World Arthritis Day: Why early detection of the autoimmune disease matters

Throughout the ongoing Covid-19 pandemic, people have been suffering from health problems because of the lack of mobility that comes with having to stay indoors. One such complication is arthritis, which contrary to popular belief can affect both young and old members of the population. The winter makes matters worse as joints and muscles tend to stiffen.

Every year, February 2 is observed as Rheumatoid Arthritis Awareness Day. It was started in 2013 by US-based not-for-profit organisation Rheumatoid Patient Foundation to raise awareness about the disease and people who suffer from it. While World Arthritis Day is celebrated on October 12 annually, the second day of February particularly focuses on Rheumatoid Arthritis (RA). According to the World Health Organization, up to 14 million people around the world have the autoimmune disease as of 2021. Other estimates say that number could be as high as 20 million. An autoimmune condition, it is known to be caused when the immune system wrongly sends antibodies to the lining of joints, which attack and damage healthy body tissue.

Mid-day Online reached out to Dr Rohini Samant, consultant rheumatologist at PD Hinduja Hospital and MRC, to understand more about the disease. Samant dwells on why people need to be concerned about Rheumatoid Arthritis and also emphasises the need for proactive early detection.

What is rheumatoid arthritis and how is it different from the other types of arthritis?
Rheumatoid Arthritis (RA) is the most common inflammatory arthritis. By inflammation, we mean that the joints are swollen and painful. This arthritis affects multiple joints, both small and large, and is symmetrically distributed unlike most other arthritis.

Another very common arthritis is Osteoarthritis which most commonly affects the knee in which there is no swelling of the joint, but there is wear and tear of the cartilage or cushion between bones which form the joint.

What are the causes of rheumatoid arthritis?
There is no single cause for RA. It is an autoimmune disease in which the body's immune system attacks its own tissues. Genetic factors play an important role. Environmental factors like infections with certain viruses or bacteria or mental stress can trigger the onset of disease in genetically predisposed individuals.

When should a person check with the doctor about the possibility of screening for arthritis?
The classic symptoms of Rheumatoid Arthritis are pain, swelling, and stiffness in the joints, which is very marked at night and in the early morning, and it can last from 30 minutes up to 2 to 3 hours in the morning.

Regular joint and body pains can occur due to several other reasons like Vitamin D deficiency, thyroid disorder, fibromyalgia etc. When you have a joint that is swollen, painful, and stiff in the morning, and when many such joints are involved at the same time, that is very suggestive of Rheumatoid Arthritis, and you must immediately see a doctor. Rheumatoid Arthritis typically affects the small joints of the hands and the feet, knees, ankles, elbows and shoulders.

At what age is one susceptible to this disease? And how prevalent is it in India?
It affects all age groups but is mostly common between 30 to 50 years of age. The female to male ratio of those affected is 3:1. The prevalence of RA in adults in India is around 1 per cent i.e approximately 1 crore adults are suffering from RA.

What is the difference between regular joint pain and arthritis?
In regular joint pain, there is no swelling of the joint. Sometimes there can be a pain at the attachment of the tendon to the bone like tennis elbow, wherein only a particular point around the elbow hurts. However, Arthritis means swelling of the joint. As I mentioned, the most common reason for having joint and body pain is Vitamin D deficiency or a thyroid disorder.

How severe can arthritis get?
Yes, people should be concerned about Rheumatoid Arthritis. It can damage the joints to the extent that if it is not treated properly on time, the patient might need replacement of the joint. Also, it may affect other organs like the lungs, eyes or blood vessels. But the good news is that if it is diagnosed and treated early, the patient can do very well with only medical treatment and surgery. Joint replacement may not be required. We have very good and effective treatment as of today for Rheumatoid Arthritis. More than 90 per cent of the patients do very well if diagnosed and treated at an early stage.

How can people stuck at home and suffering with arthritis navigate the ongoing Covid-19 pandemic?
The advent of telemedicine has made it easier for people. Most of the doctors are now accessible on telemedicine. Therefore, with the help of their children or neighbours, the older people can easily access the doctors sitting at home and thereby manage their treatment. They need not come and be exposed to the risk of Covid, they can be very well treated at home. Telemedicine has helped many people who cannot travel for various reasons.

Are there any particular kinds of exercises or routines they can follow to deal with it?
Well, the routine should include a well-balanced diet, regular exercises like walking, and a good night's sleep. Therefore, a balance of a good lifestyle is important. A physiotherapist can guide specific exercises to help strengthen the joints. So, what happens is when you don't use the joints, the muscles tend to become a little weak; hence a physiotherapist can help with muscle strengthening exercises.

Do people suffering from arthritis need to follow a particular diet or eat and avoid certain foods?
There has been a lot of research on this but as of now, there are no such blanket restrictions on diet. We advise a well-balanced diet. There should be a good amount of protein intake in the diet because that helps with healing.

There is no particular restriction in the diet. However, there are few patients who are sure that a specific kind of food aggravates their arthritis; only in such cases do we ask them to avoid it.

What are the common misconceptions around arthritis and rheumatoid arthritis?
The two most common misconceptions are that allopathy has no treatment to offer for Rheumatoid Arthritis and that the treatment comes with many side effects.

Both of these are untrue. In the present day, allopathy has excellent options in controlling the disease. Moreover, we monitor the patients regularly to see if they are developing any adverse events. We make sure that the patients are also told about the side effects so that they can come to us if they are facing any issues and it can be sorted out - the drug can be changed immediately. Most of the drugs being used have a long track record of safety. Therefore, the fear of side effects is unwarranted. Rheumatoid Arthritis today has become an eminently controllable disease.