What is the best treatment for Arthritis?

Many patients ask me what is the best treatment for Arthritis? Unfortunately there is no “one size fits all” answer. Treatment of Arthritis will depend on the type of Arthritis that the individual is suffering with and a number of other factors.

What is Arthritis?

Arthritis is an umbrella term used to describe a number of diseases affecting one or more joints in the body. Arthritis is the leading cause of joint pain in patients who present to us in the clinic at Physiocare rehabilitation and Allied Healthcare. It can be quite debilitating in an individual and prevent that individual from carrying out their work and home duties. Arthritis Australia has found that approximately 1 in 7 Australians are suffering with arthritis to date, and is the 2^nd most common cause of early retirement due to ill health in Australia! It can affect many people of all ages, sexes and races. Some types of arthritis not only can affect the joints but also the skin, heart, kidneys, lungs and also eyes of an individual.

What are the main types of arthritis?

The main types of arthritis are classified under 2 main categories: Degenerative and Inflammatory. The most common type of Degenerative Arthritis Is Osteoarthritis and this is the main type that patients present with in our clinics. This is also commonly referred to as Degenerative Joint disease or “wear and tear.” Inflammatory Arthritis or Autoimmune Inflammatory Arthritis includes Rheumatoid Arthritis, Spondyloarthropathies; Ankylosing spondylitis, Psoriatic arthritis and others, connective tissue disease and Gout (Metabolic Arthritis). Arthritis is not a single disease and diagnosing one of the common forms of arthritis is the first step. Physiotherapists are well trained at recognizing the symptoms of arthritis and guiding patients to the best course of action.

What are the main causes of Arthritis?

The main causes of arthritis is different for each type of arthritis. Lets start with Osteoarthritis which as mention previously is the most common one we see in the clinic. Osteoarthritis is “wear and tear” of an individual’s joints and is related to usage and age. OA can present itself in young individuals who have had previous injury to that specific joint. Osteoarthritis most commonly presents itself in knee, hip, fingers (thumb joint pain) and foot joints. The current evidence suggests that Inflammatory Arthritis is caused by the autoimmune system becoming dysregulated and begins to target itself and invades normal tissue. Rheumatoid Arthritis causes erosion of joints whilst Spondyloarthritis causes extra bone formation in joints. Gout which causes an inflammation of the ankle joint and hand joints is a result of a chronic imbalance between uric acid production and excretion. It can be due to external factors such as over consumption of too many “foods” or internal factors relating to metabolism. The pathology of each type is quite different, so treatments need to be different.

What are the symptoms of Arthritis

The symptoms of Arthritis will include pain, stiffness and/or swelling and a reduction in a range of movement, depending on the type of arthritis. Sometimes the individual will have no symptoms at all! In most cases, these symptoms will usually increase in severity over time and cause further disability in an individual. In treating inflammatory arthritis, pain gradually becomes better with use but worse with rest. Stiffness is prominent especially after rest and swelling of the joint feels soft and “boggy.” Rheumatoid Arthritis almost always affects the small joints of the body only e.g. fingers and toes and will symmetrically be observed. Spondyloarthritis is observed in sacroiliac joints (sacroiliitis), enthesis (enthesitis), and peripheral joints in asymmetric pattern. In Degenerative Arthritis, pain will be better with rest and worse with use, stiffness is brief and inconsistent and the affected joint feels hard and “bony” with swelling.

Is Arthritis curable?

Unfortunately Arhritis is not curable. It can however be well managed with the appropriate treatment modalities. Physical therapies or Physiotherapy is generally applicable and beneficial for most types of joint pathology i.e arthritis. Physiotherapy can prevent the disease progression of Rheumatoid Arthritis if intervention occurs as early as possible. This means that it is essential for a diagnosis to occur as early as possible and so it is important to recognize the signs and symptoms associated with Rheumatoid Arthritis early. Inflammatory-types of arthritis are eminently treatable and ‘curable’ and should be referred to a rheumatologist as early as possible

What is the best treatment for Arthritis?

The best treatment for arthritis will depend on the type of arthritis we are dealing with. In Rheumatoid Arthritis, if not treated early and aggressively through medication, patient will not return to baseline. Eventually if not treated, will damage ligaments of the joints as well. Unfortunately there is no long term treatment for Osteoarthritis. There are supplements such as glucosamine who patients have reported to improve pain symptoms for Osteoarthritis.  Symptoms will depend on how much is related to inflammation and how much is related to articular damage and so this can depend on how much relief an individual can get from treatment. If Osteoarthritis is late in its progression, then articular damage has already occurred. Resting is not a treatment for any types of arthritis. Movement is highly encouraged to maintain muscle strength and ROM. The pathology of each type is quite different so treatments need to tailored accordingly.

Our highly capable physiotherapists at Physiocare Rehabilitation and Allied Health Care will ensure that you are performing specialized and effective exercises to maximize your recovery.

The best treatment for Arthrits is early intervention. It is crucial in preventing further articular damage and disease progression.

What is Enhanced Primary Care Plan?

Enhanced Primary Care Plan or Medicare EPC is a care plan on the Australian Medicare Benefits Schedule that allows you up to 5 free sessions per calendar year for treatment with medical providers other than GPs (subject to terms and conditions)

How does an EPC work?

Firstly, the Medicare EPC is there for people who suffer from chronic medical conditions. This means you must have had a medical condition for more than 3 months.
You will need to visit your local GP and they will decide whether you are eligible to apply for additional treatments from other medical providers such as physiotherapists.
Your doctor will complete your Medicare EPC form and give you a copy with the referral letter for you to bring with you to your first visit at Physiocare so you can be added to our system.

Is physiotherapy included in an EPC?

Yes, it is.
Physiocare accepts and treats all patients that have been EPC approved.
You will be provided with up to 5 free physio sessions in one calendar year. You can then visit as a private patient, with or without private health insurance, if you require ongoing treatments.
All Medicare EPC patients receive personalised treatment plans that are designed to treat your chronic condition and alleviate your pain.
Dr Azmi, BMedSci, DPT, is a trained and qualified physiotherapist who offers caring and respectful treatments solutions that best support your comfort.

Who is eligible for an Enhanced Primary Care Plan?

Patients are assessed by their local GP and must present with a chronic condition that has not responded to treatment so far.
All Australian citizens with a current Medicare card are eligible for assessment.
Please see your local doctor for a referral prior to contacting Physiocare.

Is the Medicare EPC really free?

Physiocare bulk bill Medicare on your behalf for up to 5 free physiotherapy sessions in one calendar year.
At times, there may be a small gap payment (up to $15) to cover administration costs.