By Dr. Mahabaleshwar Mamadapur, Consultant Rheumatologist JSS Hospital, Mysuru
Rheumatoid Arthritis (RA) Awareness Day is held every year on Feb. 2. The day was created in 2013 by Rheumatoid Patient Foundation to help create awareness among those suffering with RA and to clear their misconceptions about this chronic disease.
According to Indian COPCORD survey, RA is seen in about three people per 1,000 population. RA is a chronic autoimmune disease, which means that our immune system attacks our body’s own tissue instead of germs and viruses. RA causes inflammation of the joint lining causing painful, redness and swollen joints. RA commonly affects joints in hands, wrists and knees, usually many joints at once.
Risk factors for RA
The reason for getting RA is not correctly known. It has been proposed that the genetic and environmental changes can play a role.
Age: RA can be seen in any age. It affects people in 30-60 age group more commonly.
Gender: It is 2-3 times more common in females than males.
Others: Smoking and obesity can increase susceptibility to RA.
Common Symptoms
Joint pain and swelling in more than one joint; early morning stiffness in the joints which may last more than 30 minutes; difficulty in making fist; stretching arms; tiredness, anxiety, depression and anaemia.
Less common
Weight loss, dry eyes, nodules over elbow, hands and face, inflammation of other body parts like lungs, heart, nerves and blood vessels.
Diagnosis of RA
RA is diagnosed by eliciting the symptoms, clinical examination and results of blood tests. Sometimes X rays, USG scans may be needed. Blood tests that are helpful are RF, Anti CCP, ESR or CRP.
Treatment options
There are mainly four groups of drugs — Analgesics (Painkillers), Non Steroidal Anti-Inflammatory Drugs (NSAIDs) and Disease-Modifying Anti-rheumatic Drugs (DMARDs). DMARDs take 6-8 weeks for complete action. Hence Steroids are used as bridging therapy. Regular follow up is the most important part of treatment. The safety and efficacy of drugs need monitoring at regular intervals.
Complications of RA
If left untreated, RA may cause joint damage, deformities, problems in the heart, lungs, nerves, stroke, osteoporosis etc.
Diet
Studies have shown that Mediterranean diet with lot of fruits and fresh vegetables decreases inflammation.
Avoid smoking, processed food like bakery items and use less salt.
Exercise
Experts recommend physical activity of 30 minutes per day for five days a week in the form of walking and swimming.
Misconceptions
Myth: RA patients have to take steroids lifelong.
Truth: No. You may need steroids in the initial stages for disease control.
Myth: RA is a part of aging.
Truth: RA can affect any age. However, it is more common in 30-60 years of age.
Myth: RA only affects the joints.
Truth: RA can affect lungs, heart, blood vessels, nerves, eyes along with joints.
Myth: If you feel better, medications are no longer necessary.
Truth: RA is a chronic disease like Diabetes, Hypertension. You may require a few drugs to keep the disease under control.
Myth: Exercise is bad for RA.
Truth: People with RA who exercise often have less pain than those who don’t. Research shows that aerobic, resistive and aquatic exercise reduce physical limitations and improve body function.
Remember: If you have painful swollen joints and stiffness in morning lasting for longer than 30 minutes, please consult your doctor.
Nice Article . people should consult immediately and it can be controlled well. Dr.Satish rao Kalanje at Vikram Hospital now Manipal Hospital Millers Road is treating my mother for this disease for the past 12 years and he is one of the best having returned from USA and who researches a lot on this subject and a gem of a person.
Rheumatoid Arthritis? A Cinderella disease needing pain killers and the lot.
Not a popular branch of medicine and hence the doctor mentioned returned from the USA, where it is not a lucrative tp practice.
Best treatment is available in Kerala Ayurvedic speciality, to which many Americans are attracted. It has generated a good volume of tourism
with kerala government offering luxury huts with nature around near stream which Americans like.
Ayurveda treatment with oil rub and medication are proved to be the best option.
Pain Killers initially yes but you should have the disease under control within 3-4 years depending on how good your doctors is and they give steroids and HCQS. Precaution for HCQS is regular eye check-up as prescribed by doctor as it can affect eyesight. initially Only thing to be careful is the steroids make your bone brittle and people must be careful that they shouldn’t fall and get fractured bones., but they also give calcium tablets to make bones strong. After disease under control more pain comes only in winter months of October , November, December ,January and even then you can heat the room using room heater(large electricity bill ) and stay in that warm climate .Pain killers when disease under control are only SOS meaning only if there is pain , warm climate is the best friend of RA patients and cold climate the greatest enemy. so please don’t give wrong message like lot of pain killers, they are needed initially depending on what stage of disease you go and consult doctor and so go early if you have symptoms mentioned in the article. There is no cure for disease yet and it is an auto immune chronic disease and might relapse. Sharing my mothers experience for help of other patients to make them feel better.
Hello Sanjay Kini
You are not a doctor, and all I know is you are a tourism buff, interested in promoting tourism as a business,
Not a good work getting information from the Internet. It needs a medical eye to filter this information. You are not a doctor, I am.
If you want to fork out your cash on the treatment by this doctor who returned to India, that is your business. Do not become a spokesman for him./ for any other doctor. Best to confine yourself in what you are familiar with-tourism!
Pontification by you which has become the usual feature should be confined to tourism only.
I am a doctor, and I advice patients with this diseases to seek Ayurvedic treatment, which treats this person holistically, and are often successful in relieving the suffering. That is what a doctor should do.
You have not come across the best alternative treatment , which the Kerala Ayurvedic medicines are famous for. These Americans who have tried every thing in allopathic medicines there- they have the best treatments for autoimmune disease varieties there. have been successful in getting their ailments severity reduced.
This disease manifests into several grades of severity and pain killers are often the medication of choice if this disease morphes into Arthritis end , which it often does in many cases.
Hey @Kini
Did you not some time ago, gave an example of your mother getting treated by a cardiologist in Mysore, and you recommended him for all Mysoreans? Now, your mother is treated by this doctor for Rheumatoid Arthritis, and you recommend this doctor now!
Next what, your mother had brain surgery and you recommend a very good neurosurgeon in Bangalore?
Is this the line of your business? You dish out advice on Highway structure, Chamundi Hill development as a tourism spot, electric buses as a means of tourism for the Hill, etc.. etc..
I have seen cases of Rheumatoid Arthritis controlled well by then famous Nanjangud Ayurvedic Physician called BV Pundit, an instituitiojn by himself, as well as Chandrabhan Singh, an Ayurvedic physician of repute in Mysore during 1960s.
There are excellent treatment for Rheumatoid Arthritis based on herbal medicines in Ayurveda, Never come across , any one weaned from pain killers prescribed for Rheumatoid Arthritis.
Hello @Kini again
This is the treatment regimen advised by the Mayo Clinic, arguably the best multi-speciality clinic in the world, located in Minnesota , USA, who have teams sent to advice to various countries
See:https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/diagnosis-treatment/drc-20353653
The first choice suggested in the list of treatments there, is pain killers and the others are the use of steroids-both have many side effects.
Your prognosis is at variance to what I have heard from the sufferers, and hence they resort to treatments in Ayurveda which has some effective medications and regime for the patients. This is what these Americans mentioned are seeking and they are not idiots.
But, keep posting you partial knowledge and recommendation of doctors.