Myths & Facts
There are many myths doing around regarding Arthritis.Its very important to fact check with a professional and get help instead of believing someone who has either no knowledge or half knoledge on the subjectMyth 1: Arthritis is seen in old people and is a part of aging Fact: There are many type of arthritis. While the degenerative arthritis are more common after 50 years of of age, the inflammatory arthritis like rheumatoid arthritis and ankylosing spondylitis etc. can affect at any age (mostly they start at young –middle age). Even children can get arthritis, which is known as juvenile idiopathic arthritis or JIA.Myth 2: All joint pain are arthritis Fact: Arthritis in true sense means pain and inflammation of joint (which is the meeting point of 2 bones). But there are more structures around the joints like tendon, ligaments, bursa or soft tissue etc which can be inflamed or undergo overuse degenerative changes to cause pain. In fact, they are most common causes of pain than arthritis. Evaluation by trained rheumatologists will help you to find out the exact cause of pain and treat accordingly.Myth 3 : All type of arthritis are same and their treatment is done in same manner ? Fact: There are more than 100 types of arthritis and they have to diagnose properly as their cause, treatment and outcome are different. Arthritis is broadly divided into inflammatory arthritis and degenerative arthritis. Most common type of arthritis that usually occurs in old age is a type of degenerative arthritis known as osteoarthritis. This occurs due to degeneration of cartilage (sponge like material between the bones to avoid rubbing of bone against each other). Inflammatory arthritis usually occurs due to attack of our immune system on our joints. This can happen at any age and different types of arthritis affects different joints. This group includes rheumatoid arthritis, Spondyloarthritis or Ankylosing spondylitis, Psoriatic arthritis etc. Other type of arthritis include crystal induced arthritis (induced by uric acid crystals), infective arthritis (caused by direct attack of bacteria,fungi,tuberculosis etc.) and malignancy or cancer associated arthritis. There are many systemic autoimmune diseases like SLE, Sjogren syndrome (dry eye and dry mouth) etc. where arthritis is only one of the several manifestations of the disease. All of them treated differently. Myth 4: We should do arthritis panel (Panel of blood tests to diagnose arthritis) to diagnose arthritis before going to doctor ? Fact: No, arthritis cannot be diagnosed only by doing arthritis panel tests. Usually many labs offer a bunch of tests combined together labeling as “Arhritis Panel” and offer it at a discount price. Usually this involves ESR, CRP, Rheumatoid factor, Uric acid, ASO titre etc. We often tempted to do this because we believe that it will be of help to diagnose the cause of joint pain and if this is negative this will rule out any arthritis. But believe me, if these tests will be ordered without a proper assessment of type and pattern of arthritis, these may cause more confusion than clarity. Neither can the tests diagnose arthritis themselves because many normal people can have these tests positive, and some true patients of arthritis also may have these tests negative. For example, 5% of normal population may be positive for rheumatoid factor whereas 20% of patients who have rheumatoid arthritis may test negative for these tests.Myth 5: Arthritis once started can’t be treated. Fact: Arthritis is a chronic illness like diabetes or high blood pressure etc. So although many of them cannot be cured, but if treated effectively by a rheumatologist, most patients can lead a normal pain free life. Now, there are very effective medicines available, which are able to halt the disease progression and deformity if started early in the course of arthritis (that’s why early diagnosis is so important). In addition, lifestyle modifications like losing weight, eating balanced diet without junk foods, a healthy sleep routine etc can help tremendously. Myth 6: “Orthopedics” is the only branch in medical science, who should treat arthritis patients? Fact: In contrast to the popular belief that orthopedics is branch to deal with arthritis, the branch of medicine dedicated for arthritis treatment is known as “Rheumatology” and the specialist doctors are known as “Rheumatologist”. Rheumatologist are trained at diagnosing different kind of arthritis, administering proper treatment at proper time, monitor the drug side effects and handling any untoward complications either from the disease or from the drugs. Only in last stage, if surgery is required, it is done by an OrthopedicianMyth 7: In the initial stages, you should try to manage with over the counter “painkillers” or “home remedies”. You have to only consults specialists if you develop severe arthritis or deformity Fact: No, Early diagnosis and treatment is very important for halting the progression of most inflammatory arthritis. When the symptoms start, the initial days or months are known as “window of opportunity” as there is an opportunity for reversing the disease process and avoid progression to deformity if adequate and proper treatment is instituted at this stage. If you miss this period and develop deformities, it become irreversible. So don’t delay and consult a rheumatologist as soon as you have joint pain. Myth 8: If you have arthritis, you have to under a strict dietary control and avoid many foods Fact: As per scientific evidences, there is not much relation between diet and arthritis except few arthritis like Gout where you have to restrict alcohol and red meat. Most arthritis like rheumatoid arthritis, ankylosing spondylitis etc does not need any change in diet and you can take normal diet like an normal individual. It is always important to take healthy balanced diet and do regular exercise. Avoid smoking and as they may aggravate arthritis. Myth 9: Alternative medications like Homeopathy and Ayurveda can cure arthritis and they are free from any side effect. Fact: Although many alternative therapies have an ancient origin, there are several issues with them. The diagnostic approach for identifying different types of arthritis could not evolve over time. Most of them usually put all types of musculoskeletal pain in a single basket as rheumatism which is not correct. Different types of pain have different causes and they have to be addressed separately. Although there are some reports that these medicines help, there is lack of large scale authentic trials to prove their benefits. Moreover now days many unauthorized, untrained people are practicing alternative therapy without any basic minimum knowledge regarding the cause of arthritis. Over the counter adulterated medicine (mainly with steroids) further complicates the picture and may give rise to a lot of side effects. Myth 10: Allopathic treatment for arthritis mostly includes steroids and painkillers and you will have a lot of side effects if you will take allopathic treatment for long time. Fact: Allopathy advocate the use of the drugs which has undergone rigorous randomized clinical trial including thousands of patients, demonstrating their efficacy and lack of significant side effects. But you have to consult a rheumatologist who is trained and experienced enough to use these medications. Inflammatory arthritis like rheumatoid arthritis and ankylosing spondylitis are treated with a group of drugs known as DMARDS (Disease modifying anti rheumatic drugs) which include Methotrexate, hydroxychloroquine, sulfasalazine, leflunamide etc. These drugs help in modifying the immune system there by decreasing the immune attack in the joints. These are excellent drugs, which controls inflammatory arthritis, but each of these drugs has to be monitored for their potential side effects. Recently, Biological drugs are available which are very effective drugs but has to be taken only if recommended by your rheumatologist.