World Autoimmune Arthritis Day: Understanding Autoimmune Arthritis

Autoimmune arthritis is a chronic inflammatory disease that affects millions of people worldwide, including a sizeable population in India. Rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) are the most common types of autoimmune arthritis. This article provides a comprehensive overview of autoimmune arthritis in India and explores its symptoms, diagnosis, treatment options and unique challenges faced by patients in the Indian healthcare setting.

India faces some unique challenges in managing autoimmune arthritis. Diagnosis and treatment are often delayed due to limited awareness and understanding of the condition among the general population. Furthermore, the availability and accessibility of specialized rheumatology services, including trained health professionals and diagnostic facilities, remains inadequate in many areas.

Unsplash/Representative image

Although specific statistics on the prevalence of autoimmune arthritis in India are limited, studies suggest that approximately 0.5-1% of the Indian population suffers from RA. However, data on the prevalence of other autoimmune arthritis such as PsA and AS are lacking.

Autoimmune arthritis includes a range of chronic inflammatory conditions in which the immune system mistakenly attacks your own joints, causing inflammation, pain, and potential joint damage. The main symptoms of autoimmune arthritis are:

1. Joint pain and stiffness: Persistent pain and stiffness in the affected joints is a common symptom. Pain is usually worse in the morning or after a period of inactivity. It may be described as painful, throbbing, or sharp and may affect one or more joints.

2. Joint swelling and redness: Affected joints often show swelling, tenderness, and redness. Swelling is the result of inflammation, which can cause visible swelling and swelling around the joint.

Unsplash/Representative image

3. Fatigue: Many people with autoimmune arthritis experience persistent fatigue, which can be excruciating and affect daily functioning. The exact cause of fatigue in autoimmune arthritis is not fully understood, but may be related to underlying inflammatory processes and related conditions such as anemia.

4. Decreased range of motion: Autoimmune arthritis can reduce flexibility and limit range of motion in affected joints. As the joints stiffen, along with pain and swelling, it becomes difficult to move the joints freely.

5. Systemic symptoms: In addition to joint-related symptoms, some people experience systemic symptoms such as fever, unintended weight loss, and general feeling sick. These systemic symptoms can occur especially during periods of flare-up of the disease.

Accurate diagnosis is essential for effective management of autoimmune arthritis. A combination of history, physical examination, blood tests, imaging tests, and synovial fluid analysis can help diagnose the condition. Health professionals face challenges in India due to limited access to specialized rheumatology services, delaying the diagnosis and initiation of treatment for many patients.

Unsplash/Representative image

Treatment options for autoimmune arthritis are aimed at relieving symptoms, controlling inflammation, slowing disease progression, and improving the overall quality of life for individuals living with these conditions. The specific treatment regimen will depend on the type and severity of autoimmune arthritis, as well as individual factors such as general health, age and personal preferences. Common treatments for autoimmune arthritis include:

1. Drugs:

Nonsteroidal anti-inflammatory drugs (NSAIDs): These drugs are available over-the-counter or by prescription and help reduce joint pain and inflammation. They provide temporary relief of symptoms and are often used as first-line treatments.

Disease-modifying antirheumatic drugs (DMARDs): DMARDs are the mainstay of treatment for autoimmune arthritis. They slow the progression of the disease by suppressing the immune system and prevent joint damage. Methotrexate is a commonly prescribed DMARD, but other options such as sulfasalazine, leflunomide, and hydroxychloroquine may also be used.

Biological response modifiers: Biologics are a new class of drugs that specifically target immune system proteins and pathways involved in autoimmune arthritis. They are usually prescribed for moderate to severe cases that do not respond well to conventional DMARDs. Examples include tumor necrosis factor (TNF) inhibitors, interleukin inhibitors, and Janus kinase (JAK) inhibitors.

Unsplash/Representative Image

2. Physical therapy and exercise:

Physical therapy: Working with a physical therapist can help improve joint mobility, strengthen the muscles that support joints, and improve overall physical function. Your therapist may recommend certain exercises, stretching techniques, or assistive devices to manage your symptoms.

Low-impact exercise: Regular low-impact exercise, such as swimming, cycling, or walking, improves joint flexibility, maintains muscle strength, and reduces pain. It is important to balance physical activity with rest and avoid high-impact activities that can exacerbate joint symptoms.

3. Lifestyle modifications:

Rest and joint protection: A balance of activity and rest is essential to manage symptoms and prevent joint damage. Avoiding repetitive movements and using assistive devices, such as braces and splints, help protect joints in everyday activities.

Unsplash/Representative image

Weight management: Maintaining a healthy weight is important to reduce strain on joints and reduce symptoms. Losing excess weight can significantly improve joint function and reduce pain.

Hot and cold therapy: Applying hot or cold compresses to the affected joints provides temporary relief and reduces inflammation and pain.

Autoimmune arthritis is a huge burden in India, affecting many people and causing unique challenges. Raising awareness, improving access to specialized rheumatology services and ensuring affordable treatment options are important steps towards better management of autoimmune arthritis in the country. Addressing these challenges and improving the lives of people living with autoimmune arthritis in India will require collaboration between healthcare providers, policy makers, patient advocacy groups and the pharmaceutical industry. Coordinated efforts will enable early diagnosis, effective treatment and improved quality of life for patients with autoimmune arthritis nationwide.

About the Author: Dr. Naman Jain is a Clinical Immunology and Rheumatology Consultant at Ramkrishna Care Hospital, Raipur. All views/opinions expressed within the article are those of the author.