By Dr. V. Sarath Chandra Mouli
Arthritis is a group of diseases, which cause inflammation of the joints. Arthritis can affect one joint or multiple joints. There are more than 100 different types of arthritis, with different causes and treatment methods. The most common types are osteoarthritis (OA), rheumatoid arthritis (RA), SLE(Lupus) Spondyloarthritis and Gout.
On World Arthritis Day, 12 October, people with rheumatic and musculoskeletal diseases from around the world join together to make their voices heard. It was first observed in 1996. It was started by the Arthritis and Rheumatism International to increase global awareness about rheumatic and musculoskeletal diseases.
Arthritis affects approximately 350 million people worldwide, including nearly 100 million people in India.
The theme for World Arthritis Day (WAD) 2020 is “Time2Work”.
What is the aim of organising WAD?
To raise awareness of rheumatic and musculoskeletal diseases in all its forms among the medical community, people affected by any such condition and the general public.
What is Rheumatism?
It refers to various painful medical conditions affecting Joints, bones, ligaments, tendons and muscles.
What is Arthritis?
Arthritis means joint inflammation. The signs and symptoms of arthritis are pain, tenderness, swelling, redness and warmth of affected joints.
Is arthritis a single disease?
There are more than 100 different arthritis conditions described in the literature, ranging from Osteoarthritis, Gout to connective tissue disorders like Rheumatoid arthritis and Lupus.
Who will be affected by arthritis or Rheumatic disease?
Rheumatic diseases can affect individuals of all ages and both sexes, but more common in females.
Rheumatic diseases significantly impact daily life. Early diagnosis is key to preventing further damage.
Arthritis diagnosis is often delayed for years, e.g. Rheumatoid arthritis 2 yrs, Lupus 3 yrs, Ankylosing Spondylitis 10 yrs, Sjogren’s syndrome 20 yrs.
Delay in diagnosis is primarily due to lack of awareness and non-availability of Specialists. Most of the patients go to orthopaedics, neurologist or a GP. For Rheumatic pains, one must consult a Rheumatologist.
If not diagnosed early and treated appropriately, daily activities are affected, reducing the quality of life and affecting physical abilities.
How can the situation be improved in India?
The situation can be improved by better educating GPs, by also making patients aware of relevant symptoms, by increasing the number of trained rheumatologists in the country.
There are only few Rheumatology teaching centres are available in India. India needs more than 20,000 Rheumatologists. Now there around 800 Rheumatologists are available in India. We need more DM, DNB and fellowship programmes in Rheumatology to cater to our needs. National Medical Council (NMC) should take necessary steps to increase Rheumatology training centres in India. NMC should allow more postdoctoral (post MD) Rheumatology fellowship programs across India in all teaching hospitals. Even if NMC allows 100 teaching hospitals (2 fellows per hospital/year), it will take 100 years to train 20,000 Rheumatologists. It looks horrifying.
Lakhs of patients are suffering due to non-availability of Rheumatology services in most of the hospitals. Thousands of rheumatology patients are dying due to delayed diagnosis and lack of proper treatment facilities across India.
What are the different types of arthritis seen in India?
RMDs(rheumatic musculoskeletal diseases) are classified into inflammatory and non-inflammatory conditions.
Non-inflammatory diseases: Osteoarthritis of Knees, Degenerative diseases of spine, Osteoporosis and Fibromyalgia
Inflammatory diseases: Common inflammatory rheumatic diseases are Rheumatoid Arthritis, Lupus, Ankylosing Spondylitis, Psoriatic Arthritis, Dermatomyositis, Scleroderma, Mixed Connective Tissue Diseases and Juvenile Rheumatoid Arthritis.
RMDs can affect males and females, adults and children.
Most autoimmune rheumatic diseases affect females predominantly.
Spondyloarthritis and Gout affect mostly men.
Osteoarthritis and osteoporosis are seen elderly.
Juvenile Rheumatoid arthritis is seen in Children.
RMDs are the most significant cause of sick leaves and premature retirement.
If untreated, it may reduce the life expectancy in some RMDs.
What are causes of arthritis?
In autoimmune rheumatic disease, the cause is precisely not known, but it is related to an imbalance in the immune system.
Gout is due to high uric acid in the blood. It could be hereditary or excessive intake of red meat or alcohol.
Osteoarthritis: It is linked to obesity, sedentary lifestyle and Occupational (miners, footballers).
What are the symptoms of arthritis:
Joint pains, swellings, early morning stiffness, redness and warmth of affected joints.
Muscle pains and weakness.
Fatigue.
Reduced range of movements in the joints.
Joint deformities.
Severe low back pain in the morning,
Excessive hair fall, recurrent mouth ulcers, increased skin pigmentation, red rashes on face and exposed parts of the body.
Symptoms related to internal organ involvement.
What are the risk factors?
Obesity
Increasing age
Occupation
Alcohol
Red meat
Smoking
Genetic factors
The Author is Consultant Rheumatologist, KIMS Hospitals, Secunderabad
