Physiotherapy is the prevention, treatment, rehabilitation and management of various disease conditions such as arthritis, through the use of physical approaches. In this interview with me, National Public Relations Officer of the Nigerian Physiotherapy Association, Mr. Chris Okafor, who is also a lecturer at the Physiotherapy Department, College of Medicine, University of Lagos, gives more insight about arthritis, a form of joint disorder that involves inflammation of one or more joints and how Nigerians could make healthier life choices. Excerpts:
Over the years, there have been several myths about arthritis, but as an expert in managing this condition, what would you say is the actual cause?
There are several causes of arthritis just as we have over 100 different forms of arthritis. The major complaint by individuals who have arthritis is joint pain. Pain is often a constant and may be localized to the joint affected. The pain from arthritis is due to inflammation that occurs around the joint, damage to the joint from disease, daily wear and tear of joint, muscle strains caused by forceful movements against stiff painful joints and fatigue. There are over 100 different forms of arthritis. The most common form, osteoarthritis – that is degenerative joint disease, is a result of trauma to the joint, infection of the joint, or age. Other arthritis forms are rheumatoid arthritis, psoriatic arthritis, and related autoimmune diseases. Septic arthritis is caused by joint infection. As someone is getting older, he could have conditions such as arthritis which has to do with degenerative changes in a joint. This is when a joint has been used for so many years; it naturally will begin to degenerate. Like we have spare parts for a machine or generator; the more you use the generator, the more the need to change some parts, so also the human body has spare parts. But unfortunately, in this part of the world, when the hand is getting weak, the shoulder joint is beginning to make some sound, it is not easy to just go and replace the joint and that is when arthritis has set in.
What are the symptoms that indicate an individual as having arthritis?
It would come with pains, swellings, joint crepitation that is hearing some funny sound when you move the joint. Such a person might not be able to climb the stairs, walk as fast as he should. Though there are several types of arthritis as mentioned earlier, the main thing that happens in them is that there is a change in the chemical constitution of the substances in the joints. When this happens, sufferers could have swellings of the joint, and it is because the substances which make up the joints are fighting against themselves, and is one of the things that can cause arthritis especially in younger ones.
Could lifestyle also be a source of arthritis in younger or older persons?
Yes, it could be but rheumatoid arthritis which is found mainly in younger people has a lot of genetic inputs. If it runs in a family, there is the tendency that a child might pick it up. It might be from the father, mother, grandfather and so on.
But what about sedentary lifestyle?
Oh yes! Sedentary lifestyle is an important thing to note. It is one of the major causes of arthritis. When an individual is living a sedentary lifestyle, you go to the office and sit at one place for eight to ten hours, then the driver takes you to your home, you sleep and don’t do any form of exercise, these are the kind of things that can cause arthritis.
What about young people who drink a lot of cold drinks, are they susceptible to developing this condition?
It is important to stress that cold does not cause arthritis but is an aggravating factor that could bring up arthritis. For instance, someone who already has tendencies to have arthritis should avoid staying in the cold. It’s not that the cold would cause the arthritis but would spring up the arthritis pains because cold and pains don’t go together. Thus, such a person is not supposed to expose himself to cold. If exposed to cold, then he or she is likely going to have increased pains. Cold does not cause arthritis but can aggravate the symptoms and pains of arthritis.
What about osteoarthritis?
It is the arthritis that affects the aging population because of the over uses of body parts- the joints, due to what they have done over the years. That is the one I was describing that physiotherapy treatment is very imperative to. It is not easy to change the parts even though surgery could be used at times. But basically, what is needed is rehabilitation. That is trying to treat a joint, manage the joint to restore it back to as much maximal physical function.
For how long does the rehabilitation or treatment last?
The treatment is continuous. The important part is that there are some dos and don’ts that the individual must adhere to. If the arthritis is as a result of overweight for instance, or runs in the family, one need to know what must have caused it thus the health personnel needs to explain to the person what could have led to the condition. For instance, if the individual’s arthritis was caused by sedentary lifestyle, he or she would then be advised to do a lot of exercises such as walking and this could be within his or her environment or undergoing physiotherapy exercises by going to physiotherapy clinics and enrolling in exercise programmes. So, if the individual understands what he should do, such as if he is supposed to shed his weight, if he is able to work on that, within a timeframe all will be well with him. But it is not something that can be achieved within a week or two, it takes time.
What is the minimum time frame for the positive changes to start occurring?
There is no minimum time frame. First, it depends on the physiotherapist that is attending to the individual, the extent of the arthritis, and a lot also depends on the patient himself because the extent which he complies to instructions will determine how fast he will become okay. For instance, if I tell him, do this exercise three times a week and I am not there with him and he does it only once a week, he should not expect to have the same result as someone who sticks religiously to whatever instructions he is given. Hence, the patient is the major determinant of how fast he can recover from the arthritis.
In the medical field, self medication is never encouraged. Can anybody join a physiotherapy class or must it be prescribed as well?
Yes, it must be prescribed. The problem is that in our society, just anybody can wake up and decide to do anything. For instance, someone can just decide all of a sudden that he wants to burn his fat and just go on the field to start jogging and doing all sorts of exercises. The person wouldn’t have even done a test to check his blood pressure level, heart rate, complete check up to know if he is able and fit to even do the exercises . In a normal working system, before anyone goes in for any form of exercise, he must be assessed by a physiotherapist, and a cardiologist, to know the state of the heart andto know the actual type of exercises to be done. There is a formula to calculate what type of exercise to prescribe.
Yes, because a man who is 70 years old cannot do the same exercise as a man who is 30. Also, a young man who is 20 years and who is an athlete cannot be subjected to the same exercise as an elderly man who is probably a grand or great-grandfather! But you find out that a lot of people go to gyms and the same exercises that a young man is doing is recommended to a man who is suffering from high blood pressure and possibly diabetes. It is not possible! And that is why you see a lot of people go to the field wanting to play football or take part in a race and they slum. Unfortunately, this incidence is increasing in Nigeria and it is becoming a great source of worry to those of us in this field.