Articles on rheumatoid arthritis

Rheumatoid Arthritis

Dr. N. C. Gupta, Orthopedist
Rheumatoid arthritis is an autoimmune disorder affecting the joints, symmetrically(usually). The joints become swollen, red, hot, painful & tender. The joint movement becomes limited due to pain & swelling It starts with inflammation of the synovial membrane but may involve the joint capsule and other surrounding soft tissues.It is a self limiting disease. But by the time it leaves, the patient is crippled due to contractures & deformities.Acute phase can be managed with medicines.                                     Commonly used medicines are Ibuprofen/Paracetamol/Aspirin in therapeutic doses. They help to control symptoms of pain and swelling of the joints in most of the cases by their anti inflammatory properties. Fever is also controlled.  Vitamins, minerals, anti oxidants & other supportive medicines are also needed. Omega 3 fatty acids have a very definite role to play in improving the response to the treatment.Physiotherapy helps in preventing contractures & deformities. The patient should do general exercises & keep active.He may have to be further investigatedIn established cases of Rheumatoid arthritis DMARD (disease modifying drugs) e.g. METHOTREXATE, HCQ, LEFLUNOMIDE, SAAZ etc. have to be used.They all are toxic drugs & can cause bone marrow depression along with other side-effects. They should be taken under medical supervision.Sometimes steroids may have to used.The dose of these medicines should be adjusted to the minimum required, to control the symptoms. Blood, urine Tests & other investigative procedures should be done periodically to rule out any side-effects. X rays of the affected part should be done to confirm diagnosis & assess the extent of damage.Diabetes, vitamin D deficiency or any other metabolic disorder should be ruled out. Sometimes they mimic the symptoms & create confusion in diagnosis. Associated disorders like these, most certainly affect recovery adversely.It should be ascertained that the patient is not allergic to any of the medicines that he is going to take.Rheumatoid arthritis is a chronic disorder that lasts over many years with acute exacerbation & remissions. The earning capacity of the family is adversely affected. The cost of medical treatment is high. If the patient needs surgery, it is further escalated. Most of the population in India is not covered by any medical insurance. All these factors put together create an atmosphere of depression in the family. Patient feels morally degraded &may even develop suicidal tendency.In a situation like this it becomes essential that a moral support is provided to the patient by his friends & relations. Treating doctor has avery definite role to play in keeping up the moral of patient.

Losing Weight With Rheumatoid Arthritis

Ms. Swati Kapoor, Dietitian/Nutritionist
Rheumatoid arthritis is a chronic inflammatory disorder that may affect many tissues and organs but primarily affects the small joints of hands & feet. It affects the lining of joints, causing a painful swelling that can eventually cause poor bone density and joint deformity. It can lead to substantial loss of functioning and mobility if appropriate medical treatment is not given on time.It is an autoimmune disorder which means that the body’s immune system works against own tissues and organs and mistakenly starts attacking them.Rheumatoid arthritis is more common in women between the ages of 40 and 60.Rheumatoid arthritis symptoms may vary in the degree of pain and swelling. The symptoms may also disappear at times and come back. Weight loss is also a general symptom of rheumatoid arthritis in many cases. Increased catabolism (muscle breakdown) with loss of appetite can lead to malnourishment. However weight gain is a problem with many living with rheumatoid arthritis. Carrying around extra weight can put more stress on painful joints. Excess fat stored in fat cells secrete certain hormones that can promote bone damage. So, it’s very important to lose any extra weight and maintain weight in a healthy range. With painful joints it might not be possible to maintain a regular normal exercise routine. Moreover, some medications in rheumatoid arthritis can increase appetite and can add on to pounds.Following guidelines can be helpful in maintaining a healthy weight with rheumatoid arthritis:Eat A Balanced DietChoose low calorie, healthy meal options. Minimize sugar and fat intake in the diet. Opt for seasonal vegetables, fruits, whole grains, lentils, low fat dairy products. Avoid packaged and processed foods. Take advise from a qualified nutritionist who can help you design a well-balanced healthy diet schedule which can also help in losing extra weight.ExerciseIt’s a very common myth that exercises can harm those with rheumatoid arthritis. In fact, doing joint friendly exercises and water based activities can increase muscle strength and bone structure. Strengthening exercises with low impact cardio like walking, swimming are preferable options.Avoid AlcoholAccording to some studies, drinking in moderation on occasions can help in easing joint pain in rheumatoid arthritis. However, drinking alcohol on regular basis can hinder with absorption of vital nutrients. This can also add on to the pounds as alcohol is primarily sugar and can make weight loss difficult.Maintain A Food DiaryTracking your weight loss progress by writing your daily intake can help you stay disciplined and motivated. Plan ahead your weekly meals and record it on daily basis to reduce chances of deviations and to be on the right track.Re-assess Your MedicationFew medications in rheumatoid arthritis can have side-effects like water retention and increase in appetite contributing to weight gain. If you note these changes take guidance from your doctor and ask for alternatives for such medications.Try the above tips to manage your eating and activity in a better way with rheumatoid arthritis.

6 Frequently Asked Questions About Rheumatoid Arthritis

Dr. Pravin Patil, Rheumatologist
Arthritis is a broad term that describes inflammation of the joints (pain, swelling and redness). Rheumatoid arthritis (RA) is a disease of immune system. Patient with Rheumatoid arthritis suffer from multiple joint pains and swelling. In severe cases RA can affect eyes, lungs, heart, nerves or blood vessels.1. What are the symptoms of Rheumatoid arthritisThe most common symptoms of RA are:· Pain in multiple joints · Stiffness on getting up after a period of inactivity or in the morning · Swelling in one or more joints · Joint pains worse with rest, better with use· Fatigue /difficulty in performing routine activitiesThe most common joints involved are the hands, wrists and feet. The stiffness in the morning generally lasts longer than 45 minutes.2. How common is rheumatoid arthritis?In the general population about a 1 in 100 people develop RA. It is three times more common in women than in men. 3. What causes rheumatoid arthritis?RA is an autoimmune disease. An autoimmune disorder occurs when the immune system mistakenly attacks patient’s own healthy body tissue. In Rheumatoid arthritis body's immune system attacks normal joint tissues, causing swelling of the joint lining. Once the disease begins the joints become inflamed and, if untreated, the joints, cartilage, and bone can be damaged.4. Is rheumatoid arthritis hereditary?If you have a td family member with RA then your risk of developing RA is higher than the general population.You should see a rheumatologist if you have joint symptoms.5. Is RA a disease of old people?No. RA is most common in young and middle-aged adults but can also affect children and the elderly.6. Is there any relation with climate?Many people think that weather in winter may aggravate the arthritis. This is a misconception. Cold weather may cause more stiffness in the joints, but it will not aggravate or precipitate the arthritis.

Living Well With Rheumatoid Arthritis

Dr. Dheeraj Kondagari, Rheumatologist
If you were recently diagnosed with arthritis or one of the other rheumatic diseases, you are not alone. An estimated one crore people in India of all ages and genders have arthritis or other rheumatic conditions. Many rheumatic diseases are chronic conditions. They are unlikely to go away. There may not be a cure for your condition, but effective management is available for most. Many people with rheumatic disease lead happy, satisfying lives year after year. You may be feeling anxious, even a little overwhelmed. This is a natural response to an unexpected turn in the road.How do you handle your very real concerns? By knowing the facts. First, the reality. With proper treatment, you can manage this condition and still have a good and productive life. There are numerous medications that have been proven effective and Rheumatology experts who will help. However, you also have to take control of the situation. That means making sure you get adequate exercise, ample rest and good nutrition. It also means learning about this disease and taking steps to address your own needs. The knowledge you acquire and the positive approach you take to your new lifestyle will make the difference between just coping with rheumatic disease and living well, despite your diagnosis. What is rheumatic disease?Arthritis and other rheumatic diseases are a family of illnesses that can cause inflammation (redness, swelling and pain), changes in the joints and pain in the surrounding structures.They also may make it difficult to do daily activities. In fact, there are more than 100 different rheumatic conditions including, but not limited to, osteoporosis, rheumatoid arthritis, gout, fibromyalgia, osteoarthritis, systemic lupus erythematosus, and scleroderma. While the symptoms may vary, as a rule, these conditions target the musculoskeletal system, including the bones, joints, muscles, and tendons that contribute to function. Some people also can have internal organ involvement or even more than one of these conditions at the same time. Therefore, it may take time for your primary care physician, rheumatologist, or other healthcare professional to determine your particular diagnosis and the best treatment approach for you. Your participation in this effort―and your patience―will make a substantial contribution to a successful diagnosis and your comfort levels.What can you do? Make your medical visit count!Plan ahead for your visits with your health care provider and, above all, communicate. Arrive with a list of your specific concerns. Consider bringing someone with you who can listen to the health care provider and take notes as appropriate. Respond to the medical professional's queries honestly and directly. Talk about your emotions, stress or discomfort if they are interfering with your lifestyle. Ask for a clearer explanation if you don't you understand any recommended treatment, including benefits, instructions and duration. Identify the team of medical professionals who will be of the most benefit to you. Initially,your rheumatologist, who has special training in the diagnosis and treatment of rheumatic diseases, will probably work closely with your primary care provider. Once you are diagnosed,a number of other medical care providers are available to help you manage your condition,Orthopedic surgeons, Nurse practitioners/physician assistants, Physical therapists, Occupational therapists, Pharmacists, Health educators, Psychologists. Make it a point to learn more about your medications. Rheumatologists only prescribe or recommend treatments to help patients manage their arthritis. The real key to living well with the disease lies with the patients themselves. Research shows that people with arthritis who take part in their own care fare much better. An important fact not shared openly by many doctors is that they go a mile extra to help patients who are interested in themselves and work more and more on patients who want to get better and resume their normal activities. So don’t resign yourself to fate. Only you, with the help of medicines, good understanding about arthritis and good scientific strategies can fight the disease effectively. It is very important that you take these medicines regularly and only as prescribed. You have to follow these important instructions while taking treatment for effective remedy 1)Start the medications –Early start of treatment is very important in preventing joint damage. Due to ignorance and apprehending side effects of drugs prescribed, patients do not start medications. The rheumatologist aptly takes care of patients and administers drugs as per the requirements only. If the patients do not comply and do not take the medicines prescribed by the rheumatologist, joints may get damaged permanently and one is compelled to go for surgeries to repair them, which is very costly.2) Do not give in to illogical fears about medications –Side effects are like accidents. They occur rarely and individual patient specific. If the patient follows up regularly and gets some basic tests done at regular intervals, as advised, most side effect can be identified at the earliest and corrected. Fortunately all these side effects are rare and can be managed very easily provided they are reported at the earliest possible time. Follow contraception as advised by your rheumatologist if you need to be on methotrexate, cyclophosphamide, leflunamide and mycophenolate mofetil. However after a certain washout period of these drugs, you can try to conceive again.Discuss all your concerns with your doctor.3) Don't stop the medications when you feel better. Medicines for reducing damage and inflammation need to stay in your bloodstream at therapeutic levels. Skipping a dose when you feel better could cause the pain and inflammation to return. It may be more difficult to relieve. Its better to keep it under control than allow it to flare and try to get it under control again. Your doctor will himself reduce and stop medications one by one if your disease is inactive for more than 3­-6 months.4) Keep up your appointments and do not use medicines on your own. You may not feel the need to see your rheumatologist when your arthritis is less active. Still keeping your appointments is important. Also do not continue the medicines on your own. Self treatment may be dangerous. During your regular planned visits your doctor will monitor the course of disease and determine response to treatment, adjust your treatment if necessary and Look for side effects based on clinical examination and lab tests as well.5) Do regular physical activity –Regular exercise is one of the best things for overall health. When the disease flares up, as stretching to keep joints flexible. Inactivity can make pain, fatigue and stiffness worse. As your disease becomes less active, increase your exercise. Talk to your physiotherapist about the best and safest exercises for you. Warm water aerobic exercises maybe another choice to consider as­ it relieves stiffness and pain steps down a little. 6) Quitting smoking and maintaining oral hygiene may reduce the chances of developing severe forms of arthritis according to recent evidence. They also reduce risk of cardiovascular events which is increased in Rheumatoid arthritis.7) Dietary restrictions ­- There is no clear evidence for any dietary restrictions in Rheumatoid Arthritis. However, for reducing cardiovascular risk, the American Heart Association recommends eating fish twice a week. Fish high in omega­3s are powerful anti-inflammatory foods that offer a multitude of health benefits. Don't eat fish? Other foods rich in omega­3 fatty acids include walnuts, canola oil, and soybeans.8) Fight Depression ­Living with Arthritis is not easy. It can be painful and unpredictable developments do occur. It may be hard to do normal things you enjoy. It is understandable to become sad at times, but you do not have to accept depression as a part of your disease. Discuss these feelings with your doctor. Family support is also required. Developing motivated and proper frame of mind to fight the disease is of utmost importance. According to recent evidence Individual Patient‘s interest in self care is the most important factor in the treatment of rheumatological diseases9) Don't log on without a diagnosis: Don't log on to various internet sites describing symptoms and pains to diagnose yourself. Many rheumatic diseases will be associated with elevation in sedimentation rate (so called, ESR test) pain and stiffness of the joints . So better have a documented diagnosis first. Also you should check only valid patient education sites on the web to get trustable information. 10) Whenever you are in severe illnesses due to infections, you need the opinion of a Rheumatologist available, regarding usage of the prescribed drugs.11) Pneumococal and annual Influenza vaccines are advised to prevent infections. Discuss with your doctor if you have other comorbidities like COPD,Diabetes and you are aged above 55 years.12) Get your eyes checked up by an opthalmologist every 6 months to look for steroid induced effects or hydroxychloroquine effects13) Doctors give you a prescription only after weighing potential benefits against risk. You can have increased hair loss, nausea, burning in the chest, oral ulcers, allergic reactions & skin rashes, increased friability and striae of skin, cataracts, weight gain, increase or decrease in certain cell counts, osteoporosis, avascular necrosis of bones, increase in infections, increase in blood sugars, facial hair, acne, slight increase in blood pressure, etc. while using these drugs. However, in majority of the patients these are easily manageable (Ex: increasing the dose of anti diabetic oral drugs or insulin in case of diabetic patients). It is generally advised to concentrate on the benefits of the drugs, keeping an eye on the side effects. Stopping medications out of illogical or unrealistic fears may lead irreparable damage to bones, joint deformities and serious organ damage in various diseases. Good news is that apart from the traditional anti rheumatic drugs which do work quite well,there are newer drugs in research and some, already into the market. It is possible now to prevent joint damage with these medications.

Arthritis of Hands: It Must Be Rheumatoid Arthritis

Dr. Tanoy Bose, Internal Medicine
Vital notes:RA is a chronic debilitating joint disease that affects small joints of hands and foot.More common in females aged 20 to 50 years.It is not synonymous with Rheumatic Fever which occurs in children aged less than 15 years.It has got nothing to do with monthly Penicillin injections and checking ASO titre. Somebody on Penicillin injections or being checked for ASO titre should change the doctor immediately.Untreated disease may cause deformity of hands and foot causing deterioration of quality of life.Erosion of small joints along with loss of entire joint architecture is the basic disease process.Early morning stiffness of joints along with swelling of one or more small joints of hands is very characteristic.Treatment is done with Methotrexate, Hydroxychloroquine Sulfate, Sulfasalazine, Leflunomide and short courses of steroids.Difficult diseases are treated with costly injections called biologics.The motto of treatment is “ catch early, hit hard and achieve and maintain treatment goal “Lung and cardiac complications are common in long term disease.Rheumatologists but not the Orthopedicians nor neurologist are the best person to treat the disease.Introduction:Rheumatoid Arthritis is an autoimmune disease of mankind where the cells and molecules who are responsible for security of our body, misidentify the joint tissue as foreign substance and start destroying them similar to the way they usually do when a bacteria or virus enters the body. This misdirected attack towards our own body is called autoimmune phenomenon.The worst affected parts of the body are the joints of hands and foot. These small joints that are responsible for performance of day to day activities like eating, holding, writing, typing, washing etc become painful and swollen causing stiffness and deformity. This results in poor quality of life and subsequent depression. Early diagnosis and continuous treatment with specific medicines is cornerstone of treatment.What are the symptoms?Symptoms vary from person to person and also from early stage to late stage of the disease. In early stage there may be mild pain and stiffness involving 1 to 4 small joints of the hands and feet with a typical pattern of stiffness of those joints after rising from bed. During this phase it is very difficult to diagnose the disease. But it is very important to catch the disease in this stage. Researchers have proved that joint damage and bony erosion start even before the symptoms have manifested and hence earlier the treatments better the results.In a full blown case of Rheumatoid arthritis the picture is very classical of a middle aged female presenting with pain and swelling of hand and foot joints along with early morning stiffness that responds to steroids brilliantly. Wrists and the knuckles are predominantly involved. Patients are unable to hold a pen or open the door or do cooking etc. Gripping the wrist firmly causes pain and the hand joints are warm.In a advanced case of the disease we often find elderly people presenting with crooked hands with areas of permanent swelling and skin changes due to chronic friction. The skin fold may contract chronic fungal infections and the joints are swollen and painful.A few other organs are damaged in silence and they create serious problem at the advanced stage of the disease. Lungs, Heart and Blood Vessels are frequently affected. There is accelerated cholesterol deposition in arteries of heart causing increased risk of heart attack and brain stroke. These patients frequently contract infections which are difficult to treat.Involvement of spine or low back is uncommon. However, cervical spine or the neck region is the only part of the spine that may be affected in this disease. What is the difference between Rheumatic Fever & Rheumatoid Arthritis?There is a heaven & hell difference between these two entities. Rheumatic Fever is a disease of childhood. It usually occurs in children aged less than 15 years and is characterised by excruciating pain, swelling and redness of one or more big joints of arms and legs that responds excellently to Aspirin. This disorder may cause cardiac problems and is the leading cause of Valvular Herat disease in India. It is often characterised by some skin rashes and rarely neurologic problems. The disease process, the causative agent and the clinical symptoms are completely different from that of Rheumatoid arthritis.Why Penicillin injections are given on a monthly basis?Patients of Rheumatic fever often suffer a damage to the valves of the heart during the attack of Rheumatic fever. This damaged valves are potential sites of infections that may develop in the later part of the life. This infection is called Infective Endocarditis and may cause serious complications if not addressed properly. Penicillin injections are given as a form of prevention of development of this infection and have got no relationship with the wellness or cure of the disease. People who are aged above 15 years and are being treated with penicillin for the first time for joint pain occurring in small joints of hands should immediately change their doctor and consult a rheumatologist.How is Rheumatoid Arthritis diagnosed?Rheumatoid Arthritis is diagnosed by its classical symptoms and some laboratory investigations. To identify early rheumatoid cases we usually follow a scoring system which includes counting of number of joints involved, the duration of the symptoms, checking ESR and CRP in blood and looking for the positivity of Rheumatoid Factor and Anti CCP Antibody. Patients with high values of Anti CCP Antibody are very much likely to suffering from rheumatoid arthritis and also they are very much likely to suffer a aggressive disease courseDoes each and every patient of rheumatoid arthritis develop crooked hands and foot?No. Not all patients suffer from such a devastating complications. There are important characteristics which if present predict severe destructive disease. Females, Smokers, High values of Anti CCP or Rheumatoid Arthritis, Family History of Rheumatoid Arthritis, Early evidence of Joint destruction on X Ray are a few important features who will go forward to develop destructive disease. How Rheumatoid Arthritis is treated?Continuous Physical activity of the involved joints is the corner stone of treatment. More the joints are active, less the damage.Cessation of smoking is mandatory. Smokers tend to develop early joint destruction. Medicines that used in treating rheumatoid arthritis are together called Disease Modifying Anti Rheumatoid Drugs or DMARDs.Methotrexate, Hydroxychloroquine Sulfate, Sulfasalazine, Leflunomide are the principal DMARDs. Of these, methotrexate is the backbone of therapy. Methotrexate is used on a once a weekly basis starting from a dose of 5 mg to 50mg/week and a weekly 5mg of Folic Acid supplement is given to neutralise the adverse effects of Methotrexate. The detail of the drugs is mentioned below.Why I am being given Steroids?Steroids are given for a short period of increased disease activity. In rheumatoid arthritis we do not prescribe steroids in a regular basis. It is often prescribed when the patient is put on the DMARDs for the first time and when there is break through pain or active disease during the treatment. Steroids are used in low dose in a decreasing dosage pattern over weeks and usually are not continued more than a month.What are Biologic agents? Why they are so costly?Biologic agents are highly specific molecules who directly block the action of the culprit chemicals in our body that cause the joint destruction. They are highly researched molecule an d is manufactured abroad. They are usually available in injection formats and have their own side effect profile which includes reactivation of Tuberculosis and other opportunistic infections. Usually patients are checked for latent Tuberculosis Infections, HIV, Hepatitis B and C before the treatment is started. Biologics cause excellent response to the disease causing alleviation of pain and swelling and sense of well being but unfortunately they do not provide any cure. Hence, if biologics are stopped then there are chances that the disease activity may worsen requiring more biologics or aggressive treatment with DMARDs.Conclusion:There are Rheumatologists in every city or town of the country. In case of any kind of aches and pains of joints with or without swelling that is not caused due to any trauma, one must consult a Rheumatologist. We keep on posting and distributing such articles to each and every patient so that a perfect transparency is maintained between the treatment and the patient.

Rheumatoid Arthritis

Dr. A N Roy, Rheumatologist
Rheumatoid Arthritis (RA) is a common form of arthritis, involving inflammation in the field of lining of joints, leading to warmth, decreased range of motion ,swelling and pain in the areas around joints. The cause is not yet known, although we do know the immune system plays an important role in the inflammation and joint damage that occurs.Genes play an important role in the development of RA.Symptoms:  May vary from person to person. In almost all the people who have RA, joint symptoms change daily. In some people, the disease may be mild with periods with activity (worsening Joint inflammation) called“FLARES”If you have RA, you will likely experience inflamed joints that are warm, swollen, tender, often red and painful, and difficult to move.  People with RA develop inflammation of the linings that surround the heart (Pericarditis) and lungs (Pleuritis) or inflammation of the lung tissue itself. Dryness of the eyes and mouth due to inflammation of tear glands and salivary glands (Sicca syndrome or Sjorgen’s syndrome) is also occasionally seen.  RA Diagnosis: The doctor will look for certain features of RA, including swelling, warmth and limited motion in joints throughout your body, as well as nodule or lumps under the skin.The doctor also may recommend certain blood tests and X –rays. The presence of an antibody called Rheumatoid Factor (RF) may indicate RA, but RF is also found in many people who don't have RA. A positive test for antibodies to cyclic citrullinated peptide (CCP) can also help diagnose RA. Because there are more than 100 forms of rheumatic diseases, often referred to as arthritis the diagnosis and management of RA require the expertise of a specialist. All people with RA should be treated by a Rheumatologist.Treatment of RA:  Currently, there is no cure for RA.However, highly effective treatments exist, and early treatment is critical to prevent  damage. Treatment Methods include medication and life style modifications focused on relieving pain, reducing inflammation, stopping or slowing joint damage, and improving patient function and well-being.Medications Used:  Two types Those that can help relieve symptoms and reduce inflammation &Those which can modify the disease or put in remission.Symptomatic Medications: are NSAIDs, Analgesics, and Corticosteroids. Disease-Modifying Medications (DMARDs) : Methotrexate, Hydrocychloroquine, Sulfasalazine, Leflunomide, Azathioprine, Cyclosporine & Biologics.   Physical and Occupational therapists: Physical therapists evaluate your special needs and teach you how to exercise appropriately for joint mobility, muscle strength and aerobic fitness. Joint Surgery Option: If you experience prolonged pain and disability caused by severe joint damage, you may think about total joint replacement to help you maintain independence.Can DIET help Control RA?: scientific studies have not proved that diet changes either cause or relieve symptoms of RA. Studies do show that omega-3-fatty acids , when taken in sufficient quantities, can modestly reduce RA inflammation. All patients with RA, and particularly those taking corticosteroids, should take calcium supplements and a multivitamin containing vitamin D. Smoking makes you more likely to get RA.How can you Best manage RA: Medications, rest, Physical Activity and self-management skills are the best combination of relieving symptoms, but focusing on the positive aspects of life can also help. Early use of disease-modifying medications is essential to good- long term outcomes.                  Treatment of RA requires Life –Long management.

Few Points About Arthritis

Dr. Yogesh Kumar, Ayurveda
What is arthritis? Commonly arthritis is referred to as pain in joints in layman’s language. Arthritis is the swelling and painful condition of the joints along with degenerative changes in the joints. The common sites involved are knee joint, joints of fingers, wrist and feet. There are a few clinical conditions related with arthritis are osteoarthritis, gout, rheumatoid arthritis, psoriatic arthritis and septic arthritis.OsteoarthritisOsteoarthritis is caused by wear and tear of cartilages, degenerative process of joints and normal repair work .Usually patient of osteoarthritis complains of pain in the affected joint associated with stiffness and some amount of limitation of movement.Signs and symptoms of osteoarthritis:Osteoarthritis presents with complaints like pain in the joints along with stiffness especially in the mornings and goes by itself after some time. Difficulty in the movements of affected joints.Abnormal changes in the shape and size of the affected joint and surrounding tissues.Presence of click like sound on movement.Gout: Gout is a disorder involving pain, swelling and stiffness in the joints due to deposition of uric acid crystals in the joints. The serum uric acid level increases in gout. Classically the pain involves area around toes and feet.Diagnosis is confirmed by aspiration of synovial fluid and examination of urate crystals and serum uric acid levels.Rheumatoid arthritis:Rheumatoid arthritis is a disorder involving a long standing swelling, pain, tenderness in the joints. It is an autoimmune disorder (when our body turns against itself).How can I know I have arthritis?Signs of degenerative changes in the X-ray of affected joint, rheumatoid factor, synovial fluid examination and erythrocyte sedimentation rate (E.S.R) are some laboratory procedures done to make a diagnosis of arthritis.What causes arthritis?Arthritis is caused by degenerative process in the joints with decrease in the production of synovial fluids.How can I live a better life after arthritis?Tips to live a better life for arthritis:Weight management is the mainstay of the therapy for arthritis for overweight patient. Weight reduction can work wonders.Walking for an appropriate time according to the strength of your body.Healthy diet free of fat and rich in nutrients. Use of milk, other dairy products and fish is good in arthritis.Use of walking stick for elder patients with knee pain due to arthritis.Avoid climbing stairs, sitting on floor as far as possible.Use of commode instead of Indian style latrine.Use of various supports for joints like knee brace for knee.Exercises to strengthen the muscles around the affecting joint. Exercise for arthritis should always be done under the supervision of an expert.Use of good quality calcium and other mineral supplements.Control of other diseases, if present along with arthritis.Stop alcohol and smoking completely.Is there any effective Treatment for arthritis?There is not any specific treatment of arthritis in modern medicine. There is only symptomatic treatment available in modern medicine. The chief principle of treatment includes pain killers, weight management, calcium based supplements and other expensive drugs whose effectiveness is yet to be proven.Alternative therapies: Although some other alternative therapies claim to have a proper treatment for arthritis. Treatments from Ancient Ayurveda and chiropractic therapy have shown great and bright results over the years. Patients who are not satisfied with modern allopathic treatment and looking for alternative treatment for arthritis can find better relief from therapies like chiropractics which is famous for treatment of musculoskeletal diseases. A lot of people are turning to therapies like chiropractics these days as they offer a vast knowledge and treatment options on musculoskeletal disorders.

FREQUENTLY ASKED QUESTIONS IN ARTHRITIS & RHEUMATISM

Dr. A N Roy, Rheumatologist
Q) What is Rheumatism?  A) Rheumatism is a popular term for Chronic Pain that applies to a variety of diseases that cause pain, stiffness and limitation of motion of joints, bones, tendons, ligaments and muscles. Q) Who is a Rheumatologist? A) A Rheumatologist is a specialist in treating the musculoskeletal disease (muscle, bone, joint specialist) .The role of the rheumatologist is to diagnose, treat and medically manage patients with Arthritis and other rheumatic diseases. Q) What is the difference between a Rheumatologist and an Orthopaedic Surgeon? A) A Rheumatologist is a specialist trained to diagnose, treat and manage various types of musculoskeletal problems. Surgeons who specialise in surgery of bones/joints are called orthopaedic surgeons.Q) What do Rheumatologist treat? A) Rheumatologists treat all forms of Arthritis, autoimmune disease, musculoskeletal pain disorders and osteoporosis. There are 100 types of those diseases, including Rheumatoid arthritis, Osteoarthritis, Gout, Lupus, Back Pain, Osteoporosis, Fibromyalgia and Tendonitis. Some of those are very serious diseases that can be difficult to diagnose and treat.Q) When should a patient consult a Rheumatologist?A) If the person is suffering from any of the below symptoms, he/she might behaving Rheumatic Diseases.Joint Pains and SwellingsSevere Point Pains and Stiffness in the morning.Severe back pain and Stiffness in the morning.Unexplained generalised body pains.Recurrent mouth ulcers/hair loss.Dryness of mouth/eyes, red rashes on cheeks.Recurrent heel pains.Prolonged unexplained fever after detailed work up by physicians.Wounds on skin not healing over a period of time, suspected to be due tovasculitis refereed by a surgeon/physician.Persistent problems regarding abortions referred after primary workup by aGynaecologist.Recurrent uveitis after primary work up by an Ophthalmologist.Unexplained pulmonary renal syndromes at primary care level. Q) Cause of Arthritis? A) Determining the cause of Arthritis can be difficult, because often several factors such as age, illness or infection, body weight, previous injury etc. contribute to an individual developing this problem. Q) Why me? Nobody in my family has it? A) There is a common misconception amongst people that arthritis runs in the family. This is always not true. It often arises sporadically without any family history. Q) Any Diet medication/restrictions? A) There is no scientific basis regarding food causing Arthritis, except gout, where patients are advised to have low purine diet and avoid alcohol, red meat , beans, mushroom etc. So No diet changes are required for most of these patients. Q) Does the climate influence Arthritis? A) Some patients find their Arthritis worsening in cold weather, while others during the rainy season. However, temperature/climate does not influence the course of Arthritis. Q) Can I walk, exercise, jog, or practice Yoga? A) Most Arthritis patients can walk, exercise or jog within reasonable limits. Yoga, in general, doesn’t ham Arthritis patients and can be carried along with other medicines. However, certain Yogic postures can be avoided as they may put excessive strain on the joints. It is best to consult a physiotherapist for this purpose. Q) Is Arthritis treatable? A) Yes, at present, there is treatment for the symptoms of Arthritis that help in managing pain and joint damage. These involve dietary changes, drugs, and in some cases exercise.

Do You Have a Bone to Pick With Arthritis ?

Dr. Vishwas Virmani, Physiotherapist
Inflammation of the joints, accompanied by symptoms like stiffness and excruciating pain, is called arthritis. Once called the 'old man's disease,' arthritis generally affects adults over 65. It can affect people of all ages. There are various types of arthritis viz osteoarthritis, rheumatoid arthritis, autoimmune arthritis, infectious arthritis, juvenile arthritis and more. The types vary depending on age and which part of the body is involved. For example, rheumatoid arthritis is common among the old and the injured, while juvenile arthritis affects only children.When do you know you have arthritis?Given that arthritis isn't just an old man's disease, here's a list of symptoms. You could have arthritis if you:Have a sprain or muscle tear that refuses to heal, get your doctor to take a look.Encounter numbness and a tingling sensation in the hands (are caused when inflamed tissues press against nerves in the hand and feet).Experience frequent bouts of foot pain, irritation and swelling of the joint linings (the swelling occurs due to an accumulation of white blood cells in the inflamed area.)Have inordinately stiff muscles when you start moving after a period of inactivity.Can feel firm lump-like nodules under your skin especially near the affected joints.What causes Arthritis?Different types of arthritis occur due to different reasons. Injury, abnormal metabolism, heredity, uric acid crystals, infections such as lyme disease, and an overactive immune system are some common causes.Does it primarily affect men?No. Research actually suggests that it affects women more than it does men, rheumatoid arthritis in particular. However, studies have also shown that the symptoms of this disease decrease when treated at an early stage, particularly among men.TreatmentThere are several treatments for arthritis today, the aim of which is to ease out pain and initiate a comfortable living. There are certain remedies that are commonly applicable, as listed below.Applying ice packs to swollen joints may relieve acute pain, while maintaining a balanced diet and controlling one's weight can help manage pain in the long run.Doctors also prescribe routine exercises as a part of the arthritis treatment, as exercising gives strength to the muscles and keeps the joints flexible.Using neoprene sleeves and other supportive devices can help lessen the wear and tear of joint cartilage, thus reducing pain.PreventionThere is currently no preventive treatment for arthritis. However, if detected at an early stage, arthritis can be cured completely.If you can literally feel it in your bones, don't hesitate to consult a doctor. Remember, even if it can't be prevented, arthritis can definitely still be treated.