What is rheumatoid arthritis?

Rheumatoid arthritis is an autoimmune disease marked by chronic inflammation that not only affects your joints but also your eyes, lungs, skin, heart and blood vessels. The immune system of a person suffering from the condition starts functioning abnormally, attacking the healthy cells and tissues. While other forms of Arthritis are usually linked to increased wear and tear of the joints, rheumatoid arthritis targets the lining of the joints, resulting in chronic swelling that eventually leads to bone and joint deformity.

Symptoms associated with rheumatoid arthritis

Rheumatoid arthritis is quite likely to affect the smaller joints initially and then radiate toward the larger ones. The symptoms are first experienced in the fingers and toes, from where they spread to the hands, arms and legs. Surprisingly, 40 per cent of people suffering from rheumatoid arthritis experience symptoms that have nothing to do with the joints. Common symptoms associated with the condition include:

• Early morning stiffness
• Swelling and tenderness in the joints
• Joint stiffness that increases after inactivity
• Weakness and fatigue
• Loss of appetite

What causes rheumatoid arthritis?

Being an autoimmune disease rheumatoid arthritis is caused by abnormalities in the immune system of the patient, that causes it to attack the healthy cells and tissues. These abnormalities could be a result of genetic components or certain environmental factors including bacterial and viral infection.

Treatment

Rheumatoid arthritis can be managed with medication like steroids, nonsteroidal anti-inflammatory drugs, conventional or targeted synthetic DMARDs and biologic response modifiers. Surgical procedures like synovectomy, tendon repair, joint effusion and total joint replacement are recommended in extreme cases. The treatment is usually paired with physiotherapy for better outcomes.

What is musculoskeletal pain disorder?

Musculoskeletal pain disorder is an umbrella term used for a wide range of disorders marked by pain in the bones, joints and soft tissues. The condition is very common, effecting a huge chunk of the adult population. The patient is likely to experience dull body ache and cramps in their muscles. These are accompanied by other common symptoms like pain and fatigue. You may experience the pain in any part of the body and especially in areas like the neck, shoulders, wrist, back, and lower extremities.

Different types of musculoskeletal pain:

Diagnosis and treatment

The diagnosis and treatment of the disorders call for the need for immense specialisation and advanced modalities. Your medical history will be reviewed followed by a series of tests like x-rays, CT scans and MRIs. Depending upon the underlying cause of the pain, the doctors will devise a proper treatment plan using a combination of physical therapy, exercises and medication like nonsteroidal anti-inflammatory drugs and analgesics.

• Bone pain, which is caused by fractures or other musculoskeletal injuries involving ki bones. It can also be caused by a tumour, which is comparatively uncommon.
• Joint pain, is marked by chronic inflammation and stiffness in the joints along with persistent pain.
• Muscle pain, which is accompanied by spasms and cramps, usually caused by an infection or tumour
• Tendon and ligament pain, which is caused by sprain, strain and excessive wear and tear.

What is osteoporosis?

Osteoporosis is a musculoskeletal conditions marked by the weakening of the bones as a result of which they tend to become brittle and prone to fractures. This is most likely to happen in the hip, spine and wrist. The old bone cells are constantly being replaced by a new ones, however in patients suffering from osteoporosis, body does not produce enough new cells to replace the old ones which results in loss of bone density. The condition can affect both men and women, with middle aged women being highly vulnerable.

Symptoms

Common symptoms associated with osteoporosis include:

• Gradual loss of height
• Stooped posture
• Brittle bones
• Persistent or severe back pain

What causes osteoporosis?

Our bones are constantly being renewed, with old cells being replaced by new ones. In case of small children this renewal takes place at a very fast pace however as we grow old it slows down gradually, with most people reaching their peak bone mass by the time they are 30 years old. In some cases cell renewal is not able to catch up with the degradation of the old cells, and this causes your bone density to decrease resulting in osteoporosis.

Treatment

Osteoporosis is usually treated with medication that includes biphosphonates and denosumab. This is combined with hormone related therapy and bone building medication along with healthy lifestyle modifications.

What is myositis?

Myositis is a condition marked by muscular inflammation painful swelling and weakness which is usually caused by an infection, injury, drug abuse or underlying autoimmune condition. The condition can you find a different types that include dermatomyositis and polymyositis. It usually affects larger muscle groups including those found in the hips, shoulders and back.

Symptoms

Myositis is characterized by muscle weakness which happens to be its main symptom of glide difficulty lifting arms, standing up from a seated position, climbing stairs, fatigue, trouble swallowing or breathing difficulty. In some cases the weakness is so insignificant that it can only determined with proper testing. The patient may not necessarily experience muscle pain. Other common symptoms which may be triggered by Myositis include:

Treatment

Myositis is managed with the help of immunosuppressive medications like prednisone and methotrexate. In case it is triggered by an infection caused by bacteria antibiotics will be recommended to prevent the spread of infection.

Fibromyalgia

What is fibromyalgia?

Fibromyalgia is a chronic disorder marked by musculoskeletal pain, usually accompanied by weakness, memory problems, sleep and mood related issues. The condition can increase painful sensations by affecting the way in which the brain and spinal cord process pain. The symptoms are usually experienced by severe physical trauma, surgery or psychological stress. In some cases the symptoms may build up over time, and the patient may not experience any of these in between. Fibromyalgia cannot be treated completely however it can be managed with the help of medication and lifestyle changes.

Symptoms

Common symptoms associated with fibromyalgia include:

• Body ache/fatigue/malaise
• Constipation
• Mood swings
• Sleep Disturbances

Treatment

Treatment of fibromyalgia includes a combination of medication and therapies. The patient may be prescribed pain relievers, antidepressants and anti-seizure drugs. Therapies include physical therapy, occupational therapy and counselling.

Lupus

Lupus more than a million cases per year in India, mostly seen in young females

It can affect joints, skin, kidneys, brain, eyes, lungs, blood cells and heart.

Common symptoms are skin rashes, joint pain, unexplained fever, anaemia, hair loss, mouth ulcers and abdomen pain (unexplained), recurrent abortions.

We diagnosed lupus by history, clinical examination and blood test.

Treatment

Lupus is a lifelong (chronic) condition, We treat it with steroids, HCQS, and Immunosuppressant. Biologicals are the latest modalities of treatment. If not treated people can die of its complications.

Spondyloarthropathy

It’s more common among the young population. It’s an autoimmune Inflammatory condition of the spine.

Symptoms

Common symptoms are low back pain and stiffness, more in the morning hours, reduced flexibility in the spine.

Types

• Ankylosing spondylitis: young males in the age group of 20-30 years
• Reactive Arthritis: develops afters a urinary or digestive system infections
• Psoriatic Arthritis: In psoriasis 30% patients develops arthritis.
• Enteropathic Spa: In patients with Crohn’s diseases

Treatment Include

Analgesics, immunosuppressants, physiotherapy, biologicals and life style change

Vasculitis

Vasculitis is an inflammation of the blood vessels & mostly an autoimmune cause, post-infective.

Symptoms are mainly unexplained fever, weight loss, muscle and joints pain.

Treatment consist of steroids and immunosuppressants

Mixed connective tissue disorders/overlap syndrome

Combination of two or more diseases leading to various symptoms and complications

Scleroderma: Harding and tightening of the skin and connective tissue. Mainly affects middle-aged women

Treatment includes medication, physiotherapy and surgeries.

All rheumatological disorders are managed by a multidisciplinary team (MDT)

• Rheumatologist
• Physiotherapy
• Occupational therapist
• Specialist Nurse