Is arthritis relief possible without pills or surgery?
Posted on: 03/03/2014
Beverly Miller, Contributing Editor, The Citizen: Living Well February 2014
Many seniors suffer from painful arthritis. Dr.
Douglas Fye, PT, DPT OCS CKTI, who is Director
of Rehabilitation Services at Auburn Community
Hospital, agreed to answer my questions on the
topic of relief from arthritis pain without pills or
Q: What is arthritis and what causes it? What
are the most common types?
A: Arthritis is defined as acute or chronic
inflammation of a joint surface, usually with
associated joint pain, swelling and stiffness.
Determining the cause of arthritis can be difficult,
because several factors may contribute to
developing arthritis. Some of the risk factors that can
cause arthritis include: Genetics, Age, Weight,
Poor Nutrition, Previous Injury, Occupational
Hazards, Some High-Level Sports, and/or
Illness or Infection. The most common types are
Osteoarthritis (OA) and Rheumatoid Arthritis (RA).
Q: Is arthritis an inevitable part of growing
older? What can young people do to avoid or
mitigate arthritis as they age?
A: No, arthritis is not an inevitable part of
growing older. However, approximately 12% of
Americans will develop OA and roughly 1.3 million
RA. Young (and all) people can eat nutritious foods,
maintain a healthy weight throughout their life
and exercise regularly to strengthen muscles that
protect the joints to reduce the risk and presence
Q: Can physical therapy give relief from
arthritis pain? How?
A: Yes, Physical Therapy (PT) can assess the
status of arthritis and provide intervention for acute
exacerbations and chronic symptoms. Therapy
can instruct in better body mechanics and energy
conservation techniques along with learning ways
to reduce the risk of injury or irritation. PT will
design appropriate low/non-impact exercise and
strengthening conditioning programs to increase
the muscle strength around joints and promote
optimal weight management.
Q: How do you evaluate a patient’s condition
and determine the appropriate therapy to help him
A: To evaluate a patient’s condition the PT
performs several things: taking a history, reviewing
available diagnostics (x-ray results, labs),
physically examining a patient’s strength, flexibility,
endurance, and mobility (including special tests
as indicated), assessing the type and severity of
symptom presence and then designing a treatment
plan to address the findings and involve the
patient’s goals into the appropriate therapy.
Q: How often do patients have to have physical
therapy treatments, and what is a typical time
period (in weeks or months) before relief is
A: Treatment is individualized to the patient
based upon the level of symptoms and dysfunction.
Routinely, a patient may receive PT between 1-3
times a week. Acute exacerbations should have
a rapid relieving in a matter of day(s) and chronic
related problems can be expected to improve more
gradually over a period of weeks.
Q: Do your patients do exercises at home
between treatments? Do they need to continue
these exercises after their treatment period ends?
A: Patients are provided with individualized
exercises and recommendations for activity to
perform at home for carryover of the skilled
therapy intervention. Yes, to best achieve the
identified patient/rehab goal(s) and maintain
their outcomes, patients should continue regular
performance of appropriate exercise and activity.
Q: Have you seen cases where your patients
were able to give up pain killing medication and/
or avoid joint replacement surgery as a result of
successful physical therapy? Please discuss how
this can happen.
A: There are certainly cases where patients
reduce (and occasionally eliminate) the amount
of pain or anti-inflammatory medication they
need after successful physical therapy. Routinely
patients may prolong the time before experiencing
the need to have a joint replacement and of equal
importance is that they are in an improved state of
health and function if they do undergo surgery.
Q: What are the advantages of treating arthritis
pain with physical therapy as opposed to pain
killing medication or surgery?
A: Treatment management is often done
in conjunction (i.e. physician prescribing anti-
inflammatory along with pain relieving medication
while having PT intervention). The benefit of
appropriate medication use enables a patient to be
more comfortable performing PT and promotes an
improved recovery of symptoms while benefitting
from the PT intervention. Medication is meant
to be utilized as a tool to manage the symptoms
of arthritis, not a treatment cure. Surgery is a
corrective measure to replace and restore a
severely arthritic joint (arthroplasty or osteotomy)
that usually is a fi nal decision when the arthritis has
advanced to the point of unrelenting pain and/or
limitation of function and traditional methods are
unsuccessful. PT is still closely involved as once
a patient has surgery, therapy becomes integral in
Q: Is physical therapy usually covered by
A: Physical therapy services are generally
covered by most insurance though certain
private insurance companies may limit the annual
number of sessions or amount that will be
covered. Insurance companies may require a preauthorization
to begin therapy and there may be
office co-payments required. Auburn Community
Hospital Physical Therapy has contracts with most
insurance groups. It is always suggested to verify
your individual coverage prior to receiving any care.
Q: What advice would you give someone
who is experiencing arthritis pain and who is
considering physical therapy?
A: I recommend they include seeing their primary
care provider (MD, PA, and/or NP) to address
medically related aspects of care for their arthritis
pain while also going to a physical therapist as
soon as able to address existing symptoms and
reduce future problems. The longer someone
waits, the greater the risk of worsening pain and
impact of being limited in functionally doing what
they would like to do. Help is readily available with
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