With prevalence higher than that of diabetes or cancer, arthritis has emerged as one of the widely spreading diseases in India, currently affecting nearly 200 million or about 15% of the population. Preventive measures and proper self-care are important for the country to bring down the burden from the disease, and to make a big difference to patients especially during the ongoing pandemic, when getting in-person consultation or medical intervention is proving to be difficult.

In connection with the Arthritis Awareness Month, being observed in May every year, across the world, arthritis is a swelling or tenderness in one (or more) of joints. It can affect many different parts of the joint and nearly every joint in the body. The most common forms of arthritis are osteoarthritis, rheumatoid arthritis, gout, and ankylosing spondylitis. Arthritis affects people in different ways. But the most common symptoms are pain, stiffness or reduced movement, swelling, redness, and warmth of joints. Also, the general symptoms include tiredness, weight loss, and feeling unwell.

People think arthritis is a normal part of getting older. However, this is not true. It can affect people of all backgrounds and age groups. Anyone including children and young people can get arthritis. Two out of every three people with arthritis are in the age group of 15 to 60 years.

Important for early detection.

Not many think that it’s a serious medical condition, and it needs timely medication and care so that it doesn’t aggravate further. Delay is often due to lack of awareness. Talk to your doctor if you have pain and stiffness associated with swelling, redness and warmth of your joints that begins with no apparent reason and lasts for more than a few days.

On useful preventive measures, diet and exercise can help prevent the incidence and progression of arthritis. Maintaining a healthy weight and engaging in physical activity reduces the risk of developing arthritis, especially osteoarthritis. Overweight women are almost four times more likely to get knee osteoarthritis than women with normal body weight.

Physical activity can ease arthritic pain, improve function and mood, and delay the onset of disability. Even small amounts of weight loss have proven to reduce pressure on the joints significantly. Consult your doctor or physiotherapist about the type of activity such as cycling, dancing, walking, gardening, swimming, and yoga that would be most appropriate for your condition. Exercise is crucial. Just 30 minutes of exercise five times a week helps joints stay mobile and strengthens the muscles that support your knees and hips. It’s essential to focus on low-impact activities like walking, cycling or swimming. Gentle stretching can improve your range of motion and keep your joints healthy. Try to work on simple stretches every day.

Role of a healthy and balanced diet in prevention of arthritis

A Various nutrients may help boost joint health and reduce inflammation. Foods that may help delay the onset or progression of arthritis are fruits and vegetables that provide antioxidants, low-fat dairy foods that contain calcium and vitamin D, and healthy oils such as extra virgin olive oil. These foods are a part of an anti-inflammatory diet. In contrast, foods that can increase the risk of oxidative stress, and inflammation are highly processed foods and foods that contain added sugar or salt, unhealthy fats such as trans fats and saturated fats, and red meat. Hence these foods should be avoided. Keeping blood sugar under control is also important, as high blood sugar can stiffen the tissue that supports joints and make them more sensitive to stress.

The need for avoiding injuries

An injured joint is more likely to develop arthritis than one that is never injured. Wear protective gear when playing sports and protect your joints from everyday strain using the correct technique when sitting, working, and lifting. For example, lift with your knees and hips, not your back – when picking up objects.

There is need for the public to have healthy lifestyle choices such as not smoking, avoiding stress, getting adequate sleep, and reducing alcohol intake can improve your well-being by keeping you high on emotional wellness, self-management and motivation.

Dr. Chirag Thonse
Consultant Orthopedic Surgeon
Vikram Hospital

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The novel Coronavirus that began in Wuhan, China has now become a global crisis. Following the reporting of three cases from India(all from Kerala), there is a growing number of cases of misinformation about the virus, ranging from racist explanations for the disease’s origin to false claims about miracle cures being circulated on social media.

• As per recent statistics, the death toll from Wuhan corona virus outbreak has killed at least 362 people and infected more than 17,300 globally, as it continues to spread beyond China. One person outside mainland China, a man in the Philippines, has died.
•  Nearly 60 million people remain under lockdown in Chinese cities as international researchers race to develop a vaccine and halt its spread

• Global spread: The virus has been confirmed in more than 25 countries and territories including Thailand, France, Germany, the U.S., and Canada,Malaysia,Hong Kong  since it was first detected in the Chinese city of Wuhan in December.
• Three cases of the coronavirus has been confirmed in India, all from Kerala.Over 800 people are under surveillance at their homes in Kerala for possible exposure to the virus.

Given that it is a novel virus, the need of the hour is to dispel the misconceptions surrounding the disease and raise awareness on the symptoms to watch out. This will ensure timely diagnosis and management and prevent complications.

The World Health Organization (WHO) on Thursday said that the novel corona virus outbreak has become a Public Health Emergency of International Concern (PHEIC).  

A pneumonia outbreak was first reported in December in the city of Wuhan of central China’s Hubei  Province. Experts have attributed the outbreak to a novel corona virus that has since spread across China and abroad.The corona virus is a virus that spreads through both direct and indirect contact. While direct contact happens through close contact with any kind of oral secretion, the indirect route could be through cough or sneezing – droplet infection.

Dr. Prashant Dash, Director-Medical Services, Medlife, says, “Like other corona viruses – such as the ones causing SARS and MERS – even the Wuhan virus comes from animals. Those who are infected may have flu- or pneumonia-like symptoms. It is therefore important to watch out for cough, fever and breathing difficulties and contact a specialist immediately. In severe cases, it can also lead to organ failure. There is no vaccine or treatment for this condition as of now and recovery is dependent on how strong the immune system is.”

Adding further, Dr Dash, said, “While it is not yet a public health emergency outside China, it is imperative to take precautionary measures. It is a good idea to get the flu vaccine and keep away from someone who has either returned from China or has flu-like symptoms to prevent transmission. Make sure you get information from the right sources and contact a doctor in case of any concerns.”

Some tips to follow

• Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Avoid close contact with people who are sick.
• Stay home if you experience flu-like symptoms.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
• Clean and disinfect frequently touched objects and surfaces.

^[1] According to China’s National Health Commission

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Arthritis – giving up Arthritis is not an option: Apart from medications, adapting life style changes including regular exercise, stop smoking, eating healthy and maintaining an ideal weight are important.

Joint pains and back pain are a very common ailment people visit a doctor with. It becomes disabling if symptoms become chronic. Arthritis has a big impact on the lives of millions of people worldwide. It affects them physically, emotionally and socially as well. It is important to diagnose and treat it early before arthritis takes the upper hand. World arthritis day is observed on the 12th of October every year to spread awareness about arthritis.

Arthritis means joint inflammation causing pain and stiffness. The most common type of arthritis is osteoarthritis which is due to wear and tear of joints and commonly affects knees, hips and low back. The other type of arthritis is inflammatory arthritis, which comes under the purview of a rheumatologist. This group includes rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and many more. Rheumatoid arthritis tends to affect women more than men, more so in 30-60y age group. It is an autoimmune disease. Genetic, environmental factors and smoking all play a role. About 1 in 100 people are affected by rheumatoid arthritis in India.

The symptoms suggestive of rheumatoid arthritis include pain in multiple joints, especially hands, wrists, feet and knees lasting more than 4 to 6 weeks. There may be swelling in the joints and typically severe early morning joint stiffness. Fatigue and feverishness commonly accompany. Treatment should be initiated under the guidance of a rheumatologist as early as 6 to 8 weeks of symptom onset, to be able to get a good hold on the arthritis.

The treatment is usually long term and includes medications called disease modifying anti rheumatic drugs. They may require simple pain killers or a short course of steroids when they are going through a flare up. For people with very severe arthritis we have biologic drugs that can be given in the form of tablets, injections or intravenous route. They are targeted treatment that work in a novel way and halt joint destruction. Apart from medications, adapting life style changes including regular exercise, stop smoking, eating healthy and maintaining an ideal weight are important.

We get to hear very interesting stories from patients, as to how their lives changed because of arthritis. “At 28, I delivered my first baby. Things did not go as well as I had thought, as life had other plans for me. Within a few weeks of delivery I developed severe arthritis. I could not even hold my baby due to pain. I had to be started on medications to control the pain. It was an everyday struggle juggling between daily chores, baby and a full time job. My life was ruled and dominated by the pain. I then consulted my doctor, who ran some tests and started me on these medications, advised simple measures to control the pain. Soon I was able to start to lead a normal life. I know how to take care of my joints now, with regular medications, exercise and eating a balanced diet”.

The outlook for people with rheumatoid arthritis is improving everyday with the advent of new and more effective medications. It is possible to lead a normal active life by taking regular medications and making necessary lifestyle changes. The key is to start treatment early and take it regularly.

Dr. Chethana D
Consultant-Rheumatology
Aster CMI Hospital, New Airport road
Sahakara Nagar
Bengaluru-560092
Ph: 080-43420100

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