Rheumatoid arthritis, as we all know, is a chronic disease. Chronic diseases refer to those diseases which last a long time and we have to be on their medications for a long duration. Diseases like diabetes mellitus, hypertension, hypothyroidism, and high cholesterol fall in the same category. These health conditions are manageable but not curable. But does it mean we don’t treat them? We take medications for diabetes and hypertension, but if left untreated it can cause damage to our eyes and the kidneys. Thyroid medicines are taken as uncontrolled thyroid
can lead to a lot of changes to our body habitus. The same goes for rheumatoid arthritis. In this article, Dr Naval Mendiratta, Senior Consultant Department of Rheumatology, Fortis Memorial Research Institute, highlights five advantages of early diagnosis of rheumatoid arthritis.
Preventing Joint Damage
The main complication of rheumatoid arthritis is permanent damage to the joints which can only be corrected with surgery. Dr Mendiratta said, "Rheumatoid arthritis affects not only elderly people but can also cripple even young people of 20-25 years and that too at multiple joints. Some joints can not even undergo surgery." He added, "But yes! This can be prevented. Studies over the years have proven that if we arrest the disease early, the joint damage doesn’t happen and patients remain pain-free for a long time."
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"The early word is very important to understand," he mentioned. Early Rheumatoid refers to a disease duration which is less than six months. Dr Mendiratta added, "In clinical practice, we have noticed that patients who started therapy early are the ones who don't have any joint damage and can live their regular lives. Hence disease duration is the most important factor in preventing arthritis from getting aggressive."
Minimum Use of Painkillers
As per Dr Mendiratta, "Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) or painkillers are the most commonly abused medicines worldwide. Especially in India, it is available over-the-counter and people continue to use it without a prescription or without knowing when to stop."
So do they help in controlling rheumatoid arthritis? As per our expert, "The answer is no. They only help to stop pain for their stipulated time but do not reverse the inflammation. And the harmful effects are always there on the kidneys and the gut." He added, "So, most of our patients take Disease-Modifying Antirheumatic Drugs (DMARDs) which are usually free from painkillers. An early start to DMARDS can help control the disease fast and helps the patient manage the condition with minimum use of painkillers."
Minimum Use of Steroids
Dr Mendiratta said, "We often use steroids in the early phase as bridging therapy to control the disease fast but we avoid it for long-term use. The harmful effects of steroids are well known, as they can cause diabetes, cataract, increased weight, increased facial hair, and weakened bones." He added, "To our surprise, just like painkillers, they are available over-the-counter as well and patients then become dependent on it. Patients who make early and proper use of DMARDs can restrict the use of steroids to a minimum and are even able to avoid them completely. Hence the myth that we have to give steroids for life long in arthritis, doesn’t hold true."
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Preventing Damage to Other Organs
Rheumatoid arthritis is a disease of the blood which mainly affects the joints. Dr Mendiratta explained, "If rheumatoid arthritis is not managed properly, it can harm other organs as well with lungs and eyes being the most commonly affected. It can cause lung inflammation known as Interstitial Lung Disease which is often seen in patients who have uncontrolled arthritis for a long duration. In the eyes, it can cause dryness and inflammation as well."
He added, "When left untreated, fluid in the heart is also frequent in arthritis patients, increasing the risk of heart attack, thus, early control of disease helps shut off the inflammation fast and we can prevent attacks on our other organs as well."
Having a Good Quality of Life
Many people think that their quality of life will deteriorate due to arthritis. "It is a myth that scares people, which is not true. Having rheumatoid arthritis doesn’t necessarily have to lead to joint damage. Patients who are treated in the early stage of the disease can carry on their lives normally just like other people and you won't even be able to recognise that a patient even suffers from the disease. A good quality of life is a basic right of every individual and we, as rheumatologists, aim at providing patients with the same."
Dr Mendiratta said, "The aim is to create awareness in getting treatment started early for rheumatoid arthritis. We often catch patients after almost two years of disease when joint damage has already started. So we don’t want to lose out on this crucial period and have a good quality of life with no deformities and minimum use of painkillers or steroids."
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