An Arthritis Primer for World Arthritis Day

Dr. Joe Thomas
Consultant Rheumatologist
Aster Medcity, Kochi

Every reader must have an aged relative who complains of pain in the joints. In some of these cases, the pain is diagnosed as due to arthiritis, giving rise to the impression that arthritis is a disease of old age. But nothing can be further from the truth.Arthritis is very common and World Arthritis Day is observed on October 12th each year to raise awareness about the importance of early diagnosis of rheumatic and musculoskeletal diseases that fall under the generic term ‘arthritis’.

What is Arthritis?

Arthritis is a term commonly used for the different typyes of inflammatory joint disease. In fact, there are various forms of arthritis, more correctly described as rheumatic and musculoskeletal diseases (RMDs). These conditions are commonly of two types: inflammatory and non-inflammatory. Common non-inflammatory RMDs consist of degenerative spine diseases, osteoarthritis, osteoporosis and fibromyalgia. Common inflammatory RMDs consist of rheumatoid arthritis, ankylosing spondylitis, reactive arthritis, connective tissue diseases and polymyalgia rheumatica.

Arthritis affects around 1% of the population in India, and it affects both men and women of all ages, including children and babies. Rheumatoid arthritis, fibromyalgia, and lupus predominantly affect women, while spondyloarthropathies and gout are more common in men. Worldwide, it has been seen that rheumatic diseases are the biggest cause of reduced productivity at work and premature retirement!

Arthritis has a huge economic burden on the healthcare systems and the individual’s finances. They result in costs associated with diagnosis, treatment, drugs, care, assistive devices, home support, and research. In addition,

decreased productivity and absence from work as a result of arthritis contributes significantly to these costs. If left untreated, some kinds of arthritis may also reduce life expectancy.

Causes

In some cases, arthritis can be hereditary. Arthritis can also be triggered by lifestyle factors such as smoking, excessive weight, sedentary lifestyles, increasing age and having occupations that lead to injury and overuse of joints and muscles. However, in some cases the causes are unknown.

Symptoms

Arthritis is associated with a wide range of symptoms, including: 

• Inflammation indicated by joint swelling, stiffness, redness, and/or warmth

• Persistent muscle and joint pain

• Tenderness

• Extreme fatigue, lack of energy, weakness, or a feeling of malaise

• Stiffness and restricted range in movement or flexibility

• Joint deformity

• Symptoms affecting the internal organs

• Mental symptoms like depression and anxiety

Diagnosis

Quick action upon presentation of arthritis symptoms is important. Symptoms should be assessed by a physician or a rheumatologist, as early as possible to decide on the appropriate treatment. To diagnose arthritis, the doctor will consider the symptoms, perform a physical exam to check for swollen joints or loss of motion, and use blood tests and X-rays to confirm the diagnosis. X-rays and blood tests also help distinguish the type of arthritis. Early medical treatment of inflammatory arthritis, particularly in the first three months, can prevent joint and organ damage, improve long-term function, and increase the likelihood of achieving disease remission.

Treatment and Management

Treatment focuses on managing the condition to ensure the best possible quality of life for the patient. There is no single medication or treatment that works for everyone. The aim of the treatment is to help manage pain and control the symptoms. Clinical remission, where the symptoms appear to cease, is increasingly being made possible. Commonly used arthritis medications include analgesics to reduce pain; nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation; corticosteroids to reduce inflammation and suppresses the immune system ;disease-modifying anti-rheumatic drugs (DMARDs)  to slow or stop the immune system from attacking the joints; and biologic drugs which are genetically engineered drugs that target various protein molecules that are involved in the immune response and modify the immune response. Physiotherapy is often advised to reduce the symptoms of certain types of arthritis. Psychological treatment may also be required for the anxiety and depression.