Arthritis means pain and swelling in a joint. There are several types of arthritis. Osteoarthritis, which is the most common type of arthritis, happens due to wear and tear in the joints. It commonly affects knees, hips and lower back.
Rheumatoid arthritis is the most common form of inflammatory arthritis. Rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis gout and a number of autoimmune diseases are treated by Rheumatologists.
Rheumatoid arthritis is a chronic inflammatory condition that affects about 1 in 100 Indians. Women are affected more than men, especially between 30 and 60 years of age. It is an autoimmune disease wherein our immune system causes damage to our own joints. Genetic, environmental factors and smoking have a role in causation.
Patients do very well if the arthritis is diagnosed and treated early. Delay in treatment will lead to irreversible damage to joints and disability.
Patients experience pain in multiple joints, particularly hands, wrists, feet and knees. There will be joint swelling with extreme joint stiffness in the early morning. Fatigue and feverishness usually accompany.
The diagnosis is largely made by taking a history and by doing a clinical examination. Some blood tests and xray or ultrasound scan of joints will be done to confirm the diagnosis.
The treatment is typically long-term and mainly involves medications called disease modifying anti-rheumatic drugs. These should be started early ie, within 4-6 weeks of onset of arthritis. Pain killers are advised for a short term during flare ups.Steroids in the form of tablets or intra articular injections may be considered for some during a flare up.
We now have targeted therapy in the form of biologic drugs. These are available in subcutaneous injection or intravenous forms. We also have targeted synthetic drugs available in tablet form. These have revolutionised management of RA and should be considered early for patients not responding to initial drug therapy. The outlook for people with rheumatoid arthritis is improving every day.
Apart from medicines, adapting a healthier lifestyle plays a large role in managing rheumatoid arthritis. This includes quitting smoking, avoiding excess alcohol intake, a regular exercise regime, healthy eating with a balanced diet and staying motivated.
Severe deforming RA