(If treated at this stage by modern drugs, further damage can be halted/ or delayed. If not treated at this stage effectively, damage will continue leading to the severe deformity as below.)

Deformed hand joints due to Rheumatoid Arthritis (RA)

Only a few years back, whenever somebody developed persistent joint pains and swelling, it was thought that there is no remedy except few pain killers  to relieve the pain and inflammation, patient was doomed to suffer. There was no concept of halting the ongoing march of arthritis, which usually resulted in progressive damage to the joints ultimately resulting a crippling bed ridden/ chair bound state. With the frame of mind of helplessness on part of patients as well as clinicians, these disorders were being managed by multiple agencies by unproven medications and therapies.

In the last decade or so, to deal with medical disorders of  the joints not requiring surgery, a new superspeciality called Rheumatology has emerged on the horizon of internal medicine. Modern drugs used in rheumatology have proved their effectiveness in halting the damaging effect of various arthritides especially Autoimmune diseases which include Rheumatoid arthritis (commonly known as Gathiya affecting mainly young females in child bearing age), Systemic lupus erythematosus (Multisystem inflammatory disease with skin rashes, fever and arthritis which can prove life threatening if not treated with urgency), Dermatomyositis ( Skin & muscle inflammation), Polymyositis (Muscle inflammation with severe proximal muscle weakness) and Sjogren’s syndrome (dryness of mouth & eyes and may be associated with joint pains) and of course Osteoarthritis ( Arthritis associated with age, obesity or weak musculoskeleton) to name a few. Rheumatology has developed considerably in recent years with the advent of better understanding of these diseases with modern diagnostic methods and better management with novel therapeutic modalities. A physician who deal with the whole spectrum of causes of Rheumatic deseases is called Rheumatologist. He is specially trained physican who has received specialized advanced training after obtaining MBBS & MD (Medicine) qualification   to find out & treat  the exact cause of arthritides by proven, scientific, modern rheumatic interventional techniques with the aim to halt the course of the disease and to save the joint from being deformed.

We’ve come a long way in the world of rheumatism and one of the most important things we’ve learned in recent years is that early and aggressive treatment is key to getting arthritides under control and preventing disability. But what is happening in the real world, all joint diseases are being dumped in one basket called arthritis and being treated by all and sundry by all sorts of ingredients and practices. What happens in the mean time, precious time is lost and arthritis continue to march  to damage the joint structures to limits of no return. A layman does not understand where to go, whom to seek the scientific, effective treatment. Patients go wherever their friends, relatives and medical practitioner of multiple discipline advices them to go.

Lack of awareness about the meaning of the rheumatologic terms is so acute that, what to talk about lay people, even few doctors, well educated doctors in their field are not aware about the meaning of Rheumatology & Rheumatologist. Very often patient reach to the rheumatologist after having developed multiple disabilities and deformities. With this in mind we are giving below the self explainatory table so that  everyone can decide for themselves where to go after developing the musculoskeletal pain in back or limb joints.

About rheumatism, it is a nonspecific term used by lay persons for various conditions with pain or other symptoms arising from joints (including those in spine ) or related to other elements of musculoskeletal system ( i.e. muscles , tendons, ligaments, cartilage and bone). Rheumatology includes over 120 diseases wherein arthritis and joint-symptoms are commonly present.

With the advent of Rheumatology, battlelines between patients in a partnership with their rheumatologist on one side and disorders we fight on the other have been drawn, and the scientific gauntlet has been thrown. In response to this, the clinical and tectonic plates of rheumatology have shifted in a profound manner, all for the good of our patients. Though a combination of explosions in our knowledge about basic mechanisms of disease, advances in our appreciation of the clinical “personalities” of autoimmune and musculoskeletal disorders, and the rapidity with which basic scientific wisdom is catapulted into therapeutic advances at the bedside, our patients are living better and longer lives. Today,s rheumatologist uses the multiple effective weapons in his armamentarium to detect and  intervene the disease process in its budding stage before it causes irreparable damage. He uses advanced immunological tests, imaging techniques (Musculoskeletal ultrasound, C-arm, video capillaroscopy) for this purpose. In other words, we can say that scene has changed in rheumatology for the great advantage to the patients. The need is to spread the awareness about this fact so that everyone can reap the benefit of  knowledge of rheumatology and save their joints, the basic transport of human and keep the wheels (joints) of nation moving.

The April issue of Arthritis & Rheumatism brings with it good news, which I would like to share with all the readers. I’m excited to know that even in the case of a degenerative arthritis called Osteoarthritis, lot of new researches are happening and the latest evidence has shown the presence of CPC ie, chondrogenic progenitor cells even in the late stages of Osteoarthritis and cartilage tissues had receptor for estrogen and androgen.  Local placement of these hormones may prove beneficial in future studies. I’m eagerly awaiting results. If you want to read the full article please see below,

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More often than not, people who suffer from obesity are heard complaining about joint pains much earlier in life as compared to people who maintain their optimum weight. As a doctor, it is easy to ask my patients to reduce their weight, however that is easier said than done. The larger problem at hand is motivating my patients to follow a healthy lifestyle and encourage them to actually lose the excess weight.

In my experience, there is a holistic improvement in the patients health after reducing their weight. I have treated such patients with a lot of patience and understanding as weight issues can be very sensitive, especially with women. So, I thought I’ll share some of my experiences with you.

If you know someone who is obese and is suffering from joint pains or arthritis and want to help them, the most important thing to do is, spare some time and understand why they are gaining weight. Take them to a doctor who would not only give them medicines to reduce the pain but wants to help them in the long run and tries to understand why he/she has gained weight & what increased weight is doing to his/her body systems?

What I do is, I show my patients a real vivid picture of their personality. It’s like showing them a mirror. It might sound a little insensitive to some but that’s what a well wisher will do. And it’s very important to have a doctor who you can trust to be brutally honest with you and show you the right path. Majority of the times, I have been successful in motivating my patients to reduce their excess weight and have seen arthritis symptoms ameliorate & even co-morbidities subside significantly. I motivate people on the following lines, I tell them in all sincerity that,

When you are obese, what you project to the world & tell the world about yourself is this: 

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