What is Lupus?
Lupus is a condition in which your immune system produces autoantibodies that attack your body’s own cells, tissues and organs. This can cause inflammation in many different parts of your body, though most people will only have a few of the possible symptoms. It is not yet known why the immune system produces these harmful autoantibodies.
Types of Lupus
There are two main types of Lupus:
Systemic Lupus Erythematosus (SLE). This is a more severe form of the condition that can affect many parts of the body, including the skin, joints and internal organs. It is also the most common form of Lupus.
Lupus Limited to the Skin. There are 3 types:
- Discoid lupus erythematosus (DLE).
- Subacute cutaneous lupus erythematosus (SCLE).
- Chronic Cutaneous Lupus Erythematosus (CCLE).
There are also additional specialised forms of Lupus that include drug-induced, neonatal and childhood forms.
What are the Symptoms of Lupus?
Symptoms of lupus can include:
- joint pain
- a skin rash
- extreme tiredness
- weight loss
- mouth ulcers
- hair loss
- swelling of lymph glands
- your fingers or toes changing colour in cold conditions
The number and severity of symptoms range greatly from person to person. Many people will have long periods with few or no symptoms before experiencing a sudden flare-up, where their symptoms are particularly severe. All cases of Lupus can be distressing and can have a considerable impact on a person’s quality of life.
Some medications can also cause lupus-like side effects. Therefore, if you think you have symptoms of lupus, you must discuss this with your GP.
How Is Lupus Diagnosed?
Doctors will diagnose Lupus based on the history of your illness, a physical examination and blood tests. Your doctor may also refer you to a skin specialist or a Rheumatology specialist to help with diagnosis and decide the most effective way to manage the symptoms.
Depending on which organs your doctor or specialist thinks may be affected, you may also have urine tests, X-rays, an ultrasound scan, a computerised tomography (CT) scan or a magnetic resonance imaging (MRI) scan to investigate further.
Blood test results help to distinguish lupus from other conditions that may have similar symptoms. Your doctor may use the following blood tests to help with diagnosis:
- Anti-nuclear antibody (ANA) test About 95% of people with lupus are ANA positive,
- Anti-double-stranded DNA (anti-dsDNA) antibody About 70% of people with lupus have these antibodies.
- Anti-Ro antibody test
- Antiphospholipid antibody test
- Complement level test
- Erythrocyte sedimentation rate (ESR) test
- Kidney and liver function tests
- Blood cell counts
These tests may also be taken regularly to monitor the systems affected by Lupus and determine the most appropriate treatments.
Lupus and Pregnancy
Women and their doctors are understandably cautious about being on certain drugs during pregnancy. This is because your treatments may need to be altered. Women with lupus should have a baby if they want to, but it’s best to discuss your plans with your doctors before trying for a baby.
It is best to plan your pregnancy when your lupus is inactive, and you’re taking as little medication as possible.
The management of Lupus focuses on medication, managing each presenting symptom. This means treatment can vary between individuals. Maintaining a healthy lifestyle is a vitally important aspect in helping manage the condition. Smoking, having a poor diet and being sedentary can worsen the symptoms of Lupus.
The drugs used to treat Lupus depends on the severity of the condition, and which parts of the body are affected. Treatments are often changed or adjusted as symptoms flare-up up or improve.
Non-steroidal anti-inflammatory drugs (e.g. naproxen, ibuprofen)
- reduce inflammation
- help with symptoms in your joints
- useful for skin rashes.
Steroid tablets (e.g. prednisolone)
- used for short periods for complications such as pleurisy or pericarditis
- also used for kidney inflammation or severe blood problems
Antimalarials (e.g. hydroxychloroquine)
- reduce inflammation
- used alone or with steroid creams for skin rashes
Disease-modifying anti-rheumatic drugs (DMARDs) (e.g. azathioprine, ciclosporin, methotrexate)
- used to suppress your overactive immune system
- Commonly used for long periods, and you may reduce the dose if symptoms become less active
Biological therapies (rituximab)
- removes B-cells (a type of white blood cell that produces harmful autoantibodies)
- widely used when conventional DMARDS aren’t effective.
- can be injected into a muscle, joint or vein as an immediate treatment to help control a flare-up
- can also be injected into your scalp if hair loss is a problem
Several new biological therapies which target cells and molecules believed to be part of the cause of lupus are still undergoing clinical trials.
Managing Symptoms Effectively
- Having a good understanding of your symptoms and how your life has been affected by Lupus is vitally important. Also, having a good assessment of your painful areas can help reduce anxiety or concerns about an injury.
- Understanding your symptoms and pains’ complex nature and cycles can also help you address the impact Lupus has on your life.
- Physiotherapy can help with both these aspects of understanding Lupus.
Fatigue is a prevalent symptom of Lupus. It can fluctuate greatly, meaning that you can have good and bad days, which can be a major problem. Sometimes fatigue is caused by anaemia or an underactive thyroid gland. This can be identified by a blood test and treated. However, if there is no specific cause of your fatigue, it can be more difficult to deal with. Pacing activities and doing activity/ fatigue diaries can help manage the fluctuations in activity and assist a person in achieving their goals.
Staying Active and Exercising
Being active and exercising is an excellent way to help deal with the stresses of having Lupus and managing fatigue. Regular exercise also helps to improve eating and sleeping habits, which will lead to better general health and better mental health.
- Activities such as hydrotherapy, tai chi, pilates, yoga, walking, swimming or cycling can benefit people with fibromyalgia.
- Stretching and mobility exercises can help reduce pain and tightness.
- Specific exercises to help build strength and endurance in the ‘posture’ muscles of the body and take the load off achy muscles.
Relief of Muscle and Joint Stiffness, Tenderness and Pain
- Massage – can assist pain relief and help muscle relaxation.
- Acupuncture – can be helpful in the relief of your pain.
- Joint mobilisation – can improve muscle tightness, tenderness and joint stiffness.
People with Lupus often find getting regular restorative sleep difficult. Understanding sleep and its influence on health are important in helping people who have Lupus. Poor sleep health can affect:
- Mood – Sleep benefits our mood, memory and concentration
- Brain function – Sleep helps to organize memories and improve concentration.
- Emotion – Lack of sleep can make you irritable, affecting your emotions, social interaction, and decision making.
- Immune system – Without adequate sleep, the immune system becomes weak, and the body becomes more vulnerable to infection and disease.
- Nervous system – Sleep is a time of rest and repair to neurons. During sleep, neurons rest, replenish and grow.
- Hormones – substances produced to trigger or regulate particular body functions are timed to release during sleep or right before sleep.
Improving Your Ability to Cope with Daily Stress and Depression
Daily stresses from work or home can increase your Lupus symptoms. You and your physiotherapist can work with your GP to help you develop strategies to manage these stresses.
Referral to a psychologist can also help in developing strategies to cope with stressful situations.
Surgery is not used to treat lupus. However, if a doctor or specialist felt a problem that needed surgery influenced your lupus, surgery for that specific problem may be an option.
If you have any concerns or have some specific questions regarding your condition, please ask your physiotherapist or GP.
http://www.arthritisresearchuk.org/arthritis-information/conditions/lupus.aspx – Arthritis Research UK
http://www.lupus-sle.org/index.html – Lupus Foundation
General Arthritis Information
Rheumatoid Conditions – Overview
Osteoarthritis – Overview
- Hip Arthritis (Osteoarthritis)
- Knee Arthritis
- Ankle Arthritis
- Shoulder Arthritis
- Hand or Wrist Arthritis
What is the PhysioWorks Difference?
You'll be impressed with the experienced physiotherapists, massage therapists, allied health team and reception staff who represent PhysioWorks.
To ensure that we remain highly qualified, PhysioWorks is committed to participating in continuing education to provide optimal care.
If you've been searching for health practitioners with a serious interest in your rehabilitation or injury prevention program, our staff have either participated or are still participating in competitive sports at a representative level.
We also currently provide physiotherapy and massage services for numerous sports clubs. Our experience helps us understand what you need to do to safely and quickly return to your sporting field, home duties, or employment.
How You'll Benefit from the PhysioWorks Difference?
At PhysioWorks physiotherapy and massage clinics, we strive to offer our clients quick, effective and long-lasting results by providing high-quality treatment.
We aim to get you better quicker in a friendly and caring environment conducive to successful healing.
With many years of clinical experience, our friendly service and quality treatment is a benchmark not only in Brisbane but Australia-wide.
What are Some of the BIG Differences?
Our therapists pride themselves on keeping up to date with the latest research and treatment skills to ensure that they provide you with the most advantageous treatment methods. They are continually updating their knowledge via seminars, conferences, workshops, scientific journals etc.
Not only will you receive a detailed consultation, but we offer long-term solutions, not just quick fixes that, in reality, only last for a short time.
We attempt to treat the cause, not just the symptoms.
PhysioWorks clinics are modern thinking. Not only in their appearance but in the equipment we use and in our therapists' knowledge.
Our staff care about you! We are always willing to go that 'extra mile' to guarantee that we cater to our client's unique needs.
All in all, we feel that your chances of the correct diagnosis, the most effective treatment and the best outcomes are all the better at PhysioWorks.
What is Physiotherapy Treatment?
Physiotherapists help people affected by illness, injury or disability through exercise, manual joint therapy, soft tissue techniques, education and advice. Physiotherapists maintain physical health, allow patients to manage pain and prevent disease for people of all ages. Physiotherapists help encourage pain relief, injury recovery, enabling people to stay playing a sport, working or performing daily living activities while assisting them to remain functionally independent.
There is a multitude of different physiotherapy treatment approaches.
Acute & Sub-Acute Injury Management
Hands-On Physiotherapy Techniques
Your physiotherapist's training includes hands-on physiotherapy techniques such as:
- Joint Mobilisation (gentle joint gliding techniques)
- Joint Manipulation
- Physiotherapy Instrument Mobilisation (PIM)
- Minimal Energy Techniques (METs)
- Soft Tissue Techniques
Your physiotherapist has skilled training. Physiotherapy techniques have expanded over the past few decades. They have researched, upskilled and educated themselves in a spectrum of allied health skills. These skills include techniques shared with other healthcare practitioners. Professions include exercise physiologists, remedial massage therapists, osteopaths, acupuncturists, kinesiologists, chiropractors and occupational therapists, to name a few.
Your physiotherapist is a highly skilled professional who utilises strapping and taping techniques to prevent and assist injuries or pain relief and function.
Alternatively, your physiotherapist may recommend a supportive brace.
Acupuncture and Dry Needling
Many physiotherapists have acquired additional training in acupuncture and dry needling to assist pain relief and muscle function.
Physiotherapists have been trained in the use of exercise therapy to strengthen your muscles and improve your function. Physiotherapy exercises use evidence-based protocols where possible as an effective way that you can solve or prevent pain and injury. Your physiotherapist is highly skilled in prescribing the "best exercises" for you and the most appropriate "exercise dose" for you, depending on your rehabilitation status. Your physiotherapist will incorporate essential pilates, yoga and exercise physiology components to provide you with the best result. They may even use Real-Time Ultrasound Physiotherapy so that you can watch your muscles contract on a screen as you correctly retrain them.
- Muscle Stretching
- Core Exercises
- Strengthening Exercises
- Balance Exercises
- Proprioception Exercises
- Real-Time Ultrasound Physiotherapy
- Swiss Ball Exercises
Biomechanical assessment, observation and diagnostic skills are paramount to the best treatment. Your physiotherapist is a highly skilled health professional. They possess superb diagnostic skills to detect and ultimately avoid musculoskeletal and sports injuries. Poor technique or posture is one of the most common sources of a repeat injury.
Aquatic water exercises are an effective method to provide low bodyweight exercises.
Sports physio requires an extra level of knowledge and physiotherapy to assist injury recovery, prevent injury and improve performance. For the best advice, consult a Sports & Exercise Physiotherapist.
Women's Health Physiotherapy is a particular interest group of therapies.
Not only can your physiotherapist assist you in sport, but they can also help you at work. Ergonomics looks at the best postures and workstations set up for your body at work or home. Whether it be lifting technique improvement, education programs or workstation setups, your physiotherapist can help you.
Plus Much More
Your physiotherapist is a highly skilled body mechanic. A physiotherapist has particular interests in certain injuries or specific conditions. For advice regarding your problem, please get in touch with your PhysioWorks team.
General Arthritis InformationWhat is Arthritis?
Rheumatology ConditionsRheumatoid Conditions - Overview
Osteoarthritis ConditionsOsteoarthritis - Overview
- Hip Arthritis (Osteoarthritis)
- Knee Arthritis
- Ankle Arthritis
- Shoulder Arthritis
- Hand or Wrist Arthritis
Article by John Miller
What is Therapeutic Ultrasound?Therapeutic ultrasound is an electrotherapy modality that has been used by physiotherapists since the 1940s. Via an ultrasound probe through a transmission coupling gel in direct contact with your skin, ultrasound waves are applied. Therapeutic ultrasound may increase:
- healing rates
- tissue heating
- local blood flow
- tissue relaxation
- scar tissue breakdown.
How Could Ultrasound Help?Ultrasound increases local blood flow. This increase may help to reduce local swelling and promote soft tissue healing rates. A higher power density may soften scar tissue.
Specific Ultrasound UsesMastitis or blocked milk ducts successfully respond to therapeutic ultrasound. The effect is quite dramatic, with improvement within 24 to 72 hours. The most common conditions treated with ultrasound include soft tissue injuries such as muscle, ligament injuries or some tendinopathies. Phonophoresis uses ultrasound in a non-invasive way of administering medications to tissues below the skin. This method may assist patients who are uncomfortable with injections. With phonophoresis, the ultrasonic energy forces the drug through the skin.
What is an Ultrasound Dose?A typical ultrasound treatment will take from 3-10 minutes. Where scar tissue breakdown is the goal, this treatment time could be much longer. During the procedure, the head of the ultrasound probe is in constant motion. If kept in continuous motion, the patient should feel no discomfort at all. Some conditions treated with ultrasound include soft tissues injuries such as muscles or ligament injuries, tendinopathy, non-acute joint swelling and muscle spasm.
How Does an Ultrasound Work?A piezoelectric effect, caused by the vibration of crystals within the ultrasound head of the probe creates the sound waves. The ultrasound waves generated then pass through the skin cause a vibration of the local soft tissues. This repeated cavitation can cause deep heating locally though usually no sensation of heat will be felt by the patient. In situations where a heating effect is not desirable, an athermal application occurs. Athermal doses are typical during acute fresh injury and the associated acute inflammation.
When Should Ultrasound be Avoided?Contraindications of ultrasound include:
- local malignancy,
- over metal implants,
- local acute infection,
- vascular abnormalities,
- active epiphyseal regions (growth plates) in children,
- over the spinal cord in the area of a laminectomy,
- over the eyes, skull, or testes
- and, directly on the abdomen of pregnant women. Treatment ultrasound differs from diagnostic ultrasound!
What is Osteoarthritis?Osteoarthritis is one of the most common forms of arthritis, often referred to as degenerative arthritis. The joints show signs of wear: joint cartilage becomes thin, extra bony spurs grow in response to stress, and joint motion lessens. In advanced stages, osteoarthritis can be painful, functionally limiting and depressing.
What is the Osteoarthritis Cure?Unfortunately, there is no cure for osteoarthritis. But the good news is that there are some better ways to manage your osteoarthritis and slow the degeneration process. This improvement will result in making your life easier and more comfortable. Physiotherapy is a significant part of making your life living with osteoarthritis less painful, comfier and keeping you active. Research supports physiotherapy. Physio can reduce the pain and disability associated with arthritis, especially knee osteoarthritis. http://dx.doi.org/10.1136/bjsports-2016-096458 Seek the professional and helpful advice of your physiotherapist to start enjoying life again today!
Your Osteoarthritis DiagnosisX-rays are the most straightforward test to confirm osteoarthritis. An experienced practitioner will have an excellent idea of whether you have osteoarthritis when they examine you.
How Does Osteoarthritis Affect Older People?As you age, most people develop some degree of osteoarthritis. Our joints' wear and tear may occur due to ageing, injury, prolonged microtrauma, overuse of joints, or excess weight. Permanent bony changes occur and will exist even when there are no painful symptoms. Your degree of suffering varies. Whereas some people may be symptom-free others may suffer continuous disabling pain. The most common is mild or intermittent pain provoked by episodes of increased use or minor trauma. The joints most commonly affected are the weight-bearing joints: hip, knee, ankles, feet and spine. However, osteoarthritis can affect any joint in the body and is quite common in the hands and shoulders. Severe cases may require surgical treatment, but most will respond very well to your doctor's physiotherapy and medication.
Osteoarthritis SymptomsYou can suspect osteoarthritis if you experience one or more of the following symptoms:
- joint pain or tenderness that intermittently returns
- stiffness, particularly early morning stiffness
- joint swelling or deformity
- noticeable joint heat and redness
- joint movement is strenuous.