Active Stocks
Thu Sep 28 2023 15:59:12
  1. Tata Steel share price
  2. 126.75 -1.09%
  1. NTPC share price
  2. 237.8 -0.65%
  1. Power Grid Corporation Of India share price
  2. 200.75 0.73%
  1. Tata Motors share price
  2. 613.95 -1.04%
  1. HDFC Bank share price
  2. 1,522.95 -0.28%
Business News/ News / Business Of Life/  Dealing with rheumatoid arthritis

Dealing with rheumatoid arthritis

The autoimmune disease, more common among women, is now being observed in people in their mid-20s

Where it hurts: Use of heating pads can ease pain.Premium
Where it hurts: Use of heating pads can ease pain.


Bhumika Anand, 32, co-founder of the Bangalore Writers Workshop and a media and communication professional, was diagnosed with rheumatoid arthritis (RA) at the age of 28. It started with severe joint pain in the fingers and wrists. Initially, none of her doctors indicated that she could be suffering from arthritis, for she was deemed too young.

Rheumatoid arthritis is an autoimmune disease; the immune system becomes hostile to one’s own body, attacking the joints, causing inflammation, swelling and pain. Inflammation occurs mainly in the synovial (flexible) joints, which become swollen, tender and stiff, leading to restricted movement. RA is a chronic inflammatory disease—if left untreated, it can cause severe disability and damage to organs.

Vineeta Shobha, additional professor and head, division of clinical immunology and rheumatology, St John’s Medical College Hospital, Bangalore, says the main distinguishing factor between arthritis and RA is that the latter flares up after a prolonged period of rest or inactivity, most often in the mornings, while an attack of arthritis occurs after a period of activity. Besides, RA not only affects the joint in the body, but over a period of time, it also affects organs such as the heart and lungs.

The statistics

According to K.M. Mahendranath, a Bangalore-based consulting rheumatologist and former president of the Indian Rheumatology Association, about 1% of the population worldwide is affected by RA. Anybody can be affected, even children, but it is predominantly seen in women, the proportion being 1:4, with the age of onset usually in the third and fourth decade of life. Though lately, he says, he has observed the age of onset occurring in the mid-20s, especially among people from the software industry.

The pathophysiology of RA is not entirely understood yet and there are a number of factors that may contribute to its onset. Dr Shobha explains that RA is a complex interplay between genetic factors and environmental factors, such as smoking; some viral infections may cause it; and probably hormones also have a role, as the disease is more common in women. Dr Mahendranath adds that poor dental hygiene in childhood and obesity are known to be contributing factors; the genetic factor, he says, accounts for 15-20% of cases. He says bacterial infection as a result of poor dental hygiene decreases immunity and can cause RA. Vitamin D deficiency may also be a factor, though there isn’t enough evidence yet.

There is no laboratory test to diagnose the disease. In the rheumatoid factor test, the presence of rheumatoid factor, a non-specific antibody, is taken as an indicator of the disease, but it is not always conclusive as a negative outcome cannot rule out RA. Diagnosis is made based on clinical history and presentation of symptoms.

Most people with RA experience intermittent bouts of symptoms, called flares. The most common symptoms of RA are morning stiffness, severe pain and fatigue, although intensity and progression vary from person to person and can change on a daily basis. Anand says: “Stress, any kind of emotional upheaval and cold weather can trigger a flare-up for me. I tend to be unenthusiastic and depressed during a flare-up. Managing the symptoms is a challenge as RA is debilitating and it certainly changes your life."


At present, there is no permanent cure for RA. Treatment mainly includes management of the disease to keep the inflammation in check and to relieve pain. Rest is advised along with painkillers if the pain is unbearable. Dr Shobha says exposure to warmth, such as heating pads or soaking the affected joints in warm water, can help relieve the symptoms.

Anand says: “Being in a positive frame of mind helps. Regular physiotherapy or some sort of exercise decreases the frequency of the flare-ups. Yoga, particularly practising relaxation techniques in yoga like the Yoga Nidra, and Pranayam, also help me."

Modern medicine offers several options. Dr Mahendranath recommends disease-modifying anti-rheumatic drugs (Dmards), known to relieve symptoms, decrease joint damage and improve overall functional abilities, as the primary mode of treatment. Dr Shobha adds that newer drugs such as biologics (biological agents that target specific parts of the immune system involved in the inflammatory process) are more effective in curbing inflammation, but are comparatively more expensive.

Ayurveda is gaining popularity as an alternative therapy owing to its holistic approach. Hari Pallathery, a Coimbatore-based consulting Ayurvedic physician, says a combination of internal and external treatment, such as traditional oil massages and intake of herbal concoctions, is used. The treatment is a multi-step process involving preparation of the body for cleansing and purging of toxins (Panchakarma) followed by steps to improve metabolism and strengthening of the body.


Gopi Indupriyal, a consulting physiotherapist in Bangalore, says physiotherapy helps relieve pain and strengthen the muscles surrounding the joints. Therapy includes isometric exercises (contraction and relaxation of the muscle without any movement in the joint angle), application of medicated wax to the affected joint, stretching exercises and lifestyle modification tips such as shifting weight from one leg to another when standing for long, and avoiding sitting in one position for more than half an hour.

A combination of rest and exercise is essential for the management of the disease. During a flare-up, it is best to rest the joints; once the inflammation has subsided, exercise helps to keep the joints flexible and strong. Dr Shobha says that as the peripheral joints are most affected, using the proximal, i.e larger joints, for weight-bearing activities is recommended. For example, it is better to carry a bag on the shoulder rather than holding it with the fingers.

Since RA is an autoimmune disease, it cannot be entirely prevented, but a healthy lifestyle and nutritious diet can delay the onset and mitigate the symptoms.

"Exciting news! Mint is now on WhatsApp Channels 🚀 Subscribe today by clicking the link and stay updated with the latest financial insights!" Click here!

Catch all the Business News, Market News, Breaking News Events and Latest News Updates on Live Mint. Download The Mint News App to get Daily Market Updates.
More Less
Updated: 20 Jan 2014, 07:30 PM IST
Next Story
Recommended For You
Switch to the Mint app for fast and personalized news - Get App