Arthritis pain: Early treatment a must for relief

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Arthritis pain: Early treatment a must for relief

Saturday, 12 October 2019 | GAYADHAR BEHERA

Winter is coming! And that means winter holidays, cold weather, good food and end-of-year celebrations.

However, with this holiday season comes the painful bouts of joint pain and flare-up of rheumatoid arthritis. Rheumatoid Arthritis (RA) is a systemic auto-immune disorder in which the body’s own immune system, which usually protects the health, mistakenly attacks the joints.

Usually known to affect people in their 40s, RA affects about 0.92 per cent of the adult population in India, reported in several studies by healthcare experts. Almost 20-40 new cases are reported in the population of a lakh every year which finally forces one-third of the working population to quit their work within a couple of years of the disease’s onset.

Rheumatoid Arthritis occurs when the immune system of the body starts attacking the healthy tissue. This creates inflammation and thickening of the synovium (the tissue that lines the inside of joints) resulting in swelling and pain in and around the joints.

Normally the synovium makes a fluid that lubricates the joint surfaces and helps them move smoothly. If the inflammation goes unchecked, it can damage the cartilage, a smooth elastic tissue that covers the ends of bones in a joint as well as the bones.

Over a period of time, there is loss of cartilage leading to narrowing of joint space between the bones. Gradually the joints become painful, loose, unstable and lose their free mobility. Joint deformity can occur leading to painful suffering in daily activities. As the joint damage cannot be reversed, doctors recommend for early diagnosis and aggressive treatment to control RA.

 Winter season usually witnesses a spike in complaints of frequent joint pains in RA patients. Cold weather and shorter days in winter make it harder to go outside for exercise.

Another possible reason is that the RA patients  may have more muscle spasms in cold temperatures which worsens the pain and stiffness in their joints that they are already experiencing. The cold weather can also reduce blood circulation in toes and fingers which can aggravate the pain.

Identifying symptoms

RA most commonly affects the joints of the hands, wrist, elbows, feet, knees and ankles. The joint involvement is symmetrical which means if one hand or knee affected, usually the other one is also affected. In the initial stages, anyone with RA might experience joint swelling, early morning joint stiffness lasting over an hour, fatigue, a general feeling of being unwell, weight loss and weakness, loss of function and mobility. Ignoring the early symptoms of RA can result in the progression of the pain and swelling in joints like wrists, knees, ankles, elbows, shoulders and hips which over time, if left untreated, can cause physical disabilities and loss of function. Because RA can affect other body systems like heart, lungs, skin, eyes, blood, blood vessels etc, it is called a systemic disease.

Early diagnosis is strictly recommended to help stop the progression of earlier benign symptoms which, otherwise at worse cases, can cause deformation of joints and disability. Risk of getting affected with RA is higher if one of your family members has suffered from RA as it is believed to run within the family. It is also considered to be the predecessor for Osteoporosis and Lymphoma (cancer of the lymphatic cell) as well.

 Treatment

There is currently no permanent cure for Rheumatoid Arthritis, but timely treatment can help reduce inflammation in the joints, relieve pain, minimize loss of function caused by deformity, slow down and prevent damage to the joints. Many evidence based clinical studies indicate that remission of symptoms is more likely when treatment begins early in the disease course with medications such as disease-modifying antirheumatic drugs (DMARDs) and Biologic agents along with nonsteroidal anti-inflammatory drugs (NSAIDS).

Precautionary measures

Healthy living and positive thinking are extremely important for all patients diagnosed with RA. One must understand the disease, learn to live with the pain by making simple lifestyle changes, especially during the seasonal changes.

 Active lifestyle, regular exercise (aerobic, walking, swimming, yoga), weight control, adequate rest, quitting smoking, limited alcohol consumption, and nutritious food (proteins, calories and calcium) habits are essential.

During winter, one can try indoor physical exercises to avoid the cold weather outside to improve cases of joint stiffness and weakness of muscles.

Whether it is summer or winter, staying hydrated is highly important or it will make a person more sensitive to pain.

Avocados or butter fruit, walnuts and fish can be included in the diet as the Omega-3 fatty acid can help in reducing inflammation in the joints. Regular consultation with your doctor is a must.

 (Dr Behera is Consultant Orthopedic Surgeon at BR Life Kalinga Hospital, Bhubaneswar)

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