Inflammatory Arthritis is basically a blanket term which is used to describe a group of medical conditions which affect the immune system. In fact, this means that the body’s defense mechanism has started attacking the patient’s own tissues instead of attacking bacteria, viruses & other foreign substances which are causing stiffness, pain & damage to joints. This is also known as an autoimmune disease.
There are 3 most common types of inflammatory arthritis.
- Ankylosing Spondylitis
- Rheumatoid Arthritis
- Gouty Arthritis
- Psoriatic Arthritis
- SLE – Systemic Lupus Erythematosus
These orthopedic conditions are also known as systemic diseases merely because they can affect the entire body. They can also happen at all ages. Moreover, there is no complete cure for these diseases as of now, but the outlook of people diagnosed with inflammatory arthritis seems to be far better than it was found to be 20 – 30 years back the timeline. Effective treatments nowadays begin much earlier & newer drugs are also made available, which eventually translates into lesser damage to joints, lesser need for surgery along with fewer complications. However, inflammatory arthritis is not the same as osteoarthritis in which cartilage of the joints gradually begins to wear away. This inflammatory arthritis pathway is generally a guide to information which is available & useful for the patient at every step of their disease progression, from first noticing signs & symptoms to specialized care. This pathway will direct patients to information which is relevant at each stage & to availability of treatments for international patients willing to seek affordable solutions beyond their homeland.
In the beginning, patients may only be experiencing joint pain and/or back pain, but may not yet have contacted their general physician about their symptoms. They may have gathered information from various sources & may therefore generally be aware of these diseases & their signs & symptoms.
Signs & symptoms of inflammatory arthritis generally include the following.
- Swelling in Joints
- Pain in Joints
- Stiffness in Joints
- Loss of Joint Function
Quite often only a few of these symptoms may be present, while in many cases inflammation may only be associated with generalized flu like symptoms including the following.
- Fatigue – Loss of Energy
- Muscle Stiffness
- Loss of Appetite
Whenever inflammation occurs, our body releases chemicals into the bloodstream or within the affected tissues. This release of chemicals will eventually increase blood flow to areas of infection & injury & may often result in warmth & redness of affected areas. Some of these chemicals which are released will also leak as fluid into tissues & result in swelling as well. In the whole sequence of events, this process may stimulate nerves so as to cause pain. Increased flow of blood & release of chemicals will attract white blood cells to sites of inflammation. Increased number of these white blood cells along with inflammatory substances within joints can cause swelling of synovium (joint lining), wearing down of cushions (cartilage) which are maintained at the end of bones & irritation as well.
People might visit the family doctor for the first time when they experience signs & symptoms of inflammatory arthritis. Inflammatory arthritis may often be difficult to diagnose & a confirmed diagnosis can only be made by a rheumatologist with special interest in musculoskeletal diseases. Different forms of inflammatory arthritis are treated by a specialized team led by consultant rheumatologists, so they are usually but not always, hospital based as it involves specialized area of care. This eventually suggests that general physicians may not have the skills, experience & knowledge which is required to make a clinical diagnosis. Moreover, there is no single test which can tell that a person is having ankylosing spondylitis, rheumatoid arthritis or psoriatic arthritis & therefore it is important for the general physician to suspect that the patient is having any one of these conditions. However, general physicians will quickly refer such cases to rheumatologists for diagnosis when they suspect the patient to be having inflammatory arthritis. Diagnosing inflammatory arthritis diseases may consist of all or some of the following steps.
- Complete medical history of the patient.
- Physical examination with attention to pattern of joint involvement.
- Evaluation of other symptoms apart from joints.
- Results of x-rays & other imaging tests including ultrasound.
- Blood tests & other studies.
- Disease activity scores.
Squeeze test is one of the most reliable physical examination tests for psoriatic arthritis & rheumatoid arthritis. It involves squeezing hand or foot of patients across knuckle joints. In case this test is unduly painful, it may indicate possibility of inflammatory arthritis.
In case patients are experiencing stiffness, pain and/or swelling in joints, general physicians would usually refer them to specialized rheumatologists. Some patients may get a firm diagnosis on seeing the specialist consulting rheumatologist for the first time following referral, but in many other cases inflammatory arthritis may be extremely difficult to diagnose in very early stages. Moreover, since no single test can say if a person is having inflammatory arthritis patients may need to undergo further visits & tests in order to reach a diagnosis.
In order to look for a suitable treatment following confirmed diagnosis, patient may need to undergo a number of further tests so as to help the specialist team decide on the best possible treatment plan. Quite often, these tests may look a bit confusing to begin with, especially when the patient has just been diagnosed, but rheumatologists will usually explain the case on the first visit itself. Inflammatory arthritis patients will probably see the specialist team quite regularly at the start, but will gradually become less frequent when the condition is under control. Inflammatory arthritis patients will however need to undergo regular blood tests. These will check upon progress of the condition & as to how the patient is responding to treatment. Sometimes, general physicians may also share some care with the inflammatory arthritis specialist team. Once the condition is under control, the specialist team would review the disease & evaluate the kind of impact it is having on the life of the patient, at least once every year. It is important for inflammatory arthritis patients to know as to access the specialist team whenever they have problems or flare-up of symptoms. This should include access to a nurse-led helpline number as well.
Advanced inflammatory arthritis disease will only affect a small number of cases. This may usually involve organs like heart & lungs in order to cause serious complications. Other not so serious complications may involve other long-term conditions like heart disease or diabetes. It is quite rare that other complications like vasculitis are found to occur. It would be sensible on part of the patient to remember that outlook for people with inflammatory arthritis nowadays are far better than it was a couple of decades earlier. With newer important effective treatments which are now available, outlook for inflammatory arthritis patients is much brighter with lesser disability, lesser need for surgery alongside fewer complications.
India has undeniably emerged as a leading global medical tourism destination over the last few decades. There are many factors involved in this surge, including the rising cost of healthcare services in countries across the world. On the flip side, medical procedures in India have remained constant & are still available at reasonable costs. Large pool of specialist doctors & surgeons providing high quality of treatments are some of the best experts who are globally reputed. In fact, many of them have initially trained & experienced in western countries like the UK, Canada & United States. They are well aware of the emerging trends & adept in handling latest technologies for mutual benefit. While most accredited multispecialty hospitals in the country are having dedicated orthopedic departments, it is the highly skilled English speaking nurses & the professional staff who are reassuring international patients as to a familiar environment where they can comfortably recover following affordable medical procedures. Orthopaedic Surgery India is a specialty medical tourism company which is associated with top surgeons & the best accredited orthopedic hospitals in the country offering end-to-end affordable healthcare services to people from all around the world seeking excellent low-cost medical solutions beyond their homeland. Flourishing under the well established & globally recognized Travcure medical tourism banner, Orthopaedic Surgery India is well placed to pass on a number of benefits they receive from these healthcare institutions to patients availing their services.
Can Inflammatory Arthritis Affect Internal Organs?
Yes, as part of an autoimmune disorder, inflammatory arthritis can affect internal organs. Types of symptoms which develop in this condition will depend upon the organs which are affected. However, pain will not be the main symptom as many of these internal organs do not have nerves which are pain-sensitive. Here are some good examples.
- Myocarditis – inflammation of heart will cause fluid retention or vague chest pain.
- Bronchiolitis – inflammation of small tubes transporting air to lungs will cause shortness of breath.
- Nephritis – inflammation of kidneys may cause kidney failure or high blood pressure.
- Iritis or Uveitis – inflammation of eye can cause pain or decrease in vision.
- Polymyositis – inflammation of muscles may cause weakness or achiness.
- Vasculitis – inflammation of blood vessels can cause headaches, rashes or damage to internal organs.
Treatment options for inflammatory joint diseases are aplenty, including rest, exercises, medications & surgery. Types of treatment prescribed to correct joint damage usually depend upon several factors including overall health, the age of the patient, type of disease, medical history, type of medications the patient is taking & severity of symptoms. However, goals of treatment will include the following.
- Treating underlying inflammatory disease in order to decrease inflammation.
- Relieving pain by activity modification & medication.
- Maintaining muscle strength, joint movement & overall functioning through exercise & physical therapy.
- Decreasing stress upon joints by using canes, splints & braces as required.
There are many drugs which are commonly used to decrease swelling, pain and/or inflammation in joints. It is also expected that these drugs can minimize or prevent progression of inflammatory disease as well. Some of these medications include the following.
- NSAIDs – anti-inflammatory pain relieving drugs like aspirin, ibuprofen or Celebrex.
- Corticosteroids like prednisone.
- Other medications include narcotic pain relievers, biologic therapy drugs, disease modifying treatments, or chemotherapy drugs.
Quite a few of these medications are traditionally utilized in treatments of other conditions like inflammatory bowel syndrome & cancers or to prevent rejection of organs following organ transplant. Although dosages may vary & profile of side effects may be different, these are potent medications which require close monitoring by physicians. Therefore, it is very important for the inflammatory arthritis patient to regularly stay in touch with doctors so that they can check for effectiveness & detect developments of any side effects in time.