To physio or not to physio

March 4, 2011 at 11:04 am | Posted in arthrits, rheumatoid arthritis, fibromyalgia, joint pai, Me, rheumatoid arthritis (RA) | 3 Comments
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Well … half-an-hour’s drive, ten minutes or so waiting, thirty minute consultation … and the answer turned out to be, for the moment anyway, not to physio! Aaaaaaargh! I’ve only waited since January for this appointment. Still, there were perfectly sound reasons not to physio – and at least I had a fun time in the waiting room reading old copies of National Geographic!

There was one small thing I hadn’t accounted for … I’ve just started a (very) short course of oral steroids for a very swollen knee, and the physio that works for me, or has always worked for me in the past, is ultrasound. Obviously the steroids are busy trying to reduce the inflammation, and equally obviously that is intention of most treatments including the ultrasound. Aye, but there’s the rub … (talking or rubs I must rub some of that nice ‘Nature’s Kiss’ ointment into my knee … I keep forgetting about that … but back to the main point), the way that ultrasound works (putting it simply, which is the only way I know!) is that it apparently INCREASES the inflammation quite rapidly in order to trigger the body to go ‘ooh, that’s inflamed’ and kick into place a process for doing something about it.

So … if I had ultrasound, my physio basically thought that I might well be either inadvertently cancelling some of the steroid effects or, at very least, wasting my time because the steroids might counteract the ultrasound without it being able to do anything.

Now the physio wasn’t at all sure about this, and neither am I, but we decided it was better not to risk it so I’ve got to go back again on Tuesday morning!

The more I think about it the more I’m not convinced by this whole argument … but I’m way too tired to work out why now, so I’m off to bed and I’ll give it some thought tomorrow!



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  1. Wow. I had no idea that ultrasound therapy increased inflammation in the affected joint. I’ve only experienced it once, when a chiropractor acquaintance tried it on my flared shoulder. Surprisingly, it relieved about 60 percent of the pain and improved my range of motion quite a lot. The flare stopped perhaps 6 hours later. I was impressed–and then I got the bill. Ouch. No more ultrasound treatment unless I could somehow get it covered by my medical insurance (which didn’t cover such treatments at the time).

    So, how ARE you right now? Is the short-course steroid working to ease your pain, Polly? And will you be able to resume physio sessions in the future without having to wait months? Hope so.

    Sending warm hugs and comfort your way, m’dear. Take care and keep up that wonderful sense of humor. You never fail to make me smile. 😀

  2. Yeah, I’ve found ultrasound really, really helpful in the past too – but I do tend to find that it makes it a bit worse before it gets better. (Not for long – just leaves me limping out to the car park with a slightly worried looking physio in my wake!) Thankfully I can get it on the NHS so no worries there – the NHS IS good sometimes!

    Also fortunately I have another physio appointment on Tuesday. The swelling has gone down in my knee, the stiffness is massively improved but now it HURTS!!!! Waah. And my friend Maggie’s coming down this weekend and hoping for some nice country walks. Umm …

  3. That is really disappointing when you are looking forward to an appointment and it doesn’t turn out as planned. I had no idea about the ultra sound. Hmmm….I did ask a gal to do massage on my knee once when it was inflammed and she said, “No.” She didn’t want to create any more inflammation than was already there. I do know when I have had other types of body treatments done, I am really sore for a day or two afterwards. I hope you feel better soon.

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