While dozens of arthritis types are being recognized this month — rheumatoid, gout, lupus, and so on — as physical therapists we most commonly treat osteoarthritis (OA). This refers to the degeneration of joint surfaces over time, often from overuse or previous injury. OA is especially common in weight-bearing joints such as the knee or hip, but is also frequently a problem of the shoulder, spine, feet and hands.
I’m often asked, “Can physical therapy help arthritis?”
YES! Arthritis is a disease that cannot be reversed, but the symptoms can be managed and further degeneration prevented. There are certainly times when a joint is beyond our help, but the evidence is increasing in support of non-surgical measures, especially early on.
The biggest hurdle is that people don’t know.
A 2015 article from the Annals of Internal Medicine describes a study where individuals with OA of the low back (we call this lumbar stenosis) either had surgery or physical therapy. Of the 481 individuals who qualified for the study, 65% of them chose not to participate at all because they were afraid they’d be assigned to the PT group! They obviously thought PT wouldn’t work!
I wonder if they would have chosen differently, had they known the end results:
The surgical group and the PT group had similar improvement in function by 10 and 26 weeks, and both groups maintained their improvement 2 years later! The PT group had fewer and much milder complications than the surgery group, and we all know that surgery is much more expensive than PT!
While we should never make absolute statements based on a single study, a survey of the literature seems to provide reasonable evidence that a trial of physical therapy is worth pursuing for treatment of OA in the spine…and perhaps anywhere else!
Delitto A, Piva SR, Moore CG, Fritz JM, Wisniewski SR, Josbeno DA, et al. Surgery versus nonsurgical treatment of lumbar spinal stenosis: a randomized trial. Ann Intern Med. 2015; 162:465-473.