There are 2 forms of arthritis, rheumatoid arthritis, and osteoarthritis. Neither of these conditions is curable. Though there are medications and physical treatments that can slow down the progress, or reduce the number of episodes that are experienced. There are physical treatments that can help with treating some of the secondary symptoms that are accompanied by arthritis including pain and maintaining range of motion. Sadly, there is still no cure for either types of arthritis.
What is Rheumatoid Arthritis and Symptoms of Rheumatoid Arthritis
This is a form of autoimmune disease that attacks the joints by causing inflammation and breaking down the connective tissue inside of the joint. This causes the joint to be hypermobile (moves more than it should), and can cause deformation in the joint, which is common when affecting the joints in the hands.
What is Osteoarthritis?
Osteoarthritis is a chronic degeneration of the cartilage and subchondral bones in the joint. This is the more common form of arthritis and is generally the one that is being referred to when someone says they have arthritis. Because of this I will continue with only talking about osteoarthritis.
Osteoarthritis is commonly thought to occur because of age, however, it isn’t. It can occur at any age, though more common in those who are older. Rather, there are 2 different categories that a person could be under to explain why one can get arthritis. They are idiopathic (affects 1 or several joint groups, but has an unknown starting point), and secondary (this is where the joint has had multiple joint traumas or an underlying pathology). To further explain, osteoarthritis is more common in people who have altered biomechanics, such as leg length discrepancy (one leg is longer than the other), joint hypermobility, muscular imbalances. Trauma, other pathologies, immobilization of the joint (as it decreases the circulation of healthy synovial fluid in the joint), and having certain genetic predispositions, such as obesity for osteoarthritis in the knee or Heberden’s nodes in the end finger joints. Osteoarthritis also affects women twice as much as men; and is more common in certain ethnicities than others.
Stages of Arthritis Breakdown
The stages of degradation in arthritis are when the cartilage fibers break down, causing the body to increase fluid in a joint with proteoglycans that cause the cartilage to be elastic. This causes the cartilage to become thicker. As arthritis progresses, more fibers break, and proteoglycans aren’t created as much. This causes the cartilage to thin and weaken. If the condition progresses farther, the cartilage breaks down, even more, leaving the bones in the joint to rub against each other. When this happens it causes the ends of the bones to become smooth and may even get microfractures. When this happens the body tries to create more cartilage but instead makes bone spurs along the ends of the bones. This causes the bone to become irregular, restricting the movement in the joint, and becoming even more painful. Not only can this cause pain, but during any stage of the condition, there can be episodes of inflammation and muscle spasm, which can also cause pain or even a burning feeling in the joints.
Treatment for Osteoarthritis using Massage
Treatment is meant to help with managing the condition. This includes decreasing pain, maintaining tissue and joint health, decreasing swelling, prolonging remission episodes, muscle spasm, and stiffness, along with increasing range of motion.
Depending on the joint affected by arthritis, as well as the number of joints that are affected, will determine if the massage will solely focus on the treatment of arthritis or if it will be a focused point of the treatment, but have other areas worked on that have no relation to arthritis. There are no restrictions on positioning for the treatment of arthritis, as long as you feel comfortable.
During the treatment, heat can be used to help with relaxing the muscles as long as there isn’t a flare-up in inflammation within the joint. If there is any swelling in the joint, cool will be used, and as long as you don’t have any heart conditions, heat may be used above the area of the swelling. What this does is the cool helps push the swelling out, and the heat helps the tissues above to expand, drawing that swelling towards the heat, to help with bringing it back into the lymphatic system. Depending on how cold the cool application is there is a chance that you may feel a cool trickling feeling moving up the limb. This is normal and nothing to be concerned about.
Other parts of the treatment are to further help with bringing down the swelling, such as with lymphatic drainage, and decreasing pain with relaxation techniques. As long as the client isn’t fatigued by this point in the massage, which can happen if they were in a lot of pain before the treatment, trigger points that affect the arthritic joint are treated, along with decreasing muscle spasm. This is done by stretching, working on the attachment sites of the muscle if they are too sensitive to touch, and fascial techniques to treat any adhesions that are present. At the end of the treatment, depending on the condition of the joint (will depend on if bone spurs are present), tractioning of the joint and joint play will be performed, as long as no pain is present. If there is a flare-up in the joint, joint play is postponed till the flare-up has subsided. This is because when there is a flare-up, the fluid in the joint (synovial fluid) can become slightly acidic. Moving this fluid at this time too quickly can cause tissue damage to nearby tissues. When the flare-up is back into remission, it means that the acidity level has gone down and tractioning and joint play are safe to do again