BENGALURU: Nirmol Bashar, a 24- year-old presented with increasing hip pain for the past three years. The pain increased to such an extent that he had to leave his job and was largely homebound. It was found that his hips were fused due to a condition called Ankylosing Spondylitis which involved his hips and spine severely impairing his mobility and flexibility.
The disease had progressed rapidly to such an extent that the only option was a total hip replacement that would eliminate his pain and restore his mobility. The patient did well after both hip replacement surgery. If he had taken treatment at the onset, the disease progression could have been modified and also surgery avoided at this age.
Types of arthritis
Arthritis affects nearly 15% of our country’s population. Osteoarthritis is age-related wear and tear of the joints, which is exacerbated by excessive weight and lack of physical exercise. On the other hand, younger people are affected by a phenomenon called autoimmune arthritis. It is the name given to a group of arthritis types where a person’s immune system attacks itself.
Rheumatoid arthritis is the most common type of autoimmune arthritis, which tends to affect the wrists, and small joints of the hand. Ankylosing Spondylitis affects young males in the age group of 20-30 years. It is an irreversible, inflammatory and autoimmune disease which occurs when an overgrowth of the bones results in the bones fusing together, which results in a rigidity of mainly the hip and spine.
Psoriatic arthritis can occur in people with a skin condition called psoriasis. Psoriasis causes scaly, patchy areas to build up on the skin.
The affected joint areas can be almost anywhere on the body, including the knees, fingers, toes. Reactive arthritis occurs in people who have a history of certain bacterial infections. Treatment of autoimmune arthritis usually involves prescribing the patient on disease-modifying drugs or more recently evolved class of drugs called ‘Biologicals’, which after short duration of treatment can completely resolve the symptoms for pronged periods of time.
Watch out for early signs
Arthritis symptoms can start in various ways. Osteoarthritis may include joint pain and progressive stiffness that develops slowly. Early symptoms of rheumatoid arthritis include painful swelling, inflammation and stiffness in the fingers, arms or wrists. Pain and stiffness followed by swelling and tenderness of joints can be considered early warning signs for arthritis.
We are increasingly seeing people in early 40s with signs and symptoms of arthritis. Besides ageing and genetic risk factors, obesity or excess weight can contribute to the progression of arthritis. Elevating the risk is sedentary work and eating too much junk food, which can also be a risk factor for many other metabolic disorders.
Low body weight, muscle weakness, low levels of vitamin D and vitamin B12, low haemoglobin in blood, improper posture, infections, injuries can also be risk factors for arthritis among youngsters. A BMI (Body Mass Index — a measurement made by comparing the height and weight of a person) of more than 30 makes the degeneration of joints and bones faster.
One should cut down on the amount of fried and processed foods and include more vegetables and fruits in the diet. Even tobacco and alcohol use can lead to a number of health problems, including some that may affect joints. Smokers are more at risk of developing rheumatoid arthritis, while those who consume alcohol have a higher risk of developing gout. Besides, food that is high in omega-3 fatty acids, fish, and certain fruits and vegetables should be included in the diet.The author is Senior Consultant Joint Replacement and Arthroscopy Surgeon Manipal Hospitals, Bengaluru
Coping with arthritis
People with arthritis need to follow a strict daily regimen to keep their condition under control, and minimise pain and discomfort. This includes a religious devotion to daily exercise, use of physiotherapy and heat therapy to keep the joints mobile and check inflammation. Besides avoiding smoking and eating a balanced diet, it is also important to check weight gain, as excessive body weight can put greater pressure on the knees and the feet, and accelerate damage. In advanced arthritis of any cause, where other treatments have been exhausted, joint replacement surgery offers an excellent option to restore pain-free mobility and an independent active lifestyle.