Arthritis: Delaying treatment can lead to deformities
Arthritis, a term for conditions that cause inflammation, pain, and swelling in the joints, can be controlled with medication.
Denial and fear of medication, and turning to unscientific treatment methods, are often what complicates treatment for rheumatoid arthritis, say doctors. Take the example of 45-year-old Sudha (name changed) from Chennai who was diagnosed with rheumatoid arthritis five years ago. As she was hesitant to get it treated with modern medicine, she turned to native therapies. Her condition worsened over time, as she developed deformities in the knee and hand joints, leaving her immobile. She finally came to a hospital for treatment and is now taking medications to manage her condition.
She will require surgical intervention, but for now she is managing with medicines. Her condition has vastly improved as she can now cook food and manage her chores by herself. Earlier, she couldn’t even get up from the bed. If she had started treatment early, the deformities could have been prevented. Deformities occur when chronic inflammation or mechanical wear alters the physical structure of a joint, destroying the stabilising cartilage, bone, ligaments, and tendons. These changes shift the bones out of alignment, creating visible structural deformities and significantly reducing mobility.
“This is the mistake people mostly make. They delay the treatment when diagnosed with arthritis, and end up with complications. Most of them will be in denial mode, or go for native treatment rather than choosing allopathy,” said Dr Thilagavathi Nambi, senior consultant, rheumatology, SIMS Hospital, Chennai.
“Arthritis including rheumatoid arthritis can be controlled with medications without needing surgical intervention, but the patient should come to the doctor early. Earlier the treatment, better the outcome,” Dr Nambi added.
“Sometimes, the joint inflammation can start in the nearby tissues like muscles and tendons,” said Dr A Aravindan, assistant professor, department of rheumatology, SRM Institute of Science and Technology, Kattankulathur.
Some of the common types of arthritis are osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus commonly known as lupus, ankylosing spondylitis, juvenile idiopathic arthritis, gout, psoriatic arthritis and septic arthritis. Rarely blood vessels are also affected called vasculitis. Some common signs of arthritis are morning stiffness, swelling, joint pain or reduced mobility that affects day-to-day activities.
The most common form of arthritis is osteoarthritis, caused due to wear down of cartilage associated with ageing, resulting in bones rubbing against each other and causing pain and stiffness. Rheumatoid arthritis, lupus,psoriatic arthritis and ankylosing spondylitis are due to autoimmune disease where one’s immune system attacks the joints. Instead of natural aging, the immune system mistakenly attacks the body’s healthy tissues, causing chronic inflammation.
Septic arthritis is caused by an attack of previous viral or bacterial infection including chikungunya, tuberculosis and other infections. Gout is caused by abnormal deposits of uric acid in the body that gets deposited on joints. In Juvenile idiopathic arthritis, the cause is unknown, doctors added. “Age factor (45 to 50 years) and obesity are the main reasons for osteoarthritis. These people develop activity related pain. They initially have pain while climbing up stairs and doing certain activities. As the arthritis progresses, their activities will be limited. They can develop deformity if not treated early, said Dr Arun Kannan, consultant, Orthopaedic Surgeon, Apollo Hospitals, Chennai.
While there is no cure to reverse cartilage loss, osteoarthritis can be managed with a combination of lifestyle changes, medications, supportive therapies, and, if necessary, surgical options. The core goal of treatment is to reduce joint pain, maintain mobility, and improve quality of life. “The treatment for osteoarthritis depends on how severe the condition is. In the early stages, the treatment will include preserving the remaining cartilage, limiting or modifying certain activities which would control pain and preserve the cartilage. Weight reduction will also help,” said Dr Arun.
Joint pain- Aching or soreness during or after movement.
Stiffness- Reduced flexibility or trouble moving the joint, often worse after resting or in the morning.
Swelling and warmth- Redness and tenderness around the joint capsule.
Decreased range of motion- Difficulty performing everyday activities.
General Treatment and Self-care- Lifestyle adjustments- Maintaining a healthy weight to reduce pressure on joints.
Physical activity- Engage in low-impact exercises like swimming or walking to build supporting muscles.
Medical care- Using targeted pain relievers, anti-inflammatory medications, or seeing for customised care.
Osteoarthritis- It is the most common form of arthritis. It happens when the smooth cartilage protecting the ends of the bones breaks down.
Bones then rub against each other, causing pain and stiffness.
Risk factors-
Aging- Years of use natural wear and tear on the joints.
Joint injury- Past sports injuries, fractures or surgeries can damage the joint.
Excess weight- Excess body weight puts heavy pressure on weight bearing joints like the knees and the hips.
Genetics- Family history can make some people more likely to develop it.
Repetitive stress- Jobs or sports that put constant stress on the same joint and increase the risk.
Gout is considered as temporary arthritis, as it comes and goes. One of the serious types of arthritis is lupus in which multi organs including kidneys, lungs, and skin are involved. “It is a tough disease to treat for doctors. Nephrologists and rheumatologists will jointly treat lupus,” said Dr Aravindan. Thorough and repeated clinical examination is important to find out the cause and treat effectively. “Laboratory investigations including blood tests and diagnostic investigations like X-ray, MRI, CT, PET and other imaging techniques are used for evaluation,” added Dr Aravindan.
Arthritis is broadly classified into inflammatory and non-inflammatory types based on the underlying biological mechanism driving the joint damage. The primary difference lies in the source of the problem: inflammatory arthritis is caused by an overactive immune response attacking the joint lining, while non-inflammatory arthritis is primarily caused by mechanical wear, structural breakdown, or metabolic deposition.
“The distinction between inflammatory and non-inflammatory types is made through blood tests that look for specific markers — such as rheumatoid factor, erythrocyte sedimentation rate, C-reactive protein, anti-CCP antibodies, and antinuclear antibody. In select cases, uric acid levels and HLA-B27 testing also help pinpoint,” said Dr Varaprasad Narayanaswamy, assistant professor, department of orthopaedics, Government Medical College, Omandurar, Chennai.