United Arab Emirates, Dubai – 05 May, 2015: Suffering from a joint pain, stiffness with a swelling? Most people would consult a General Practitioner or take over the counter pain relief medication in the hope that the aches and pains would go away. However, this could be an indication of a more serious problem, namely rheumatoid arthritis. According to the Emirates Arthritis Foundation, 20% of UAE’s population suffers from a form of arthritis. Statistics for the percentage of rheumatoid arthritis sufferers are however unclear.

“The number for arthritis sufferers in the UAE is most likely higher particularly because the condition often goes undiagnosed.  There is a general lack of awareness of the different types of arthritis and people don’t always approach the right specialist to get a timely diagnosis so we feel that there is a sizable population that is not diagnosed and are still suffering,” said Dr. Bhavna Khan, Rheumatologist at Burjeel Hospital for Advanced Surgery, Dubai.

“Some types of arthritis are caused by lifestyle choices such as a lack of exercise, obesity, very poor exposure to sunlight that causes Vitamin D deficiency and an unhealthy diet. Rheumatoid arthritis however is an auto immune disease and is caused by the body’s immune system attacking own joints. It predominantly affects more women than men for unclear reasons, possibly hormonal effects may have a role to play. Rheumatoid arthritis can affect people of any age including children, but commonly seen in young women.  It is not caused by aging as is a popular belief. My youngest patient is 18 months old and my oldest 75 years old,” she continued. “It is not diagnosed early because symptoms can be vague. Initial symptoms include joint pain, stiffness and slight swelling in the area of the pain with people taking pain killers to combat it. More often than not their condition is treated by general or orthopedic doctors and patients rarely see Rheumatologists directly.”

“At the early onset of rheumatoid arthritis, the lining of the joint, synovial membrane gets inflamed and this leaks fluid into the joint space leading to swelling and stiffness. If the inflammation is not treated and becomes chronic, it invades the cartilage destroying it and eventually damages the bone surface and ultimately the bone,” Dr. Bhavna explained. “In advanced cases of the condition, sufferers do not have cartilage and their bones start rubbing against each other leading to osteoarthritis.”

As the disease progresses patients have difficulty in simple daily tasks such as opening a bottle, squeezing tooth paste or even washing their hair. In the case of rheumatoid arthritis in the knees and feet, mobility will also be affected.

Early diagnosis and treatment can lead to the effective management of the condition.

There have been huge advances in the treatment of Rheumatoid arthritis and if diagnosed and treated very early, joint damage can be prevented. Even though diagnosed early, many people are reluctant to take medication due to fear of side effects.  Very often the crucial period of treatment is lost and people may end up developing joint deformation and disability. And in the long term if not treated, Dr. Bhavna points out the condition may have a systemic impact – it can cause lung inflammation, high risk of heart disease, and in some severe cases can be associated with certain types of blood cancers known as lymphomas. Hence it is absolutely vital to start early treatment and be monitored by Rheumatologist on a regular basis. Taken under appropriate supervision, most of the medicines are safe and highly effective. 

“Joint replacement surgery is the last option when it comes to treating rheumatoid arthritis – this is usually the stage when joints are severely damaged. Modern advancements mean we can prevent joints reaching this stage. Early treatment includes use of simple anti inflammatory medicines, or short term use of steroids. Long term treatments are usually required with medicines known as disease modifying agents. Treatment plans are usually tailored to each individual. There are newer medicines called Biologics and are generally reserved for people who have severe disease or fail to respond to conventional medicines. These medicines drastically improve the quality of life, preserve the joins and avoid long term damage. If a patient is diagnosed early they can also go into long term remission,” Dr. Bhavna said.