Musculoskeletal Disorders and Arthritis

Musculoskeletal disorders, including the various forms of arthritis, are a leading cause of pain and activity limitation and a frequent reason people seek occupational therapy. By affecting joints, muscles, tendons, and bones, these conditions can make grasping, lifting, and many everyday tasks painful or difficult, and occupational therapy works to preserve and adapt occupational performance.

Definition

Arthritis denotes inflammation of one or more joints producing pain, stiffness, and reduced movement; in occupational therapy it stands as the prototypical musculoskeletal disorder whose impact on hand function and daily activities is addressed through occupation-focused assessment and intervention.

Scope

This topic introduces the musculoskeletal conditions seen in occupational therapy, with arthritis as the central example, alongside hand and upper-limb disorders and work-related musculoskeletal problems. It covers how joint disease and other musculoskeletal impairments translate into difficulties with daily occupations and the occupational therapy approaches of joint protection, adaptation, and hand therapy. It is a reference overview and offers no individualized treatment plan.

Core questions

• How do arthritis and other musculoskeletal disorders limit participation in everyday occupations?
• What roles do joint protection, energy conservation, splinting, and assistive devices play in occupational therapy for these conditions?
• How does occupational therapy fit within the broader medical management of inflammatory and degenerative joint disease?

Key concepts

• Inflammatory versus degenerative arthritis
• Joint protection and energy conservation
• Hand and upper-limb function
• Splinting and orthoses
• Assistive technology and adaptive equipment
• Work-related musculoskeletal disorders

Mechanisms

In inflammatory arthritis such as rheumatoid arthritis, immune-mediated synovial inflammation damages joints and surrounding tissue, producing pain, swelling, deformity, and loss of range and grip; degenerative disease such as osteoarthritis involves cartilage loss and mechanical joint change (McInnes & Schett, 2011; Smolen et al., 2016). Occupational therapy addresses the resulting limitations by retraining and adapting tasks, protecting vulnerable joints, conserving energy, and providing orthoses and assistive devices so that valued occupations remain feasible.

Clinical relevance

Occupational therapy contributes to the multidisciplinary management of arthritis and other musculoskeletal disorders, focusing on function, hand use, and participation rather than on pharmacological control of disease. This entry describes that role generically; it is a reference resource and not a basis for individual diagnostic or treatment decisions.

Epidemiology

Arthritis is among the most common musculoskeletal causes of pain and disability; rheumatoid arthritis affects roughly half a percent to one percent of adults in many populations, and osteoarthritis becomes increasingly common with age, together making musculoskeletal disorders a major driver of activity limitation (Smolen et al., 2016).

Evidence & guidelines

Medical management of inflammatory arthritis is guided by recommendations such as the EULAR recommendations for rheumatoid arthritis (Smolen et al., 2020), within which rehabilitation and occupational therapy support function and self-management. Occupational therapy practice for these conditions is organized within standard texts (Schell & Gillen, 2019) and emphasizes joint protection, adaptive strategies, and hand therapy.

History

Occupational therapy for arthritis developed alongside twentieth-century rehabilitation and rheumatology, with established traditions of joint protection education and splinting; as disease-modifying drug therapy transformed inflammatory arthritis outcomes, the occupational therapy emphasis broadened toward function, self-management, and participation (Smolen et al., 2016; Schell & Gillen, 2019).

Seminal works

• smolen-2016
• mcinnes-2011

Frequently asked questions

What is the difference between inflammatory and degenerative arthritis in this context?

Inflammatory arthritis such as rheumatoid arthritis is driven by immune-mediated joint inflammation, while degenerative arthritis such as osteoarthritis involves cartilage and mechanical joint changes; both limit daily occupations, which is what occupational therapy addresses.

Does occupational therapy treat the arthritis itself?

No. Medical treatment manages the disease; occupational therapy focuses on protecting joints, adapting tasks, and maintaining hand function and participation in everyday activities.