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.

 

 

 

This is only for your information, kindly take the advice of your doctor for food, medicines, exercises and so on.   

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12 Things You Should Never Lie To Your Doctor About

When it comes to a meeting with a doctor, a few white lies may actually snowball into a real tragedy. And while you may not see any harm in concealing a bad habit, forgetting to mention a multivitamin you take, misrepresenting the amount of exercise you do, or simply not showing up at the doctor’s office for a while, all of these things may really harm your health and pose a serious health risk. Learn which 12 common lies you should never say to your doctor by reading through the list below.

1. Make sure to state all the medications and supplements you’re taking, even over-the-counter drugs and nutritional supplements

Anything that you ingest or inject into your body may interfere with its functioning or another medication you are prescribed, so not mentioning them to your health provider puts you at risk of side effects and drug interferences, which can potentially endanger your physical and mental health.

These medications include:

• Prescription medications (e.g. blood-thinners, antidepressants, antibiotics, and heart medications).
• Over-the-counter medications (such as aspirin).
• Herbal remedies (botanical remedies and herbal supplements).
• Vitamins and supplements (complex vitamins, amino acids, minerals, protein supplements, weight loss supplements).

The symptoms of a problematic drug interaction vary and can potentially be life-threatening: extreme drops in blood pressure, an irregular or fast heart beat, liver and kidney damage, nausea, upset stomach, and headache. The list of drugs and symptoms goes on, and only a licensed professional can confirm whether the combination of drugs you’re taking is safe.

2. Mention all past surgeries and medical procedures, even minor ones, including pregnancies and labor

Being honest with your doctor about every minor surgery or cosmetic procedure that happened years ago might not seem important to you, but this information may be a crucial clue to your doctor that can help diagnose and treat your condition. Be explicit about any surgeries and medical procedures you’ve been through, including:

• Cosmetic and plastic surgery.
• Labor complications or abortions. 
• The removal or skin bumps or lumps.
• Trauma, etc.

This is important because some surgeries increase your likelihood of developing certain diseases and symptoms, e.g. a removed gallbladder may make you experience bloating and abdominal pain after eating fatty or spicy foods.

In addition, your previous surgeries may give your doctor some additional insight to what’s going on or point to a bigger issue, like a cosmetic filler may get inflamed or cause severe and even chronic allergic reactions, which may not be diagnosed unless you disclose that you had this procedure.

Finally, anesthesia-related issues, such as the possibility of complications, are always a consideration before an upcoming surgery, and a history of previous surgeries may help your doctor better gauge the dose and kind of anesthetic to be used.

3. Don’t lie about your age and your parents’ medical history

Disclosing the patient’s age accurately is extremely important, as many crucial preventative medical procedures are age-dependent. This may help you prevent serious diseases, such as cancer, for one. Another preventative measure that you might be missing out on are immunizations, the majority of which are age-dependent, especially for kids.

Speaking of children, it is of utmost importance to be accurate about the age of small kids, as the medications they can take safely and effectively lean on the age of the child. It is also important for everyone to notify their doctor about any conditions that run in their family, such as cancer, diabetes, genetic conditions, etc., as your doctor will assign additional tests and screenings for you to prevent or manage the condition you are likely to have inherited from your family.

4. Never misrepresent how much you exercise, as well as the quality of your diet

It is understandable that we want to look good in our doctor’s eyes and often state that our activity levels are higher than they actually are, but a lack of exercise, as well as an unhealthy diet,  can set you at risk of diabetes and heart disease, and your doctor has to know how much you actually exercise to be able to access your long-term health.

For one, they can actually help you choose the diet and exercise regime that is best-suited for your lifestyle. But a lack of exercise isn’t the only danger, as your doctor may direct you to abstain from exercise or certain foods for different reasons, and if they don’t know that you work out and eat too much or too little of something, you’re setting yourself to more complications.

5. Always state the truth about how much time you spend outdoors, especially without sun protection during the day

Unprotected sun exposure increases your likelihood of developing skin cancer, even during short trips from the car to the shopping mall, to work, or home. Even if you don’t get sunburned regularly, but don’t wear and reapply sunscreen, or used to tan without sunscreen on in the past, you’re at a higher risk of this condition, as are the people who visit tanning beds.

If any of the above-mentioned conditions apply to you, share this information with your doctor, as you will require more thorough and regular skin examinations.

6. Don’t lie about your oral health

We all know how we’re supposed to brush and floss twice a day, and we’re often very eager to share that knowledge with the dentist, even when we don’t really follow this recommendation ourselves.

But the truth of the matter is that your oral health is inevitably connected to your overall health, and poor oral hygiene has been linked to a variety of health issues: frequent coughs, cardiac disease, problems conceiving (in women), and several others. Be explicit about your oral hygiene habits and improve them if your doctor claims it may be causing your health issue. 

7. Honestly state your own medical history, including the last time you’ve seen a doctor

Let’s face it, for most of us, going to the doctor is a dreaded chore, especially if you know that you have a particularly uncomfortable procedure to go through, and a few months delay can swiftly snowball into years for some people. Whatever is the case for you, be straightforward with your healthcare provider about the last time you paid them a visit, as during this time, you might have missed a few preventative procedures, immunizations, and routine checks.

In simple words, your doctor will make a more thorough examination when they know that you haven’t been to a doctor for a while. The same rule works for your health history: e.g. a previous history of many allergies, for example, increases your likelihood of having asthma, so it warrants a more in-depth investigation of the lungs.

On top of that, your medical history may influence the kind of medical treatment you can or cannot receive for a non-related condition, so always make sure to notify the doctor of any other conditions you have or used to suffer from, including allergies and chronic illnesses.

8. Be honest about uncomfortable matters, such as bowel movements, menstrual cycle, mental health, etc.

While it may be a very uncomfortable topic of discussion to you personally, things like bowel movements, reproductive and mental health are what most doctors deal with on an everyday basis. Furthermore, factors like erectile dysfunction or anxiety may be an important diagnostic criterion of seemingly-unrelated conditions, and letting your doctor know about these symptoms will help you feel better in the long run.

Apart from that, symptoms like constipation or diarrhea may be pointing to problems with your medication. Finally, some medications may be dangerous for you, e.g. certain heart medications may worsen one’s depression symptoms, so it is key to tell your doctor about your condition for them to choose a different medication for you.

9. Tell your doctor if you haven’t followed the directions before a medical procedure

Telling an anesthesiologist that you have fasted before a surgery when you didn’t can cause severe complications, as during sedation, the contents of the stomach may spill over into the respiratory tract, making you choke on your food or develop pneumonia.

It is important to reschedule your surgery, in that case, as going under the knife will endanger you. But a fast not kept before surgery isn’t the only issue, as not following the doctor’s directions may also mess with your blood test or imaging results, so it’s best to be explicit if you haven’t really followed the instructions as you were supposed to.

10. If you haven’t understood something your doctor told you, ask a follow-up question

It is natural to ask follow-up questions, but many patients are too modest and don’t want to impose their concerns to their doctors.

In reality, however, it is crucial that you understand exactly what to do after leaving the doctor’s office, be it making appointments to other specialists, how often to take the newly-prescribed medication or how to prepare for an upcoming screening or procedure. Don’t be afraid to raise any questions and concerns, even if it takes some extra time at the doctor’s office. 

11. Let your doctor know if you forgot to take the prescribed medication

It is crucial for your doctor to know if you made any alterations to your medication schedule, as taking too much or too little of the medication, or skipping as little as a day can really affect your health. And it doesn’t matter if you stopped your antibiotics a few days early, skipped contraception or forgot to take your heart medication, you should always keep your doctor informed about this.

The same goes for misrepresenting the amount of painkiller you take daily, even if it’s an over-the-counter one. If you have to take more of the medication your doctor prescribed or supplement it with an over-the-counter one, it can damage your liver and build up the number of toxins in your body, but it isn’t all.

If you’re taking a prescription painkiller, it is crucial to stick to the doses you were prescribed, as several painkillers (e.g. Percocet, Vicodin, Norco, Ultracet) are combination pills and they include strong opioid medications in addition to acetaminophen, which are addictive and damaging to your health.

12. Be explicit If you smoke, drink alcohol or take any recreational drugs

This last point is actually a crucial one, as it can be life-threatening. Alcohol consumption and drug use can mess with the rest of your medications, making them less effective or causing side effects. Marijuana use, for example, can render some antidepressants, heart medications and blood thinners ineffective.

A severe alcohol habit is no less harmful, however, as alcohol withdrawal symptoms can kill an in-patient, especially if the patient didn’t disclose their habit and the doctors don’t suspect they’re supposed to treat withdrawal symptoms and not something unknown.

Smoking tobacco, on the other hand, increases one’s likelihood of developing a variety of lung diseases, erectile dysfunction, heart disease, and stroke. Finally, all of these habits may interfere with your vital signs and health tests, which will prevent you from getting the treatments and health screenings that you really need.

 

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