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Treatment2GoExploring Hand Therapy

Manual

OA:Tips, Tricks, and Trivia

Exploring Hand Therapy, Corporation d/b/a Treatment2Gowww.handtherapy.comwww.treatment2go.com

727-341-1674Fax: 727-388-3904

Treatment2Go is a trademark and d/b/a of Exploring Hand Therapy.

Exploring Hand Therapy d/b/a Treatment2go 1

OSTEOARTHRITIS

Tips, Tricks, and Trivia

disclaimer

IMPORTANT NOTE:As with all of our health-related products, these products are not meant to replace any physician's diagnosis or treatment. Always consult your physician with questions prior to starting any treatment regimen. Always follow manufactures instructions before implementing any tips or tricks. Always follow your State’s Practice Acts and facility policy and procedures.

OA

Osteoarthritis occurs when cartilage in your joints wears down over time. Cartilage is composed up to 85% of water which diminishes as we age.

OA Affects any joint in your body -commonly affects joints in the hands, hips, knees and spine.

Osteoarthritis typically affects just one joint, though in some cases, such as with finger arthritis, several joints can be affected.

STATS and Trivia

American Arthritis foundation estimates about 75 million Americans have OA

Women 2x more likely to get vs. men

Estimated 39 million doctor visits per year are Estimated 39 million doctor visits per year are related to arthritis or 25% of all visits

Accounts for 50% of NSAID

Cause

It isn't clear what causes osteoarthritis in most cases. Researchers suspect that it's a combination of factors


STATS

Older age.Osteoarthritis typically occurs in older adults. People under 40 rarely experience osteoarthritis.

Joint Injuries

Injuries, such as those that occur when playing sports or from an accident, may increase the risk of osteoarthritis.

Sex. Women are more likely to develop osteoarthritis, though it isn't clear why. y

Bone deformities.Some people are born with malformed joints or defective cartilage, which can increase the risk of osteoarthritis.

Obesity. Carrying more body weight places more stress on your weight bearing your weight-bearing joints, such as your knees. But obesity has also been linked to an increased risk of osteoarthritis in the hands, as well.

symptoms

Pain in a joint during or after use, or after a period of inactivity

Tenderness in the joint when you apply light pressure p

Stiffness in a joint, that may be most noticeable when you wake up in the morning or after a period of inactivity

Loss of flexibility may make it difficult to use the joint

ULTIMATE GOAL ULTIMATE GOAL IMPROVE ADLs Increasing flexibility

Decreasing pain, stiffness, tenderness


MILD OA

Mild osteoarthritis pain is when the pain is bothersome, but not enough to have a great impact on your daily activities

REST does not mean STOP moving

Pain or inflammation in a joint: Rest joint (area) for 12

to 24 hours Implement joint Implement joint

protection

Modify activity for a few days to limit joint repetitive motions

Try taking a 5-minute break every hour

Resting the joint(s) can mean splinting

Neoprene to allow motion & light support and ultimately reducing the stress on the structures

You can isolate to one joint that is the culprit, try a joint specific splint and wear for 1 to 2 days to see if pain decreases

Night

Night pain -- try to quiet or rest the entire hand with a thermoplastic

I like the Smart Splints by Imakbecause they are comfortable, washable, breathable and relatively inexpensive

If knee, hip, foot

CaneWrap

HEAT •Increases flexibility•Increase blood flow•Increase ROM•Decrease stiffness•Decrease pain•Decrease spasms•Increase relaxation

Microwavable heat is nice & convenient. This CarolonHOTMITT can heat the hand evenly. Plus you can walk around while it is on.

Wraps can be heated and

applied for 15 to 20 minutes

(Imak Products)


Heat and Stretch

Paraffin: Pre-treat with 7-10 dips for 10 minutes.Apply stretch and re-dip.Maintain stretch for 10 additional minutes

GENTLE Do not cause

pain

Clinic or home units

Heat

Warm towels with a towel

heater/warmer Bath and shower are great ways to warm cold “stiff” joints; especially

good with AM joint stiffness

Try electric blankets Heat•Warm Joints before an activity, hobby, exercise, or work •Heat may increase ease of the task

Heat is best used when inflammation is not severe

Clothing to keep joints warm –keeping people active

Sporting specialty stores (REI) have athletic gear such as cycling under

armor, outdoor warming sleeves and more

Stylish ARM WARMERS Excellent to keep joints

warm and flexible Great for juvenile RA Can wear when

exercising Or just wear casual or

under clothing


Contraindications to Superficial Heating

Insensate tissue

Edema

Circulatory deficiency/steroid dependency

Areas prone to bleeding

COLD THERAPY

Numbs the nerves around a sore joint

Can help decrease inflammation

Quiets muscle spasms

Can help reduce pain

COLD

Cold is great with acute RAUsed with OA typically following heavy joint use or if inflammation

present

Cold Therapy

Direct Contact – problem is poor conformity

Cryotherapuetic Methods

Immerse towel in water and place in freezer

Duration limited by Duration limited by tolerance; no more than 10 - 15 minutes

Improves conformity

ICE TOWELS

COLD WRAPS

REPLACES STIFF ICE PACKS

ICE Tape® is a semi-elastic polyurethane bandage saturated with a hydrophilic (water seeking) gel . Stays cold for several hours


Cold Therapy

Soft gel sheetsCan cool for 6 hours

Reduces skin up to 4 degWorks via evaporation

Contains mentholCo a s e oStays on pretty goodSafe and comfortable

Fairly inexpensiveNo refrigeration needed

Contraindications to Cryotherapy

Cold intolerance/hypersensitivity

Open wounds

Circulatory deficits Circulatory deficits

Uncontrolled hypertension

Over the Counter Creams

Some creams numb the pain area by creating a hot or cool sensation.

Other creams contain medications, such as aspirin-like compounds, that are absorbed into the skin. p ,

Counterirritants

Contain ingredients that irritate the skin

Menthol, oil wintergreen or eucalyptus oil

Rub on area creating a hot/cold sensation givingTemporary pain relief

Counterirritant

Rosewater

Glycerin

Make our lotion with

Eucalyptus

Glycerin and Rosewater Hand Lotion(this is the most basic and easiest to make

1-1/2 cups distilled water 3 teaspoons of rose oil (soluble) 1/3 cup of glycerin Vegetable Glycerine Oil from NOW has a rich, lubricating

texture that is easily soluble in water. And because it is d i d i l f bl il i i h ll iderived entirely from vegetable oil, it is hypoallergenic

Blend all ingredients until smooth and clear and place in a clean bottle with a top.

Alternative: rose water and just substitute 1-2/3 cups rose water for the

rose oil and distilled water) http://www.helium.com/items/375579-homemade-hand-cream-recipes


Home Made lotion

Light Hand Cream 1 oz. emulsifying wax

1/2 oz cocoa butter 3 teaspoons carrier oil

1 teaspoon glycerin f12 oz. rosewater (or 12 oz purified water with a

teaspoon of vitamin C powder added) Warm the rosewater and glycerin.

Melt the wax and cocoa butter in a double boiler; take off the heat and add the rosewater and glycerin. Add the carrier oil and beat until thick. Place in a clean jar with a top.

Use caution with any remedy

Seaweed Lotion 1/4 cup of aloe vera gel

1 tablespoon powdered kelp 1 cup purified water 2 tablespoons of sweet almond oil2 tablespoons of sweet almond oil

Mix all ingredients well and bottle. The best things about all of these recipes is that you

can always add a drop or two of essential oil to change the fragrance if you wish and you never need to worry about running out; you just whip up another batch.

Topical Analgesics:Aspirin-like pain rubsContain salicylates (aspirin) and are absorbed into the skin

Chili Pepper Seeds - CAPSAICIN

Substance P is important for sending pain messages to the brain

These creams deplete nerve cells of the chemical substance P minimizing pain transmission Good for joints

(fingers, knees, and elbow) close to the skin

Prescription pain gels and patches

NSAID patches and Gels Voltaren Gel

Lidocaine patches doca e pa c es (liddoerm)

When patient’s ask about how to use refer them to

the pharmacists or prescribing MD

WORD ABOUT CREAMS/GELS/SPRAYS

Always follow manufactures directions

Do not put hot packs, heating pad, plastics over the area that the pain cream was applied

Do not exercise for at leat an hour after apply pain creamshour after apply pain creams

Do not go in the sun and do not apply sunscreen

May cause CARDIOVASCULAR complications. READ precautions and warnings


Common for therapists’ to see

Bone spurs: (hard lumps) Bone spurs: (hard lumps)

may form around the affected joint Heberden & Bouchards nodes: abnormal enlargements

of the bone or cartilage - about the size of a pea or smaller - may occur in the finger joints, and may be aggravated by osteoarthritis.

Swelling

Nodes

Heberdens’ at DIPJ Bouchards’ at PIPJ

Great for single joint pain

Pain reductionProtection

Generates heat

Silipos is one brand name. Many companies carry variations of the product

Neoprene digit

original

Notice red tip: Make sure sleeve is the correct size: Apply , wait 10 to 15 minutes before you can assess. Always give written precautions

Full Finger Silipos Sleeve

LINED WITH GEL


Variety of ideas

sew the tip

Elastic tapes/stick to self

Gloves with GEL

•Great for night use to help reduce morning pain and joint stiffness

Cotton Gloves

Great to help decrease pain, increase blood flow, decrease

joint stiffness

Joint Protection

Spread the weight of an object over several joints. Use both hands Walking stick or cane.

Maintain good posture. Poor posture causes uneven weight distribution and may strain ligaments and muscles. The

i t t i t i b lki Th easiest way to improve your posture is by walking. The faster you walk, the harder your muscles must work to keep you upright. Some people find that swimming also helps improve their posture.

Choose appropriate tool/device for the job. Ie, shoes wearing comfortable cushioned shoes that properly

support your weight is especially important if you have arthritis in your weight-bearing joints or back.

Joint Protection Tips

Do not o er do Do not over do: If an activity feels like it is too much; It is

Know limitations and respect the limitations Important chores/activities do first before pain and/or

fatigue occurs Exercise very important to protect joints Good night’s sleep and good nutrition is important

Balance between rest and activity

Difficult especially when active; chronic pain can become depressing

Adjust activity level j yaccording to the pain level Good days and bad days

BAHAVIOR


Body mechanics

Incorrect wrist position Better

Ulnar deviation

Straight wrist… stability

Cookware design

Better Two handle

pots

Distribute the weight and decrease joint stress Use two hands to even-out the load

INCORRECT CORRECT

Ergonomic toolsTool conforms

Light weightNon –slip grips

Can Pull Opener

Cans be challenging

This is easy to li ht i htuse; lightweight

Aids in regaining

independence in the kitchen

Reduce stress

Uses both handsSlower but protects joints Rolling cutters


Assistive Devices •Use hot water to loosen a jar lid or tap a spoon on the lid• Use knife to loosen the vacuum seal by prying under the lid•Don't twist or use your joints forcefully

Food ProcessorFree standing

electric can opener

Increase energy level

Try electric pans

Can sit down to cookEasy to use

Easy to cleanCan be mobile

Cleaning

Avoid hard pinching

Soak pans after removing foodLet dishes drip dry

Using a tool decreases stress on hand/finger joints

Do this

Wring out wash cloth with a twist using a hard grip;

especially if symptoms are present

Use both hands to “milk” the cloth

Don’t do this Reduce stress & fatigueon knees and hips

ANTI FATIGUE MAT


Roll out kitchen shelves for

common items

SafetyInexpensive

SuctionBattery

Under the counter lighting

Vacuum

Light weight

Do one room a day

Don’t over do

Do when joints feel Do when joints feel good

Don’t do when joints feel inflamed or fatigued

READING: Don’t do this

Hold a book with a later pinch thumb

Do this

Rest the book on your open palms

Rest the book on a table freeing your hand

Do this

Rest the book on the palms and grasp book with your fingers and

h bnot your thumb


Reading stands

Many designs

Adjustable

Can use at computer desk favorite chair or

Adjustable to any positionUpside-down or sidewaysHolds weight of a book

desk, favorite chair, or in bed

Hands free approach

Diet

Maintaining healthy weight decreases stress on joints

Fruits and vegetables & h l i & whole grains are considered essential to help maintain healthy lifestyle and recommended by the Arthritis Foundation

Good Night’s Sleep Tips

Reserve bed for sleeping Avoid late night liquids and

spicy food Avoid caffeine and alcohol

at nightg Listen to music, read, bathe,

yoga, tai chi before bed to relax

Keep room quiet Room temperature should be

comfy

Good Night’s Sleep

Any local merchant

Eye Pillow (Imak Products) Black out curtains

Try body pillows and memory foam pillows and mattresses

DRESSING

Sit when possible

Save energy and try putting under-pants into pants and pull p pboth up at same time

Use suspenders

Comfortable cloths

Slip o shoes

Velcro closures


Containers Try pump designsAvoid grasping actions that strain

your finger joints

Don’t use a clutch-style purse; instead us a purse with a shoulder strap

Shoulder Saver Devices

Use your strongest muscles Don't push open a

heavy door Lean into it.

Door levers not knobs

Keylessoptionsoptions

CAR GO KEYLESS:Entry to carStarting car

Can be installed

Increase grasp & decrease fatigue


Keep wrist straight

Don’t grip the steering wheel tight

Stretch at red lights

Keys

GoKeyless

Build-up key handles

Keylesshouse

HygieneNice, fairly light weight and easy to use but expensive

The good ‘ole built up handles are

inexpensive, reliable and accessible

Oral B electric toothbrush

Keep mouse at perfect height/distance

Try to maintain hips at 90 degreesUpright

Sitting


•

Keyboard designs

flexible

SHORT CUTS

Try to use keyboard short cuts to limit mouse use

Use computer penhancements Magnifier

Voice activation

Increase contrast

Computer support

Soft-Flex computer support

Imak smart thumb computer glove

Lap top and accessories

NON SKID WRIST RESTHeight adjustable table

Writing

Pi h i j i

Modifying Grip

Pinch increases joint stress

Wider pen decreases joint stress

•Use felt tip pens for ease of writing•Use computer when possible


Scissors Decreases stress on joints

Fiskars ergonomic scissors

Spring scissors

Turning on a Lamp

Built up knob

Voice or Motion activated device

LIFTING

To pick up an object, bend your knees and squat while keeping your back straight

•Keep object close to body•Use leg muscles

•Tighten abdominal muscle•Both hands•Don’t twist

GOODBAD

Supports•Arthritis gloves•Fingerless for tactile •Includes thumb•Comfortable•Day and night use•This glove is from ImakProducts •Many designs and manufactures •Try them and see how you like before you recommend

Great for Day use

Supports thumbAllows full motionProvides warmthProvides warmth

North Coast Medical

Long Term Use


Buddy Strapping

Quick, Convenient, inexpensive Functional use

Randomized Study in 2002

Showed positive effects on hand function with patients who practiced home joint protection exercises . Grip strength increased by 25% in the exercise group versus no improvement in the control

^ Stamm TA, Machold KP, Smolen JS, et al(2002). "Joint protection and home hand exercises improve hand function in patients with hand osteoarthritis: a randomized controlled trial". Arthritis Rheum. 47 (1): 44–9. doi:10.1002/art1.10246. PMID 11932877.

exercise group versus no improvement in the control group. Global hand function improved by 65% for those practicing joint protection

Exercise Considered one of the most important component of

managing chronic conditions such as OA

Improves joint mobility

Improves muscle strength

Improves endurance Improves endurance

Improves overall conditioning

Improves ADLs, balance, proprioception

Improves a healthy weight and lifestyle

Improves sleep patterns

May help increase self esteem

Exercise

Flexibility or ROM exercises

Strengthening exercise

Endurance or aerobic Endurance or aerobic exercises

Flexibility

Body Improve ADLs

ROM improves balance & posture

Less prone to injury Less prone to injury

Improves circulation

Can decrease stress

•Stretch before exercise•If you don’t exercise; then stretch 3X/week

•Problem area stretch daily or 2X a day

Pain-Free Stretching Tips

Feeling tension (OK) Feeling pain (NO)

Try to hold 15-30 seconds

Breath In through mouth

Out through nose

Controlled motionsseco ds

Target muscle groups frequently used Hands

Neck, shoulder

Calves, thighs, hips

Controlled motions Don’t bounce

Don’t over stretch; start slow or warm up first Walking, shower


Neck Stretches

Shoulders back and back straight. Looking forward tilt your head towards your shoulder (ear to shoulder) Do (ear to shoulder) Do not shrug your shoulder. You will feel the stretch along the neck and into the arm (blue arrows) Repeat other side

Increase intensity by active assisting the stretch with your hand

Neck

Sit with back straight and shoulder straight.

Look forward. Rotate your head so you are l ki looking over your shoulder. Keep head steady.

Hold stretches for 15 to 30 seconds.

Repeat the other side.

Shoulder

Shoulder Put your hand above

your elbow and stretch arm by bringing it across upper body at shoulder height. Do not rotate your trunk. Feel the stretch around the shoulder blade and the back part of the shoulder.

Stretches

Raise your arm with elbow bent over your h d U th th

Shoulder Lying down or erect

head. Use the other arm to assist in pulling it over and back behind your head. This will stretch the triceps & into the shoulder.

Shoulder Arms out in front of body at shoulder height (elbows straight) Pull your arms back like

you are going to touch your elbows try pinching your shoulder blades together.

Alternative stretch is to bring your arms behind your head & clasp your hands - now squeeze your shoulder blades together.

Comfortable tension should be felt

Forearm Stretches

Feeling tension is ok; but should be comfortable

Wrist circles; Controlled motions


Hand Flexibility and coordination

One finger at a time

Flexibility

START - cupped

Straighten & spread

Flexibility

GentleUse one hand to push the

other

Stretch and bendStretch and bend in opposite direction

Flexibility Flexibility

Good stretch

Keep heads of MPJ on surface

Lift PIP and DIP joints Lift PIP and DIP joints off the table

Hold 15-30 seconds


Flexibility

Try touching the tip of each finger to tip of thumb

Tendon Gliding

B

START

Always return to position A between each glide

A

B

C

Functional Exercises

lifting Laundry, grocery,

d hild

Power Transfers from bed,

chair, floor Going up/down stairs Walking up hills,

Daily strength movements

grandchildren

Reaching Clothing, refrigerator,

dishes on/off shelves, grabbing items from floor or from overhead

inclines

Balancing Walking Housework, anything

where movement and holding objects

Strength Building Exercises

Build stronger muscles

Stronger muscles means better i d d

Isometrics (static)

Isotonic (dynamic)

Examples

increased endurance, joint protection, and decreases risk of injury

( y ) Dumbbells (free weights)

Resistance tubing

Body weight strength training

Machines

Strength Building

Start with low resistance

Work Major muscle groups

10 – 13 repetitions comfortably

Strength building should be done 2 to 3 times a week

Upper body

Lower body

Trunk (core)

WrittenVerbalDemos

Illustrations

Exercises (must be patient specific)


Tip newgrip.com Tip: Specific to patient – don’t follow step by step protocols instead use them as guidelines

Consistency is more important than intensity

Benefits will take

Build around enjoyable activities

Motivation is challenging

Benefits will take weeks to notice

Don’t over do Listen to body

Join a class (fitness ctr) Try to find class

geared to pain relief Arthritis classes Senior classes Tai Chi for seniors


Wall push up

Kitchen counter push

Push up

Incorporate into every day life

pup Do a few while waiting

for the microwave to finish

Firms chest, arms, back and abs


Don’t let knees go further than toes

Strengthens knees

Squats or lunges

Most reaching, lifting and/or bending requires lunges or squats

Quads

Hips Tai Chi


Lift your purchases to strengthen arms

Shopping

Lift 3 rep front,

Side

Back Grocery bag

Clothing bag


Dumb bells Body weight

like in chair push up kitchen counter push

Chair liftsItems around the house to use for functional exercises

like in chair push up, kitchen counter push ups, wall push ups

Lunges and squats

Resistance band and loops

Balls (weighted) Soup cans

Socks filled with rice and sand


Endurance or Aerobic

Start slowly

May take months to

Walking

Biking

Physical conditioning

yreach 30 minute workouts

Workout 4 to 5 times a week

Low impact exercises

g

Swimming

BuildsCardiovascular

endurance

Aerobic Aerobic exercise activates immune system. Less susceptible to minor viral illnesses, such as colds and flu

Keep arteries clear. Aerobic exercise increases the concentration of high-density lipoprotein (HDL, or "good") cholesterol and decreases the concentration of low-density lipoprotein (LDL, or "bad") cholesterol in your blood

Help manage chronic conditions.p gAerobic exercise helps lower high blood pressure, control blood sugar and relieve chronic muscle pain. History of heart attacks, aerobic exercise can help prevent subsequent attacks

Strengthen your heart. A stronger heart doesn't need to beat as fast. A stronger heart pumps blood more efficiently, which improves blood flow to all parts of your body.

Overall exercises

Tai chi and yoga. These movement therapies involve gentle exercises and stretches combined with deep breathing.

Many people use these therapies to abate stress in h i li h h ll di h f d h i their lives, though small studies have found that tai chi and yoga may reduce osteoarthritis pain.

Tai Chi is a low-impact aerobic activity, so you can chill out and burn some calories at the same time. Another advantage to Tai Chi is its low risk of injury.

EHT has a great TAI CHI course

Moderate osteoarthritis

Osteoarthritis pain that persists despite the discussed previous (initial) treatments may require medications.

Everything we discussed so far will continue but may d difi dneed modified

Don't assume that taking a medication is all that is needed. In order to get the most from treatment, encourage exercising when possible and resting when you need to.

Overweight, continue working to lose weight.

Cortisone shots

Injections of corticosteroid medications may relieve pain in your joint.

It isn't clear how or why corticosteroid injections work in people with osteoarthritis. p p

Doctors may limit the number of injections you can have each year, since too many corticosteroid injections may cause joint damage.

Education relating to taking meds

Therapy (OT/PT) Identify problems related to medication schedule,

difficulty opening jars, organization, identify meds

Take medications as recommended. By taking medications regularly instead of waiting for

pain to build, the overall intensity of discomfort or pain will lessen.

CORRECTION: I said in film Decreased function obviously I meant to say INCREASE FUNCTION


Acetaminophen

Acetaminophen (Tylenol, others) can relieve pain, but doesn't reduce inflammation. It has been shown to be effective for people with osteoarthritis who have mild to moderate pain.

Taking more than the recommended dosage of acetaminophen can cause liver damage, especially if three or more alcoholic drinks are consumed in a day.

Acetaminophen can also affect other medications

NSAIDs

Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation.

Over-the-counter NSAIDs include ibuprofen (Advil, Motrin, others) and naproxen sodium (Aleve).

Stronger versions of these NSAIDs and others are available b i ti by prescription.

NSAIDs have risks of side effects that increase when used at high dosages for long-term treatment.

Side effects may include ringing in your ears, gastric ulcers, cardiovascular problems, gastrointestinal bleeding, and liver and kidney damage. Consuming alcohol or taking corticosteroids while using NSAIDs also increases the risk of gastrointestinal bleeding.

Tramadol

Tramadol (Ultram) is a centrally acting analgesic that's available by prescription.

Tramadol has no anti-inflammatory effect, but can provide effective pain relief with fewer side effects -such as stomach ulcers and bleeding - than those of such as stomach ulcers and bleeding - than those of NSAIDs.

However, tramadol may cause nausea and constipation. It's generally used for short-term treatment of acute flare-ups.

Sometimes docs recommend using tramadol in combination with acetaminophen to increase pain relief.

Treatment options for severe osteoarthritis

•Stronger painkillers. Prescription pain pills, such as codeine and propoxyphene (Darvon), may provide relief from more severe osteoarthritis pain. •These stronger medications carry a risk of dependence, though that risk is thought to be small in people who have severe pain.•Side effects may include nausea, constipation and sleepiness. •Surgery for osteoarthritisSurgery is generally reserved for severe osteoarthritis that isn't relieved by other treatments.

Limerick

Arthritis can be a bum deal.

It can hurt so bad you can’t feel.

But if you treat it right

Y ’ll th li ht You’ll see the light

And be able to cook a great meal.

Thank you

Alternative medicine

Ginger. The ginger plant is best known for its use in cooking, but some research has found ginger extract may be helpful in reducing osteoarthritis pain. Limited studies have been conducted with ginger in people with osteoarthritis and results have been people with osteoarthritis, and results have been mixed. Side effects of ginger supplements can include heartburn and diarrhea. Talk to your doctor before taking ginger supplements, since they can interfere with prescription medications such as warfarin (Coumadin).


Alternative medicine

Glucosamine and chondroitin. Studies have been mixed on these nutritional supplements. Some have found benefits for people with osteoarthritis, while others haven't. Tell your doctor if you're considering taking these supplements. Don't use glucosamine if you're allergic to shellfish. Chondroitin sulfate may affect blood levels of warfarin if you're taking that medication.

Alternative treatments

Acupuncture During acupuncture, tiny needles are inserted into your skin at precise spots. Practitioners believe the needles free or redirect your body's energy in order to relieve pain. Studies of acupuncture for knee osteoarthritis have been acupuncture for knee osteoarthritis have been mixed. Most studies haven't found a benefit, though some have found some short-term relief of pain. Acupuncture can be safe if you select a reputable practitioner — ask your doctor to suggest someone. Risks include infection, bruising and some pain where needles are inserted into your skin.

Alternative treatments

Magnets. Some people believe placing magnets near your affected joint can relieve osteoarthritis pain. Some small studies have found magnets can provide temporary pain relief, though others haven't found any benefit from magnets. It isn't clear how magnet therapy might work. Still, a variety of magnetic products, such as bracelets, are available. Magnets appear to be safe.

Exploring Hand Therapy www.handtherapy.com Treatment2Go www.treatment2go.com

Osteoarthritis Quick Reference Home Program HEAT:

Helps painful joint increase blood flow

Provides local pain relief

Quiet muscle spasms

Improves flexibility COLD: (commonly used in acute phases of RA but also with OA)

Numb the nerves around the sore joint

Quiet muscle spasms

Reduce pain STRETCHING:

Condition joints to become more flexible

Slowly and gently bending or straightening as far as your joint will go

Do not stretch to the point of discomfort

Overtime with repetition a joints comfort range gradually improves

Always begin exercises with stretching the joints and warming the body STRENGTH:

Challenges the body to build stronger, larger muscles to help improve posture and move joints more easily

Isometric exercises are gentle o Push or pull against a stable pressure and joints do not move

Isotonic exercises o Move a joint through a range of motion

EXERCISE:

Improves joint mobility

Improves muscle strength

Improves overall conditioning

Helps maintain healthy weight DANGER SIGNS during or after exercise (call doc/therapist)

Unusual or persistent fatigue

Sharp or increased pain that won’t go away in 24 to 48 hours

You become weaker

Range of motion is less and sometimes painful and doesn’t go away in 24 to 48 hours MOFIFICATIONS to EXERCISE: If pain occurs do one or combination of the following:

Decrease the frequency of the exercise

Decrease the repetitions

Decrease the arc of motion or if performing isotonic stop and perform isometric

Decrease the intensity and perform slower and gentle (don’t overdo it)

Exploring Hand Therapy www.handtherapy.com Treatment2Go www.treatment2go.com PAIN MANAGEMENT:

Splint or brace for a few hours or day for pain relief

Pain relieving creams

Medication prescribed by your doctor

Implement the above exercise modification HAND HEALTH:

Pinching, twisting or squeezing should be performed gingerly

Implement joint protection principles and energy conservation principles

Use ergonomic devices

Try to type vs writing REDUCING STRESS on the HANDS:

Do things less often or in moderation will reduce how often the hands pinch, grip or twist

Try to take some mini breaks even if for short periods o Plan your activity

More demanding activities should be done early in the day or when feeling best

Warm your hand/wrist to reduce pain o Before you engage in an activity and after or ice after

Crafts Writing Sports/activities Meal preparation Daily life

o Ease pain Look into splints, supports, gloves

o Allow easier range of motion

Alter or adjust your “tools” or technique o Modification of a technique or tool to reduce the stress of your hands/wrist o Ergonomic tools help redistribute stress from small joins to larger joinst

DO NOT SQUEEZE:

o Stretch your hand/wrist joints do not squeeze o Minimize or do not use squeezing balls, grip devices or anything to put undue stress on the

damaged joints o Isometric exercises are better for improving grasp

o Careful with isometrics as they can cause pain especially with hip and knee joints o Isometrics for grasp (tennis ball) is recommended

Exploring Hand Therapy www.handtherapy.com Treatment2Go www.treatment2go.com SUPPORT for hand/wrist

Wear as OT/Doc recommends

Daily pain management

Increase functional use of hand

Can increase warmth to the hand/wrist

Reduce stress on the hand/wrist

Pain relief Splint/support: _________________________________ Recommend Use: _____________________________________ Precautions/Notes:

Documents

OA tips tricks trivia - · PDF fileTips, Tricks, and Trivia ... Sex. Women are more ... polyurethane bandage saturated with a hydrophilic (water seeking) gel