Anyone that has recently been diagnosed with a rheumatology condition understands that it can be daunting. There are a growing, but limited, number of support services for people with these conditions in Singapore.
What are Rheumatology Conditions?
Rheumatology conditions are auto immune diseases that cause pain and inflammation to joints, tendons, muscles and ligaments. As the immune system malfunctions, it can cause the body to attack healthy joints and cause pain, erosion and restrictions in movement. Auto immune diseases can also affect other organs in the body including the eyes, lungs, heart and skin. Although the exact cause of many of these conditions are unknown, experts suspect that hereditary variants and environmental factors combine to make certain individuals more susceptible to auto immune diseases. There are over 200 types and subtypes of diseases.
The most common types of Conditions include:
Lupus Juvenile Arthritis (Systemic and polyarticular)
Ankylosing Spondylitis Juvenile dermamyositis
Septic arthritis Psoriatic Arthritis
Rheumatoid Arthritis Ehler Danlos Syndrome
Fibromyalgia Hypermobility Syndrome
The good news is that physiotherapy is an excellent and proven evidence-based method to reduce the impact of the disease on your everyday life.
The typical hallmarks of a rheumatology condition include:
- Pain and joint stiffness first thing in the morning
- Swelling in a joint
- Redness, tenderness and warmth around a joint
Sometimes combinations of rashes, fatigue, frequent eye inflammation or infections and muscle soreness can be an early indication that you have a rheumatic disease.
If you are experiencing a combination of the following, you should seek advice from a rheumatologist. Unfortunately, there is no specific test that can diagnose an auto-immune disease. Your rheumatologist will recommend certain blood tests and scans to confirm a diagnosis.
The British Society for rheumatology (BSR) and the children’s offshoot (BSPAR) have specific guidelines that we follow closely at PhysioActive. Guidelines on education, exercise, disease modifying drugs (DMARDS) and pain management are evidence-based and updated regularly. We would encourage anyone with an auto-immune condition to familiarise themselves with their recommendations.
Please seek advice from your rheumatologist doctor or specialist nurse if you are experiencing a flare up of your symptoms. Following your medical consultation, physiotherapy plays an extremely important role in the prevention of pain, loss of mobility, joint erosion and maintaining a healthy lifestyle.
The “Avoiding HARM Principle”
We ask adults to follow the “avoiding HARM principle”:
Heat – counterproductive as it increases bleeding and swelling in the affected area.
Alcohol – delays recovery. Avoidance during a flare up is highly encouraged.
Running – rest and from unsupervised high intensity exercise in the initial 72 hours is advised.
Massage and Manipulation of the effected area is not encouraged in the acute phase.
Physiotherapy can help manage acute pain and swelling in conjunction with your medication. Here at PhysioActive, we use a combination of kinesiology taping, electrotherapy and splinting in the acute phase. Long term management of rheumatic disease also requires education on independent pain control modalities, managing flare ups, ongoing assessment for the prevention of joint erosion, personalised exercise programmes and disease education.
For children with acute pain, we closely follow the BSPAR guidelines; early access to assessment with a rheumatologist is absolutely critical. Following this assessment with your medical team, physiotherapy is important in the ongoing management of the condition. As with adult conditions, our physiotherapists can also assist in biomechanical assessment, pain management, safe exercise and conditioning and crucially, education. For children with rheumatic conditions, school and play can commonly be affected. Here at PhysioActive, we teach children the required skills to control their activity pacing in order to have an inclusive life at school and at play.
A new diagnosis can be overwhelming but please remember that there is help out there and Physiotherapy can help reduce the impact of the disease on your everyday life.
This post has been written by Physiotherapist Anthony Corr.