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.
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.
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.
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.
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.
Experts recommend physical activity of 30 minutes per day for five days a week in the form of walking and swimming.
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.