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. Your therapist should focus on strategies to help you manage fatigue so you can participate in the activities you need or love to do, he adds.
Called the four Ps, these rules include:
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.
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.
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.
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, a physical therapist at Cora Physical Therapy in Knoxville, Tennessee.
Here are Seahorn’s tips for exercising with psoriatic arthritis.
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.
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 much to perform 10 reps, then decrease the weight,” Seahorn says.
Begin with a goal of two sets, and 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, and only if you can do more than 10 reps easily.
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, foot-pounding exercises may be painful. For this reason, Seahorn usually recommends “closed-chain exercises,” such as the elliptical machine or the stationary bike. “Any exercise where your foot doesn’t leave the surface is a closed-chain exercise,” he says. These exercises 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,” Seahorn says.
Above all, “listen to your body,” he adds. “If you have significant pain during an activity, then 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 back off the intensity or duration.”
If psoriatic arthritis is interfering with your ability to do everyday tasks, know that there are specialists who can help. Talk to your doctor to see if working with a physical or occupational therapist is right for you.