1. How can a physical therapist help me with psoriatic arthritis?
Physical therapy can help reduce joint pain, improve joint mobility, and teach you strategies to help manage your symptoms. A physical therapist (PT) will work with you one on one to develop a treatment approach that is specific to your psoriatic arthritis (PsA) symptoms.
Tools your PT can use to help reduce pain and improve your quality of life include:
- gentle exercise
- modalities such as heat or electrical stimulation
- soft-tissue mobilization
- joint mobilization
- adaptive equipment recommendations
- posture education
2. What can I expect at a session?
During your initial visit, your PT will perform an evaluation and develop a treatment plan that best fits your needs. If you’ve been experiencing severe pain, the session may focus on using modalities such as heat, ice, laser, ultrasound, or electric stimulation to reduce your discomfort.
Once your pain levels have subsided, your PT can show you exercises to improve your joint mobility and help further reduce discomfort. PTs will also use manual therapy (hands-on treatment) to help reduce stress in the soft tissue surrounding the affected areas. You’ll also receive a home program to help you manage your symptoms on your own.
3. What exercises or stretches can help with pain relief?
Everyone living with PsA will experience slightly different symptoms.
Because of this, it’s hard to list a set of generic stretches and exercises that will help everyone. This is why having a one-on-one physical therapy evaluation is absolutely essential. Your PT will develop a set of stretches and exercises that best fit your specific needs.
4. Are there any exercises or stretches I should avoid?
You should avoid any exercises or stretches that cause pain. Also, avoid exercises or stretches that cause you to spend too much time in the end ranges of movement.
Stretches should be comfortable. You don’t need to hold them for more than 5 to 10 seconds to get relief.
The key to alleviating joint stiffness and pain is increasing mobility to the joint. This means you should increase the frequency you move or stretch, not the length a stretch is held. Examples of exercises you should avoid include lifting heavy weights, jumping, playing intense sports, and running.
5. What exercises or stretches can help with mobility?
Exercises and stretches help to improve joint mobility and health by encouraging the circulation of synovial fluid. Synovial fluid acts like WD-40 to lubricate your joints and produce smoother movement.
Exercise also helps improve blood circulation throughout your body. Blood contains oxygen and nutrients that are essential for joint and all soft tissue health. The key is finding exercises and stretches that are useful for you.
Swimming, cycling, walking, gentle yoga, tai chi, and Pilates are examples of useful exercises that shouldn’t exacerbate your symptoms.
6. Are there any assistive devices I should consider?
If you’re having issues walking, you may want to consider using a cane or rolling walker to ease pressure on your legs. Using a cane can be helpful if you’re only having pain in one lower extremity. A rolling walker may be helpful if both of your legs are giving you trouble.
Rolling walkers also have a seat for you to sit and rest if you’re tired or experiencing pain.
Using a wrist brace may be helpful if you’re having issues with your wrists or hands. Most pharmacies have wrist splints and braces that can help alleviate stress on your joints.
A simple lumbar support brace can be helpful in reducing stress on the spine.
7. How do I know if my pain is normal or too much?
Exercises shouldn’t cause you pain. But it’s normal to feel some stretching or muscle pulling while performing your exercises.
The best advice is to start slow and simple and see how you feel the next day. If you feel fine, then continue with the same program for a week or two. After this, you can gradually progress your reps and sets, and add new exercises or stretches to your established program.
If you have a lot of pain the day after exercise, you’ll know you did too much. You and your PT can adjust your program accordingly.
8. What changes can I make at my job to manage my condition?
Taking adequate rest breaks, performing gentle stretches a few times a day, and practicing good posture are tips that are applicable to any job.
If you work at a desk and on a computer, you may want to consider an ergonomic setup so that your back remains straight and your computer screen is at eye level.
If you have an active job that requires lifting, then you’ll want to adjust your technique when performing your duties. Avoid twisting your body and remember to use your legs when lifting objects close to the ground.
Gregory Minnis received his doctorate in physical therapy from the University of St. Augustine with a focus in orthopedic manual therapy after earning his BS from the University of Delaware. Greg’s work experience includes sports medicine, orthopedic physical therapy, neurological rehab, and advanced assessment/treatment of gait impairments. He has completed the coursework for his manual therapy certification, covering advanced treatment of the pelvic complex, spine, and extremities. As a competitive athlete and former Division I soccer player, Greg enjoys working with injured athletes and loves spending time outdoors biking, skiing, and surfing.