Physical and occupational therapists are two types of specialists who can help strengthen the muscles around affected joints, increase flexibility and range of motion, and protect joints from further damage. A 2021 review found that physical activity improved psoriatic arthritis symptoms, specifically pain and fatigue. A skilled physical or occupational therapist can assess your abilities and find ways to make moving easier for you at home and at work. A physical or occupational therapy program is tailored to your specific needs, strengths, and weaknesses and is based on which joints are affected. For instance, some people with psoriatic arthritis experience pain in their knees, while others feel it more in their hands; meanwhile, others may experience more joint inflammation in the spine. The first step is a full evaluation by a qualified occupational or physical therapist, says Casimiro “Casey” Degliuomini, OTR/L, an occupational therapist at the Hospital for Special Surgery in New York City. These types of specialists can assess your needs and structure the most effective approach for you.
How Occupational Therapy Can Help Psoriatic Arthritis
For starters, occupational therapy for psoriatic arthritis typically follows four simple rules for energy conservation, since fatigue is a common limiting factor, according to Degliuomini. Called the four Ps, these rules include:
Positioning
Sometimes simple position changes around the house or office can make a big difference in psoriatic arthritis symptoms, Degliuomini says. Rearranging the positioning of commonly used items throughout your home can help limit unnecessary movements that may exacerbate symptoms, he notes.
Prioritizing, pacing, and planning
This means taking a look at what you have to do each day and developing a strategy that works best. If your joint pain and stiffness are worse in the morning, for example, it may make sense to schedule strenuous activities later in the day. “An occupational therapist can work with you to determine what your needs are day to day and develop a strategy to prioritize and space out tasks in a way that will allow you to get things done while avoiding overstressing your joints and limiting fatigue,” Degliuomini says.
Making Tasks Easier
Your occupational therapist can also recommend exercises designed to boost flexibility and increase energy, which Degliuomini says can help make all of your tasks easier to perform. Your therapist will take into account your body’s specific needs to ensure any activities are not too strenuous on your joints, so you can reap the maximum benefit without overdoing it. An occupational therapist can also suggest adaptive tools to help you better perform the activities of daily living, maintain independence, and achieve a better overall quality of life while helping protect inflamed and painful joints. There are more innovative tools available today than ever before to help people with psoriatic arthritis live better. For example, if you have trouble with a tight grasp, you could use tools with a special handle, and padding could be added to items around the house to make them easier to grab, Degliuomini notes.
The Benefits of Physical Therapy for Psoriatic Arthritis
A physical therapist has some of the same goals as an occupational therapist when treating someone with psoriatic arthritis, the National Psoriasis Foundation (NPF) says. “The main goal for physical therapy for those with psoriatic arthritis is to maintain flexibility and range of motion, and this usually starts with a regular exercise program that includes strength training, stretching, and some aerobic activity,” says Robb Seahorn, PT, CSCS, a physical therapist and certified strength and conditioning specialist at Cora Physical Therapy in Knoxville, Tennessee. Here are Seahorn’s tips for exercising with psoriatic arthritis.
Warm up and cool down
Warming up and cooling down are especially important for people with joint pain, because these movements prepare the body for activity, he says. Your warm-up and cooldown can be an easier form of the exercise itself or some light range-of-motion movements and stretches, he suggests.
Incorporate strength training
For strengthening, using lighter weights and doing more repetitions is the way to build up the muscles around the joints. Focus on good technique — quality over quantity — Seahorn advises. Make sure all movements are slow and controlled and try to perform at least 10 repetitions of any strengthening exercise. “If the weight is too heavy to perform 10 reps, then decrease the weight,” Seahorn says. Begin with a goal of two sets, then increase the number of sets gradually. Increase resistance gradually as well, adding no more than 10 percent to the weight per week, he says — only if you can do more than 10 reps easily.
Add aerobic exercise
Also known as cardio, this type of exercise can help you get and keep your weight down, which reduces pressure on inflamed joints. One caveat: Certain weight-bearing, high-volume, foot-pounding exercises may be painful. For this reason, Seahorn usually recommends gravity-reducing “closed-chain exercises,” such as the elliptical machine or the stationary bike, or gravity-reducing treadmills. “Any exercise where your foot doesn’t leave the surface is a closed-chain exercise,” he says. These exercises build strength and endurance but won’t harm your joints from harsh impact. “For people with severe joint pain, water-based exercises may be more appropriate, because water takes pressure off the joints. This could be traditional swimming or water-aerobic activities,” Seahorn says. Above all, “listen to your body,” he adds. “If you have significant pain during an activity, stop and find an alternative exercise that’s less painful. If you have pain for multiple days after exercise, you may have overdone it, so you may need to scale back the intensity or duration.”
When to Seek Physical or Occupational Therapy
If psoriatic arthritis is interfering with your ability to do everyday tasks, these specialists can help. Talk to your doctor to see if working with a physical or occupational therapist is right for you.
