Local anaesthetic
  • Treatment does not involve General anaesthetic
    General anaesthetic
  • Treatment does not involve Regional block / Spina
    Regional block / Spina
  • Pain
    Pain

    Minor

  • Mobility
    Mobility

    Minor

  • Daily activities
    Daily activities

    Minor

  • Driving
    Driving

    None

  • Leisure activities
    Leisure activities

    None

  • Light exercise
    Light exercise

    Minor

  • Heavy exercise
    Heavy exercise

    Minor

  • Light work
    Light work

    Minor

  • Heavy work
    Heavy work

    Minor

  • Intimate
    Intimate

    Minor


Overview

What stage?

  • Used to support and supplement other treatments, especially surgery.

What does it involve?

  • The first session will involve taking a full history and physical examination. Following this, the physiotherapist will plan various exercises tailored to your needs and personal circumstances.

  • This may include sessions showing you how to use aids and devices to help with activities of daily living (ADL). For example, walking aids and helping hands.

  • The exercises will be focused on strengthening knee muscles (quadriceps and hamstrings), stretching, joint mobilisation, feedback exercises and self-management advice.

  • Further adjustments to your exercise plan will be made after a review by the therapist. 

Effort/burden

  • Consistent adherence to the plan; changing your routine activities and practising exercises requires organisation, commitment and motivation.

  • Time will need to be dedicated to your exercises each day.

  • Visiting the physiotherapist clinic and spending up to one hour per session there. For example, a course may be six seasons occurring once a week or once a fortnight.

Benefits

  • Many arthritic patients report a decrease in the intensity of pain after modifying their activities.

  • Moderate drop in pain, improvement in activities of daily living (ADL) and mobility in the long term.

  • Physiotherapy is low to moderately effective based on the stage of the disease. Studies say that patients can experience up to 70% improvement in pain in the early stages, especially when exercise and mobilisation is combined.

  • This will also improve your general fitness, and help with cardiovascular health and weight loss.

Chances of cure

  • Physiotherapy alone is unlikely to cure arthritis.

  • Adherence to the exercise plan is important for a better outcome.
     

Limitations and side effects

  • Minimal side effects reported.

  • Physiotherapy will only work with adequate motivation and commitment.

  • This treatment requires regular visits to the physiotherapy centre, which may include a time and cost commitment including parking charges.

  • Exercises are based on an ability to perform, rather than a fixed goal.

  • Physiotherapy is not recommended if the patient has significant cardiac problems or exercise-induced cardiac arrhythmias.

Risks

  • No major risks identified.

  • Pain may increase in the initial stages and some people may notice an increase in swelling.

Cost

  • Low cost option for both the patient and the NHS.

  • Patient: Some may wish to enrol in a gym and therefore have a membership fee cost.

  • NHS: £25 to £30 per session, costing approximately £200 per course.

What if no treatment is done?

  • Arthritis will continue to deteriorate.

  • Symptoms will get worse; sometimes rapidly.

  • Will have a negative influence on other management options, e.g. surgery, in the future.

References

Peloquin L, Bravo G, Gauthier P, Lacombe G, Billiard J-S. Effects of a cross-training exercise program in persons with osteoarthritis of the knee. A randomized controlled trial. J Clin Rheumatol, 1999; 5:126–36.

https://academic.oup.com/rheumatology/article/44/1/67/2899142

https://ard.bmj.com/content/62/12/1145.long

https://www.mayoclinic.org/diseases-conditions/arthritis/in-depth/arthritis/art-20047971

https://ard.bmj.com/content/64/6/906

https://www.ncbi.nlm.nih.gov/pubmed/24462672

https://www.oarsijournal.com/article/S1063-4584(14)00016-8/fulltext

https://onlinelibrary.wiley.com/doi/full/10.1111/j.1756-185X.2011.01612.x

https://www.sciencedirect.com/science/article/pii/S1836955311700029


Simple Pain Management Prescription Analgesics