Pain & joint rheumatism - When movement causes anxiety
Pain & joint rheumatism - When movement causes anxiety
A blog article for therapists who want to understand chronic inflammatory processes holistically
By Florian Hockenholz, physiotherapist, osteopath & yoga teacher
Rheumatoid arthritis - usually referred to medically as rheumatoid arthritis - is more than "just" an inflammation of the joints. It is an autoimmune disease that affects the entire system: metabolism, immune system, psyche and attitude to life.
The pain is omnipresent: stiff in the morning, pulling during the day, throbbing at night. It wanders, flares up, calms down again - and over time leaves behind not only physical but also emotional traces.
Silent inflammation - a loud pain
Rheumatoid arthritis is a chronic inflammatory systemic disease. The immune system mistakenly targets the body's own tissue, especially the synovial membrane. This leads to inflammation, joint effusions, swelling - and in the long term to changes in the joint structure.
But even in seemingly "calm" phases, a pain often remains that is difficult to categorize: sometimes dull, sometimes pulling, sometimes burning. This is partly due to central sensitization processes - the nervous system has learned to "transmit" the pain permanently, even when the inflammation has passed.
Therapeutic challenge: Activate - but how?
Many patients with rheumatism develop a fear of movement: they are too worried about triggering a flare-up or further damaging the joint. The result is rest - which often leads to even more pain, instability and exhaustion.
This is our task as therapists:
Individually dosed activation instead of blanket exercises
Targeted mobilization - in the safe, non-provocative area
Training in joint protection, body awareness and everyday economy
Understanding pain mechanisms - without trivializing or dramatizing them
Education on anti-inflammatory self-care and lifestyle factors
Rheumatism is more than just an orthopaedic problem
Rheumatism also affects sleep, the psyche, the intestines, the immune system and the vegetative balance. Many sufferers struggle with constant exhaustion, depressive moods and a diffuse sensitivity to stimuli.
That's why it takes more than a splint or an exercise sheet. It needs a holistic view - and a nervous system that can feel safe.
What works?
Mindful movement with clear joint guidance and variable load
Fascia and breathing work to promote vegetative regulation
Touch-based therapies that provide safety and pain relief
Education that explains connections and strengthens self-efficacy
Conclusion:
Therapy for rheumatoid arthritis does not mean exercising "despite the pain" - but working with the pain. Attentive, respectful, stabilizing. In this way, movement becomes something that strengthens again - and does not frighten.
📅 Webinar tip:
The possibilities and limitations of physiotherapy and occupational therapy for joint diseases.
Register now: www.hockenholz.com/webinare