As a practicing Rheumatologist I come across people with arthritis harbouring the mistaken notion that arthritis confines its symptoms to the joints alone. Certainly, most common arthritic disorders involve the joints with pain and swelling of the joints being the most common symptoms however, in many instances, this is just the tip of the iceberg. Arthritic disorders more appropriately “Rheumatic disorders” can affect any part of our body like skin, eyes, hair and sometimes vital organs like lungs, heart, kidney, and brain. Rheumatological diseases if left untreated apart from disability can increase the risk of heart diseases and stroke and can be a silent killer like diabetes and hypertension.
There are more than 100 different types of arthritis, that is why it is sometimes called the disease of many faces. The most common type of arthritis encountered in day-to-day practice is Osteoarthritis, which is caused by the inability of joints to repair themselves, leading to increased wear and tear. This may be due to prior injury or obesity, which puts extra burden on joints. While it is more common with age, it is important to note that it is not a normal part of aging and that it does not occur only in older people. Treatment mainly involves life style modification and sometimessurgeries.
Then there is inflammatory arthritis which is caused by the immune system reacting against its own body. Examples include Rheumatoid arthritis, Psoriatic arthritis, Gout, Juvenile arthritis, systemic lupus erythematosus etc.
Common symptoms are pain, redness, swelling and early morning stiffness of the joints lasting more than 30 minutes. Apart from joint symptoms patients may present with patchy skin lesions, excessive hair loss, dry eyes and mouth, low grade fever and excessive fatigue. Patients may also present with sudden kidney failure, stroke in a young age, lung and heart disease. The trigger can be our life style, some infections, smoking, alcohol, and some genetic reasons.A wide range of drugs called anti-inflammatory/disease modifying anti rheumatic (DMARDS)/ Immuno-modulatory drugs are available to treat these disorders.
Rheumatological diseases should be recognized as major diseases of public health concern. Early diagnosis and timely access to treatment can prevent further damage and burden on the individual and society. By consulting a Rheumatologist these diseases can be diagnosed early and treated in time so that one can lead a disability free normal life.
Misconceptions about Rheumatic disease
Rheumatic diseases are the second most common cause of disability throughout the world. Unfortunately, the symptoms are often dismissed and a variety of misconceptions can often delay people from seeking help. Knowledge of the facts regarding rheumatic diseases is important and can help find appropriate therapy and solution for sufferers so that the quality of life can be equal to that of healthy people. Seeing a rheumatologist early can dramatically improve long term outcomes for patients.
Here are some myths about rheumatic diseases:
Myth 1: Rheumatic disease is another name for arthritis
Rheumatic diseases are specifically autoimmune and inflammatory diseases that cause the immune system (body’s defense system during infection) to attack joints, muscles and organs.Arthritis is one of the common affections of these diseases.
Myth 2: Symptoms are just aches and pains
The symptoms of rheumatic diseases can be difficult to pin point. Other than aches and painsrheumatic conditions can cause patients to develop deformities so severe that they can ultimately make daily tasks, like walking or getting dressed, feel impossible.Patient may present with nonspecific symptoms like eye irritation, fatigue, fever, hair loss, chest pain or more severe symptoms related to kidneys, heart, lungs, or brain.
Myth 3: You do not need to see a specialist
If you notice the symptoms of rheumatic disease, it is imperative that you talk to your primary care physician who will refer you to a rheumatologist if your symptoms indicate a rheumatic disease. Rheumatologists specialize in diagnosing, managing, and treating rheumatic disease and determine appropriate treatment, including medications and monitoring.
Myth 4: Rheumatic diseases only affect the elderly
Rheumatic diseases can affect children like Juvenile arthritis. Some arthritic disorders are more common in young age like Rheumatoid arthritis and Lupus. Some arthritis can be found in elderly due to deposition of uric acid in joints like Gout.
Myth 5: Rheumatic diseases only affect women
Lupus, osteoarthritis, and rheumatoid arthritis are more common in women while gouty arthritis is more common in men.
Myth 6: Rheumatic disease can be caused by eating certain food
The only rheumatic disease associated with food (alcohol, shellfish, large amounts of red meat) is gout
Myth 7: Rheumatic disease is a hereditary disease
Rheumatic diseases are not directly passed on from parents to children, although in some types of rheumatic diseases, there are genetic factors that influence the tendency of the off spring to suffer from the same disease.
Myth 8: Traditional medicine is safer and more effective in curing rheumatic diseases
There is no scientific evidence that traditional medicine (herbal medicines, magnetic bracelets, bee sting etc) can cure rheumatism. Some of them, such as certain herbs, are even very dangerous and can cause complications such as stomach bleeding in sufferers who consume them
Myth 9: Injection into joints can harm the joints or cause bone loss
In certain circumstances injections into the joints are needed in the treatment of joint pain, if done correctly this therapy is very helpful for sufferers who experience inflammation of the joints.Injection into joints do not cause bone loss, and should be performed by a doctor who is an expert in their field.
Myth 10: Medicines for rheumatism should be stopped immediately if the pain is gone or reduced because rheumatic drugs are harmful to the kidneys
Consultation with a doctor is very important regarding the use of rheumatic drugs. Some drugs must be continued for the long term even though the pain has disappeared. It is better not to take anti pain medications yourself for a rheumatic problem, because each drug has its own properties and side effects, so it needs doctor’s supervision while using these drugs.
Myth 11: Rheumatic diseases are incurable and depend on medication for life
It is not always true that rheumatism is incurable. In some rheumatic diseases such as joint pain due to viruses, it can heal with the disappearance of the viral infection, however there are some diseases that require long term therapy and can be controlled with drugs so that the patient does not feel pain and can carry out activities like other healthy people.
Myth 12: Rheumatic disease is not a serious disease, many over the counter drugs are used to treat this disease
In fact, on the contrary, do not consider rheumatism a normal disease, because some of these diseases can cause disability, some even endanger life and need proper handling.
(Author is Senior Consultant Rheumatology, Paras Health Srinagar)
