What is the possible prognosis?
In the past, rheumatological diseases were ignored and patients suffered from deformities and disability with many of them being wheel chair bound or bed-ridden. Also, the autoimmune diseases were often not diagnosed correctly with resultant damage to internal organs and also mortality. However, with appropriate expertise and care while utilising the best of currently available treatment modalities, we can effectively prevent the damage and improve patient’s quality of life and also prevent mortality.
What are the various methods of management?
- Modern science has effective treatment for arthritis and related conditions.
- Disease modifying drugs like Methotrexate control the arthritis very well and prevent deformities and damage. Drugs like Steroids, Azathiopurine prevent abnormal attack of immune system and can be organ and life saving.
- Biologics are highly effective drugs which are used in severe arthritis.
- Osteoporosis is best treated with Calcium, Vitamin D supplement and bone preserving and bone forming medications.
- Joint injections given in certain cases are effective in controlling arthritis
- Apart from medications, physiotherapy plays important role in maintain joint mobility and strengthening the muscles. Lifestyle modification, weight loss and activity modification are useful in degenerative joint disease.
What is the importance of screening?
- It is a well established fact that treatment for arthritis is most effective when started early. It is, therefore, essential to diagnose it in its initial stages. Consulting a rheumatologist at the earliest signs and symptoms helps in early diagnosis. Careful clinical examination, certain blood tests and x-rays are used to confirm the disease.
- Osteoporosis is a silent disease and needs evaluation of bone health with DEXA scan in the high risk group to prevent fractures.
What are the common signs and symptoms?
- Arthritis (which literally means inflammation of the joints) is characterised by pain swelling and limited movement of the joints along with stiffness which is worst in the morning for at least 30-60 minutes.
- Autoimmune diseases lead to fever, rashes, oral ulcers and muscle weakness. Various internal organ involved can cause breathlessness, decreased urine output and convulsions.
- Osteoporosis results in fractures at the spine, wrist and hip with minimal trauma.
Are you in the high risk group?
Though the exact cause of many arthritis and autoimmune diseases are unknown, there are specific risk factors.
- Age: Contrary to the popular belief that arthritis affects only elderly, it can affect any age group, including children. Young females in particular are at high risk for arthritis and autoimmune diseases. Post menopausal women are at increased risk of osteoporosis. Osteoarthritis is age related (> 50 yrs) degeneration of joints. Some arthritis affecting the spine is more common in young males.
- Family history of arthritis also increases the chances of developing arthritis.
- Calcium deficient diet, lack of exposure to sunlight, lack of exercises leads to Metabolic Bone Diseases.
- Certain infections, smoking, stress contribute to the risk of arthritis.
Why one needs to be aware?
Arthritis, if untreated, damages the joints leading to deformities and disability thereby restricting movements and functionality. Autoimmune diseases can irreversibly damage internal organs like kidney, lungs, brain and can be life threatening. Osteoporosis results in fractures with minimal injury and affects quality of life. The good part is that if treated timely, these diseases can be controlled effectively and damage can be prevented.
What are these diseases?
Rheumatic diseases can be classified in to the following groups:
- Arthritis which affects the joints and spine: Rheumatoid Arthritis, Ankylosing Spondylitis, Psoriatic arthritis, Osteoarthritis and Gout.
- Autoimmune Multisystem Diseases which affect the joints, skin, various internal organs of the body: SLE, Vasculitis, Myositis and Sarcoidosis.
- Metabolic Bone Diseases: Osteoporosis, Osteomalacia and Vitamin D deficiency.
- Soft Tissue Rheumatism: Myofascial Pain, Fibromyalgia, Tendinitis and Bursitis.
Who is a Rheumatologist?
A rheumatologist is a physician who is qualified, by additional training and experience in the diagnosis and treatment of arthritis and other diseases of the joints, muscles and bones. After four years of medical school and three years of training in internal medicine, rheumatologists devote additional two to three years in specialised rheumatology training.
Painful, stiff joints from rheumatoid arthritis need to rest most of the day!
Fact: With appropriate treatment patients can remain people mobile and could take up exercise and physical activity and retain their jobs.
Because treatments for rheumatoid arthritis are complex, it’s best to wait until the disease progresses before beginning treatment!
Fact:There is now abundant proof that treating rheumatoid arthritis early prevents joint damage and disability. Ideally, treatment should start as soon as possible after diagnosis. Delaying treatment can mean worse outcomes down the road.
Joints deformities cannot be prevented!
Fact:The joint deformities can be prevented if the treatment is optimised by the best use of medicines. This requires a lot of skill and experience which a qualified rheumatologist can provide.
Medicines used in the treatment of Rheumatoid arthritis are harmful!
Fact:Treatment of rheumatoid arthritis is complex and should always be supervised by a qualified rheumatologist. Used judiciously medicines will give desired benefit in rheumatoid arthritis and side effects can be minimal.
Rheumatoid arthritis is an incurable disease!
Fact: In the last 10 years the options to treat rheumatoid arthritis have expanded tremendously. With early diagnosis and systematic approach to treatment rheumatoid arthritis can be very effectively treated. In every stage of the disease use treatment can relieve pain and stiffness.
Myths and facts regarding Rheumatoid Arthritis
Rheumatoid arthritis is a disease where inflammation leads to pain, stiffness and if left untreated, destruction of the joints. Besides the joints it can also affect eyes, skin, bone marrow, lungs and heart. It is important that the diagnosis is established soon and the treatment started. Treatment is best supervised by a qualified rheumatologist to ensure that patient has the best treatment. Some unfounded myths regarding the rheumatoid arthritis and its treatment could prove detrimental to overall health.