Myths & Facts about Arthritis
1- What is Arthritis (Myth: Arthritis is only one condition)
Fact: Arthritis means inflammation (pain, swelling) of joints; the term arthritis has been used to describe more than 200 conditions that affect joints, tissues that surround the joint, and other connective tissue.
2- Who is affected (Myth: only elderly people get arthritis)
Fact: People of all ages, gender, and races can have arthritis although females are more affected than males.
3- Risk factors (Myth: Age is the only risk factor)
Fact: Genetics, smoking, obesity, occupation-related, presence of other autoimmune diseases like hypo/hyperthyroidism, some infections, etc are the risk factors.
4- Symptoms of arthritis (Myth: Pain is the only symptom of arthritis)
- Swelling, pain, stiffness, and decreased range of motion of the affected part are the common complaints of patients with arthritis.
- Stiffness and pain are worst in early morning hours and in the night and some relief in the daytime or after some physical activity.
- Symptoms can be mild, moderate, or severe.
- Severe arthritis can result in chronic pain and impair a person’s ability to perform everyday tasks like gripping of the fingers and grooming.
5- Long term effect of arthritis (Myth: There are no long-term effects of arthritis so treatment can be ignored if pain tolerance is good)
- Persistent inflammation in the joint may lead to deformity and permanent joint damage.
- Arthritis can have effects on other organs like lungs, kidney, heart, eyes, liver, and brain.
- Compare to the general population, life expectancy has been shown to be reduced in patients with arthritis. Arthritis actually can kill.
6- Types of Arthritis (Myth: There is only age-related arthritis exists):
- Arthritis as such broadly divided into inflammatory arthritis and degenerative arthritis or osteoarthritis.
- Inflammatory arthritis is characterized by swelling/inflammation in joints.
- Common inflammatory arthritis is Rheumatoid arthritis (RA), Spondylarthritis group (Ankylosing spondylitis, Psoriatic arthritis, Reactive arthritis, arthritis associated with Uveitis and Inflammatory bowel disease), Juvenile idiopathic arthritis (JIA or childhood arthritis), and Gout (due to high uric acid).
- Degenerative Arthritis or Osteoarthritis (OA) is related to wear and tear of cartilage/joint and is essentially an aging process.
7- How to diagnose particular arthritis (Myth: diagnosis of particular arthritis is done by lab tests only and if tests are negative, inflammatory arthritis can be ruled out)
An arthritis specialist or rheumatologist would take a detailed history, perform a physical examination, and may do blood tests and imaging scans to help determine the type of arthritis.
The diagnosis of rheumatological disorders is mainly clinical.
Sophisticated immunological tests like RF (RA factor), Anti CCP, ANA, ANCA, HLA B27, HLA B51, Anti ds DNA, Anti SSA, SSB (Ro, La), ENA, APLA, Uric acid, etc could support the diagnosis only when the pre-test probability is high based on clinical profile.
The fact is history and physical examination contribute 90 to 95% to diagnosis and tests sometimes may be negative even in presence of particular arthritis/rheumatological condition.
Various advancements have been made in laboratory techniques in recent times.
8- Treatment (Myth: Steroids and painkillers are the only treatment):
DMARDs (Disease-modifying antirheumatic drugs) are the main treatment.
There are two types of DMARDs: conventional (cDMARDs) and biologic (bDMARDs).
Biologic DMARDs have changed the treatment and outcome of these diseases significantly and we can expect very good control of disease activity (complete remission).
9- Myths: all patients get similar treatment.
Fact: Rheumatologists typically make individualized treatment plans as one may not suit others depending on age, gender, pregnancy, and many other factors.
10- Myth: Patients with arthritis cannot have a normal life.
Fact: With the availability of the latest medicines, patients with arthritis can live a normal life with all their life plans.