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How can I speak openly with my physical therapist?

I've had RA since 1979, and it's been in sort of a remission. I take Xeljanz daily and Naproxen when needed. I do have a lot of deformity in all my fingers and knuckles of both hands. I've been taking physical therapy for over a year dealing with back pain due to herniated and bulging disks. My pt also does some hand therapy. Just recently she used the Jamar hand dynamometer which measures force in kg and lbs from 2kg to 5 lbs. I squeeze the instrument as hard as I can to measure strength. A couple hours later I noticed a severe flare on my left wrist which is the weaker hand and wrist. My question is I should have known better that this instrument is difficult for RA patients. How do I politely tell my physical therapist that this tool is not suitable for me? She knows I have RA but may not fully understand the consequences of the gripping causing pain and flares. Thank you so much for replies.

  1. Thanks for writing Janet. It is good that you are getting physical therapy, but sorry to hear one of the exercises led to a flare. You shouldn't worry about telling a physical therapist when any part of treatment is causing pain - a PT is there to help and a good PT will want to know. My wife, Kelly Mack (a contributor here), was diagnosed at two and has used a wheelchair since her late teens. She has used PT extensively throughout her life, including re-learning how to walk several times. PT can make a huge positive difference and in this article she writes about the benefits of going back to PT for refresher treatment, even with extensive RA damage: My point is that working with, including straight-forward communication with, a PT should always be geared towards the greatest benefit to you - the patient. Wishing you the best. Richard ( Team)

    1. Thank you so much Richard for your response and advice on how I can talk with my PT on one of the tools she used on me to measure grip and how it caused a flare with me squeezing too tight on it. I do definitely plan on talking with her the next pt session. I'm not sure why I was questioning myself on how to communicate, but now I realize this is very important as the pt should be geared towards my benefit.

      I read with great interest Your wife's story on returning to pt for refresher treatments. I am really inspired by Kelly's story and plan on responding. Thank you again.

      1. Your experience, unfortunately, is not unique. I have been to at least six different PT places in my thirty some od years of RA. Only the last place I found is what I would consider informed and caring about RA. The others were basically sports medicine in disguise. One PT put my elbow off the side of the table and pushed down on it so hard I saw colors and stars. I mean my sight actually turned different colors and stars started to pop off in my vision. He had no idea how to treat RA but he sure wore a ton of sweatbands. You have to find a PT who understands that RA isnt an injury, it’s a condition, and if you feel like the one you are using doesn’t understand that (which is totally possible) it may be time to find another. I’m sure some of our users here have suggestions for wherever you live. It might help to check out Facebook page too, Keep on keepin’ on, DPM

        1. Hi Daniel,
          Thank you for your response. That had to be so painful with the elbow exercise by that PT. I hope it was a lesson learned by the PT. You mentioned they need to think of RA as a condition, not an injury. That is so on spot as I think they are so used to treating injuries that they may think the same with RA>

          I hope you now have a good PT. Thank you for the FB link. This will be great to hear of others' experiences and for the support. I wish you the best.

      2. Hi Janet. Thanks for reaching out. Good for you for telling the PT what happened. Honest communication is the only way they learn. I myself had a poor experience, and I never returned to that PT. I also reported her to my MD. Since that time, I have been blessed with excellent therapists, because I have communicated. Keep doing what you are doing, and reach out here anytime. Encouraging hugs to you. Mary Sophia ( Team)

        1. Thank you Mary Sophia for your reply and support and for sharing your experience. I'm so glad you now have excellent therapists. I continue to have therapy at the same place, but have been working more closely with one of her Assistants who is more gentle and understanding of how RA affects a person. I am grateful i can com here to this community for support. Thank you again and hugs back to you.

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