DJD, or degenerative joint disease, affects over 20 million Americans and is caused by osteoarthritis, other diseases and trauma. If affects about half the adults over 65 year old and is the leading cause of chronic disability in the United States, according to the website MSGuidelines. DJD can affect all joints, but is most prevalent in the knee and hands.
Considerations
DJD of the knee caused by osteoarthritis begins as painless changes occur inside your knee joint. The components of your knee joint including cartilage, collagen and other substances, which begin to erode. As this occurs, debris particles irritate the joint lining called the synovium. This causes stiffness, inflammation and swelling, which results in pain. DJD can be caused by osteoarthritis, rheumatoid arthritis and a number of other inflammatory processes, but the results are similar. Your knees swell, you are in pain and you have difficulty walking. The treatment for the process includes physical therapy.
Exercise Guidelines
Your health care provider will follow treatment guidelines that help to make a diagnosis.They will also recommend physical therapy as part of your treatment. The goal of physical therapy in managing DJD is focused on keeping your knee cartilage as healthy as possible, maintaining or improving the range of motion of your knee joint and strengthening your tendons and muscles. This action allows them to help absorb some of the stress put on your knee joint. Your physical therapist will work with your doctor in creating a treatment plan that may include isotonic, isokinetic and isometric exercises in addition to postural and stretching exercises. Specific exercises may include range of motion, both active and passive, progressive walking and quad sets.
Modality Guidelines
In addition to exercise, your physical therapist may use different modalities to help improve and manage your symptoms. Modalities can help reduce pain and improve knee joint function. For treatment of DJD, your physical therapist may use heat or cold treatments, massage and ultrasound. Your therapist will determine how often you need to perform your exercises and undergo application of modalities based on your specific health needs and concomitant conditions.
Education Guidelines
According to treatment guidelines created by the Institute of Clinical Systems Improvement, your physical therapist should also take part in educational tasks. These include a discussion of basic techniques including the use of ice, compression, elevation and rest of the affected knee. Instruction should also include warnings to avoid prolonged standing, kneeling, squatting and stair climbing. Finally, extra body weight puts even more stress on your knees. If you are overweight, your physical therapist will likely suggest weight loss as part of the educational outreach activities.
Payer Guidelines
Third party payers have specific treatment and reimbursement guidelines they create for use by their member physical therapists, other health care providers and their beneficiaries. If you have health insurance, be sure to call member services to learn about your payer's physical therapy guidelines. Usually, you will be allowed a set number of visits with the physical therapist over a given amount of time. The guidelines will also include the type of services eligible for reimbursement. Because payer guidelines differ, it is to your benefit to become familiar with yours if you will be involved in physical therapy activities.
