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Joint Protection In Lupus

(Download   Joint_Protection_in_Lupus.pdf)

Joint protection methods are designed to help you perform your daily activities with a minimum amount of stress to the involved joints in order to reduce pain, preserve joint structure, and conserve physical energy. By incorporating special methods of grasping, pinching, lifting, carrying, and transferring into your daily activities, you can help to prevent future deformities from occurring thus preserving an optimum in physical and functional status.

General Principles in Joint Protection

1. Respect for pain.
2. Balance between rest and work.
3. Maintenance of muscle strength and joint range of motion.
4. Reduction of effort to do a job.
5. Avoid positions of deformity.
6. Use the strongest joint to do the job.
7. Use each joint in its most stable and efficient manner.
8. Avoid holding or staying in one position for prolonged periods of time.
9. Avoid activities which cannot be stopped immediately if they become too stressful.

The following outline contains suggestions that will assist you in dealing with your arthritis more effectively:

When one or more joints are swollen - Rest

1. Curtail daily activity and household chores.
2. Exercise within a pain-free range without resistance (gentle active range of motion).
3. Wear prescribed splints to rest joints.
4. Use adaptive equipment to decrease stress on affected joints.

When joints feel better:

1. Slowly resume daily activity and chores. Avoid heavy chores initially.
2. Resume exercise program, begin with active range of motion exercises as prescribed to you slowly and as tolerated.
3. Try to do some of your normal activities without your adaptive equipment.

Respect pain during exercise and routine activities:

1. Exercise only to the point of discomfort.
2. You have exercised too much if you have joint pain that lasts for two or more hours. Next time do a little less.

Take rest periods. Rest periods help you to:

1. Restore processes in the body needed to combat your systemic disease.
2. Improve your overall endurance for activity.
3. Enhance the endurance of specific muscle groups.

Therefore:

1. Plan your day to include rest periods.
2. Lie down in bed when you take a rest.
3. Many short intermittent rest periods may be more beneficial to you than a 2-3 hour nap.
4. Proning helps to keep knees and hips straight.

Posture:

1. Avoid static standing and sitting. Stand up and change positions every 20 minutes and stretch if you have been sitting for a long period.
2. Remember good posture. 
   Standing:             Stand straight, head high, shoulders straight, stomach in, hips and knees straight.
   
   Walking:              Walk erect as in standing posture: keep hips and knees straight, let arms swing easily at sides, so not sag or shuffle.
   
   Sitting:                 Use straight back armchair with firm seat, sit with head up, shoulders straight, stomach in, keep feet flat on floor.
   
   In bed:                   Lie straight, flat on back, keep knees and hips straight, arms and hands straightened at sides, use a firm mattress. If you need a pillow under head, use a small one. Never put a pillow under your knees.
   
   Rising to a Standing Position:   Slide forward to edge of chair, lean forward (rock if necessary), straighten hips and knees at the same time and stand (if unable - push up with your palms, not your fingers).
3. Avoid positions of deformity ie. Sleeping with pillows under your knees; assuming "hands on stomach" position while sleeping or sitting; sitting for a long period of time with hands over the arm rests and wrists in a bent position.

Use your larger joints for the job to avoid stress on smaller joints:

1. Carry your purse at your elbow, not in your fingers or use a shoulder bag.
2. Use a wall or electric can opener, not the kind that requires you to use your fingers to twist/turn.
3. Squeeze a sponge by pressing it against the side or bottom of the sink instead of wringing it out.
4. When reading a book, use a book holder or palm of your hands instead of holding book with your fingers. Position it at eye level to prevent your neck from getting stiff.

Reprinted with thanks to the Greater Los Angeles Chapter LFA and Arthritis Association of the South Bay - USA.

Reviewed by:                     Sister Rachel Robinson, August 1994
Reviewed by:                     Sue Barwick - Registered Nurse, July 2002