Occupational Therapy Can Benefit Rheumatology Patients

Imagine you have a rheumatoid arthritis (RA) patient who’s struggling with her regular activities. It takes her seemingly forever to get ready in the morning because of her painful, swollen joints. She finds it hard to cook because she can’t grip pots, pans or milk gallons like she did before. She doesn’t want to socialize much, because she feels flustered managing her difficult daily routine.

For patients like this and others who face challenges due to their rheumatologic condition, occupational therapy (OT) may be just the help they need.

“Occupational therapists are key players in arthritis management,” says Theodore Fields, MD, director, Rheumatology Faculty Practice Plan, Hospital for Special Surgery, New York. Dr. Fields commonly refers patients with hand, wrist and elbow problems to OT. He finds that patients better manage their condition and activities of daily living with help from occupational therapists.

Occupational therapists can be part of a team of allied health professionals working with rheumatology patients, depending on the patient’s particular challenges, motivation and insurance. In addition to occupational therapists, other parts of the allied health mix can include physical therapists, chiropractors, massage therapists and acupuncturists, says rheumatologist Elyse Rubenstein, MD, Providence Saint John’s Health Center, Santa Monica, Calif.

Although occupational therapists may step in most often to treat patients with arthritic conditions, they treat other rheumatologic conditions as well, including scleroderma, psoriatic arthritis and ankylosing spondylitis, says occupational therapist Jane W. McCabe, MS, OTR/L, CAPS, Laguna Hills, Calif. Occupational therapy also may be part of postoperative care for certain kinds of joint-related surgery.

What Happens in OT

Just what is it that occupational therapists do with patients who have rheumatologic conditions?

First, there’s a little bit of education that takes place. “Someone recently said to me, ‘I don’t work anymore, why do I need you?’ I had to chuckle,” says occupational therapist Elsa Perniciaro, OT, Los Robles Hospital, Thousand Oaks, Calif.

Another misconception some patients have is that occupational therapists will help get their joints working like they did previously. “We’re not going to do that,” says Perniciaro.

What therapists actually do is educate patients on how to reduce joint strain—frequently referred to as joint protection, says Petros Efthimiou, MD, FACR, associate chief of rheumatology, New York Methodist Hospital, and associate professor of clinical medicine and rheumatology, Weill Medical College of Cornell University, New York. “Additionally, occupational therapists can help the patient analyze their daily activities, rethink the way they do things, position their bodies and achieve the right balance between rest and activity,” he says. “Therapists can also provide splints, either custom or ready made, to support affected joints.”