Exercise Therapy for Arthritis: Sometimes It Takes a Village

The article by Dr John Whyte and Mr Robert Marting, “Exercise Programs for Your Arthritis Patients: A Quick Guide” (CONSULTANT,  March 2005, page 341), was a very well-written, informative, and practical guide for physicians who treat patients with osteoarthritis or rheumatoid arthritis. I hope the article helps raise awareness of exercise as an effective and often overlooked treatment modality for arthritis. Primary care physicians may want to consider consulting a physiatrist to help with this aspect of management. Physiatrists, or physical medicine and rehabilitation physicians, are specifically trained to employ exercise programs in the management of various musculoskeletal conditions.1 There are several advantages to consulting with a physiatrist before referring a patient to a physical therapist. Specifically, a physiatrist can make a detailed physical therapy prescription, adjust the physical therapist’s orders, and perform subsequent long-term follow-up to monitor and upgrade a home exercise program. — Todd P. Stitik, MD Co-Director, Osteoarthritis and Interventional Spine Clinic Associate Professor of Physical Medicine & Rehabilitation New Jersey Medical School Newark REFERENCE: 1. Stitik TP, Yonclas P, Foye PM, Schoenherr L. Nonpharmacologic management of knee and hip osteoarthritis. J Musculoskel Med. 2005;22:61-70.   Dr Stitik’s suggestion to consider consultation with a physiatrist is excellent. Solid data demonstrate the effectiveness of exercise in patients with arthritis. If a physician feels illequipped to counsel patients about exercise, he or she should enlist the help of colleagues, such as physiatrists. In light of recent controversies about various analgesics, it is more important than ever to be aware of the effectiveness of exercise as both short- and long-term therapy. — John J. Whyte, MD, MPH Washington, DC