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Advice For Rheumatology (Rheumatoid Arthritis)

MD - General Medicine, Fellow [FACE]
Rheumatologist & Immunologist, Kangra
Advice For Rheumatology (Rheumatoid Arthritis)

Based on latest data available till date.

Maintain social distancing
➢ wash your hands frequently and use sanitisers
➢ use face mask
➢ do not go out of home unnecessarily

▪ patients of rheumatology like rheumatoid arthritis, sle, ankylosing spondylitis, vasculitis are not at 
Increased risk of getting coronavirus as compared to the general population
▪ well controlled disease or arthritis offer better protection against any infection including coronavirus,
As compared to the uncontrolled disease
▪ patients should not stop taking their medicines without asking the doctor
▪ covid-19 disease behaves similar to that of general population in patients taking rheumatology 
▪ patients taking biological medicines, high dose steroids or cyclophosphamide, elderly should takes
Extra precautious and should maintain social distancing and must not go out of their homes 
▪ as of date there is no hard evidence that hydroxychloroquine prevents infection from coronavirus.

Rheumatoid Arthritis - How To Treat It?

Dr.Rajeev Siwach 90% (19ratings)
MBBS, MS - Orthopaedics
Orthopedic Doctor, Jodhpur
Rheumatoid Arthritis - How To Treat It?

Rheumatoid Arthritis is an autoimmune condition wherein the body’s immune system mistakenly attacks the linings of the joint. This condition affects both sides of the body including the eyes, hands and legs. Unlike the depreciating damage of osteoarthritis, rheumatoid arthritis causes a distressful swelling that consequently leads to bone deformity and even erosion. As such, it is one of the more important characteristics of the condition which distinguishes it from other forms of arthritis. It often leads to debilitating disabilities.

Risk factors and complications
Factors such as obesity, smoking, age (affects mostly after the age of 40) and many environmental factors increase the risk of Rheumatoid arthritis. In severe cases, rheumatoid arthritis can lead to a plethora of other conditions such as:

  1. Dry mouth and eyes
  2. Osteoporosis
  3. Abnormal body composition

Blood and imaging tests will first be carried out. Based on such diagnosis, you may be advised medications such as steroids or Nonsteroidal anti-inflammatory drugs (NSAIDS). Now in case of severe pain, one would have to take to surgery. Varying surgeries work on different joints of the body and some of these include:

  1. Arthroplasty: This procedure replaces all or a part of the joint for instance, the knee or the hip.
  2. Arthroscopy: A procedure which helps pull out inflamed tissue or debris from the required joint with the help of light, small instruments.
  3. Cervical spinal fusion: Pressure on the median nerve is eased with this procedure.
  4. Hands and foot surgeries: These procedures help correct dysfunctional joints of the hands, fingers, legs and toes.
  5. Synovectomy: Synovectomy helps remove more intricate tissues which are inflamed or otherwise.

What to consider before you opt for one?
Although these various surgeries often restore almost-normal movements in the patient, they can only do so in two or possibly three joints. And of course, it goes without saying that you should consult with an orthopaedist orthopaedic surgeon) experienced in arthritis and joint surgeries before opting for such.

1280 people found this helpful

Arthroplasty - What Should You Know?

Dr.Sunil Kumar Dash 90% (70ratings)
MBBS Bachelor of Medicine and Bachelor of Surgery, MS - Orthopedics, Fellowship, Depuy Joint Replacement
Orthopedic Doctor, Bhubaneswar
Arthroplasty - What Should You Know?

Arthritis has often turned out to be a party-pooper for aged people. The worsening pain as one grows older is a concern for many, with more than 10 million official cases filed per year, in India. Hip and knee arthroplasty, in a strict sense, is the surgical reconstruction or replacement of joints that swell with age.

Main types of arthroplasty
Arthroplasty is generally done on people aged sixty or above and those suffering from osteoarthritis, frozen shoulder, joint stiffness, etc. The main type of arthroplasty is a joint replacement, where the actual organ is surgically replaced with a prosthetic version of it. It aims to improve the muscle strength of the injured portion of the patient's body. Surgeries sometimes go wrong, but more than 90% of hip replacement surgeries have turned out to be successful in the last decade or so. Another popular form of arthroplasty is the Inter-positional arthroplasty, in which skin, muscle or tendons are inter-positioned to keep the inflammation in check.

More details that you need to know

Recovery time
Once a joint is appropriately replaced, the patient needs about three months to get back to a regular lifestyle, especially in the case of knee surgery. For hips, the recovery time drops to around two months, although it mostly depends on the patient’s condition before surgery and the successfulness of the operation.

What can you expect post-surgery?
If both knees or both hips need to be surgically replaced, doctors attempt to do it together, which reduces the chances of more pain during surgery. After the knee surgery is done, it’s prescribed not to kneel until fully recovered. It does not necessarily hurt the patient, but they do not exactly like the temporary pain. And after the hip surgery is done, patients can not immediately return to their usual sleeping position. It takes them almost two months to sleep on their back, and not on their operative side.

What are the risks involved?
There are certain risks involved with a hip and knee arthroplasty. In patients with rheumatoid arthritis, arthroplasty often worsens the condition of space between two joints. Otherwise, allergic reactions to the anesthesia are common. Sometimes, the recently replaced unstable joint becomes prone to another accident just after surgery.

Arthroplasty that costs about Rs.5 lakhs can be heavy on the pocket. Thus, you can look for insurance options before opting for the procedure. Patients who refuse to undergo surgery, are prescribed to take certain drugs that help with arthritis. And due to their refusal, they are also mandated to perform light exercises that keep their joints mobile.

Arthritis is an alarmingly growing concern with statistics showing there is a possibility of surgery demands exceeding 3 million by the end of 2030, mostly due to obesity and work rate of the middle-aged people. And since hip and knee are the most affected, arthroplasty is going be a necessity in the next twenty years, if it is not kept in check.

5419 people found this helpful

Knee Replacement & Rheumatoid Arthritis - How Former Can Help Latter?

Dr.Jyoti Prakash 88% (39ratings)
MBBS Bachelor of Medicine and Bachelor of Surgery, MS - Orthopaedics
Orthopedic Doctor, Kolkata
Knee Replacement & Rheumatoid Arthritis - How Former Can Help Latter?

You may have reached a ripe age with all the worldly knowledge at your disposal to share with the world. You may have reached a stage where you no longer feel like a learner in important areas of life and could easily be someone who has the experiences and the expertise to help people out in times of their trouble.

However, you may also be at a juncture where your knees in particular may not be your best friends anymore. You may be facing a lot of joint issues and the knees may be a pair of joints that give you immense pain and discomfort when you climb stairs, walk some distance or even just stand or sit. It is very likely that you may be suffering from rheumatoid arthritis and may experience unbearable pain in a lot of joints of the body.

Though when you are afflicted with rheumatoid arthritis, you feel pain in more than one joints, but the knees are the worst affected areas in most cases and a lot of patients are advised to undergo a knee replacement surgery to be able to control the pain. There may be a lot of debates and doubts about whether a person suffering from RA should go under the knife to experience a new life after the surgery.

Some may not agree:
Just as all things have two sides to them, there are those who may be in favour of a knee replacement surgery and those who may not suggest taking the surgery. The reasons why a lot of experts may not favour the surgery include reasons such as the recovery period may take too long, though the surgery may be carried out for the knee joints, it may not be able to help in bringing down the pain in the other joints and arguments such as the replacement surgery may not be absolutely successful all the time.

Here is why you should get it:
Though the patients may have to go through pain in getting a set of new knee joints, there are a lot of reasons that help the patients in taking up the resolve to get the surgery done. Here are a few reasons why it may be the thing to do:

  1. The surgery help you get back in time when you were able to lead a life free of pain in the knees. While the other joints may experience pain when you suffer from RA, the pain in the knees comes across as the most painful and when that is tackled, more than half the battle is won.
  2. While it may be easy to tackle the pain in the other joints through simple physio exercises, it is difficult to manage the knee joint pain and a surgery may be the ultimate relief for the problem.
  3. When a major pain region such as the knee is tackled, it becomes simpler to handle the other joints and the problem of RA may be resolved entirely.

With such advantages from the surgery, it may make sense to a lot of people to get over with the procedure and experience a better quality of life.

1345 people found this helpful

Revision Replacement - What Should You Know?

Dr.Sunil Kumar Dash 90% (70ratings)
MBBS Bachelor of Medicine and Bachelor of Surgery, MS - Orthopedics, Fellowship, Depuy Joint Replacement
Orthopedic Doctor, Bhubaneswar
Revision Replacement - What Should You Know?

The shoulder is a complex joint consisting of a number of bones, ball, socket, and cartilage. For people suffering from arthritis of the shoulder joint, a total replacement of the shoulder joint is often a successful procedure. It significantly improves pain and range of motion. However, in case the patient is suffering from a special type of arthritis of the joint known as “cuff tear arthropathy”, a total shoulder replacement often does not produce the desired result. These people suffer from large rotator cuff tear as well as arthritis. For such patients, a reverse shoulder arthroplasty often show better results.

Reverse Shoulder Arthroplasty

In traditional total shoulder replacement, the device put into the joint consists of a plastic cup fitted into the glenoid bone, also known as the socket, and a metal ball attached to the top of the humerus, the upper arm bone. In a way, it mimics the configuration of the original shoulder joint. However, in case of reverse shoulder arthroplasty, the positions of the metal ball and the socket are interchanged. The plastic cup is attached to the humeral head whereas the metal ball is attached to the glenoid bone.

Benefits of the Procedure

A reverse shoulder arthroplasty works better for patients who have a large rotator cuff tear along with arthritis. There are a number of rotator cuff muscles in the shoulder and they help to hold the arm in position as well as provide power to the arm during extreme movements. In case of people with large rotator cuff tear and arthropathy, the upper arm has to rely on different muscles for movement because the rotator cuff muscles don’t function. Hence, the arm has to depend on other muscles such as the deltoid muscles, to position and power the arm. This is why a reverse arthroplasty is carried out.

Who Can Undergo This Surgery?

Every patient with cuff tear arthropathy is not a candidate for reverse shoulder arthroplasty. Surgeons recommend this surgery when the patient is suffering from:

● A total tear of the rotator cuff which cannot be repaired

● A special type of shoulder arthritis known as cuff tear arthropathy

● An unsuccessful shoulder replacement surgery

● Extreme shoulder pain along with difficulty in lifting the arm over the head or away from the body

● A complex type of fracture in shoulder joint

● A chronic dislocation of the shoulder

● A tumor in shoulder joint

Doctors can also suggest this procedure if the patient had previously tried other remedial measures such as medications, rest, physical therapy, injections, etc., but was not successful in alleviating the pain and improving the range of motion of the shoulder.


There are some medications that you need to stop before the surgery since they may cause excessive bleeding after the surgery. Some of these medicines are blood-thinning medicines and Non-steroidal anti-inflammatory medicines.

5728 people found this helpful

Rheumatoid Arthritis - Effective Management Of It!

Dr.Pranjal Pankaj 87% (35ratings)
MBBS, MD - Internal Medicine
Internal Medicine Specialist, Kanpur
Rheumatoid Arthritis - Effective Management Of It!

Over time, our joints, connective tissues and muscles go through a lot of wear and tear. Additionally, certain conditions may also cause problems, including inflammation and conditions that create persistent pain. These conditions usually fall under the broad category of arthritis, which can be of many types. Rheumatoid arthritis (RA) happens when your immune system targets your joints and causes inflammation. RA influences the joints on both sides of the body, for example, both hands, wrists and knees. This symmetry separates it from other kinds of arthritis. It can affect the skin, eyes, lungs, heart, blood, or nerves.

Various signs of inflamed joints are as follows:

  1. Stiffness: Functioning of the joints becomes rigid and doesn't move properly. It is particularly severe in the morning. While those with different types of arthritis have stiff and immobile joints in the morning, people with rheumatoid arthritis take over 60 minutes before their joints feel free.

  2. Swelling or Inflammation: Liquid enters the joint and gives rise to inflammation.

  3. Extreme pain: Irritation inside a joint makes it painful and delicate even to touch. In a chronic condition, this may also lead to fractures.

  4. Redness and warmth: The joints might appear hotter and more pink or red than the skin around it.

Needless to say, your lifestyle choices affect all aspects of your physical wellbeing, and that also include your joints- especially if you are suffering from arthritis.  It’s a common theory, that joints which are strained and stressed by bearing the burden of extra pounds show more inflammation, wear and tear and stiffness which lead to aggravation of arthritic pain. Here are a few holistic approaches to consider; certain changes in your existing lifestyle that can help you to reduce your arthritic pains:

  1. First and foremost, it’s important that you must indulge in plenty of exercises every single day, to keep pounds off and thus help yourself handle this degenerative disease.
  2. In case of creating a healthy diet plan, stick to low calorie and low carb foods. Also be sure that you are consuming lots of vegetables and fruits in your diet. This also helps you to keep fit and put a break on the obesity factors that are detrimental to your health.
  3.  As even a few extra pounds can worsen arthritic pain, keep track of your weight and talk to your orthopedic doctor to determine your optimal and healthiest weight. Focus on this prescribed weight coefficient and keep tracking your weight loss patterns unless you have reached your goal.
  4. Cut down on alcohol. There has never been a finer alternative to that. 
  5. Feeling depressed or stressed by arthritic pain is a common syndrome among arthritic patients. Nevertheless, on the flipside, such reactions actually worsens the agony of this disease and inhibit you from doing what you need to do, such as taking medications and exercising to keep yourself fit at the end of the day. 

Although admittedly, making drastic modifications in your lifestyle can be painful and difficult at first, these are the best remedies for easing arthritic pain in a natural way.
Don’t just rely on medications, take control of your disease in a holistic manner and you’ll soon find yourself in control of your life again.


If rheumatoid arthritis is not treated immediately after diagnosis, it might cause further complications in the future such as lymphatic blood cancers, osteoporosis (a medical condition resulting in brittle and weak bones), blockage of the arteries and dry mouth syndrome (Xerostomia).

The treatment of rheumatoid arthritis includes:

  1. Prescribed dosage of non-steroidal anti-inflammatory drugs such as Ibuprofen and Naproxen, anti-rheumatoid drugs such as Methotrexate and steroidal drugs such as Prednisone help in reducing inflammation and pain. The dosage depends on the intensity of the condition.
  2. Performing regular exercises which will help you retain flexibility of the joints and subsequently cure rheumatoid arthritis.
  3. In extreme cases, the doctor might suggest surgeries such as:
    • Synovectomy: A surgery that removes the damaged portion of the joint
    • Joint fusion: This option will realign the joint and reduce the pain If you wish to discuss about any specific problem, you can consult a internal specialist.
1797 people found this helpful

How Does Siddha Treat Rheumatoid Arthritis?

Siddha Specialist, Chennai
How Does Siddha Treat Rheumatoid Arthritis?

Rheumatoid arthritis refers to a chronic, inflammatory disease that affects the joints and the surrounding tissues. The condition attacks the lining of your joints, especially in the legs and arms, known as the synovial membrane. This leads to painful swelling, and may eventually result in joint deformity and bone erosion.

Early Signs of Rheumatoid Arthritis -

The initial symptoms of rheumatoid arthritis include the following –

• Swelling, warmth and tenderness in the affected joints
• Morning stiffness that may persist for long
• Firm bumps of tissues – known as rheumatoid nodules – beneath the skin of your arms
• Unintentional weight loss

Siddha Approach to Rheumatoid Arthritis -

According to traditional Siddha system, the signs of rheumatoid arthritis bear resemblance to two diseases – Vazhi azhal keel Vayu, and Uthiravatha suronitham. This has been mentioned in Siddha literature.
Uthiravatha suronitham occurs results from derangement of the humour Vatha. Symptoms include swelling and pain in smaller joints, loss of appetite and mental distress.
Vazhi azhal keel Vayu is caused due to derangement of Pitta and Vatha humour. Symptoms involve abdominal discomfort, lack of sleep, pricking pain, swelling and redness – particularly in the ankle and wrist joints.
Siddha system resides on the principle that consumption of certain foods, like potatoes and raw unripe bananas produce more vayu in the intestine, which eventually causes inflammation in the joints. Exposure to rain and cold air also aggravate the Vatha and Pittham humour.

Treatment and Management -

Treatment in Siddha is particularly aimed at restoring the balance of elevated Vatha and Pittham humour through medication and purgation. A healthful diet is recommended to rejuvenate the physical constituents.

• Avoiding cold and sour food items, such as curd and tamarind can help balance Vatham and prevent progression of the disease
• Salt intake and non-vegetarian foods, especially red meat should be avoided strictly
• Avoid alcohol consumption, smoking and tobacco – it promotes inflammation of the joints

Besides dietary changes and restrictions, Siddha treatment largely relies on medicines prepared from natural plant extracts and herbal oil. Some of these medicines are consumed orally, while others may be applied to affected joints to counter rheumatoid arthritis.

Rheumatoid arthritis is a debilitating condition that is likely to interfere with your daily activities and functional abilities in the long-term. Siddha treatment approach can offer relief from rheumatoid arthritis symptoms and improve your quality of life.

2360 people found this helpful

Rheumatoid Arthritis - What Causes It?

Dr.Sanjeev Kumar Chhaparia 93% (72ratings)
MBBS, MD - Internal Medicine, Senior Residency - Internal Medicine
General Physician, Patna
Rheumatoid Arthritis - What Causes It?

Rheumatoid Arthritis is a dreaded disease, but not a fatal one. Sounds contradictory? Not really. People suffering from Rheumatoid Arthritis can experience severe pain and deformity. However, it is not likely to cause death.

It is a progressive disease that starts with pain and may end up deforming the affected joints. One may have to put up with pain and deformity for the rest of life. If not treated, the disease can also spread to other organs such as eyes, skin, lungs, kidneys, heart etc.

Causes of Rheumatoid Arthritis

A unique aspect of Rheumatoid Arthritis is that it is not precipitated by the wear and tear of joints, like Osteoarthritis. It is an autoimmune disorder that is precipitated when the immune system of the body attacks the joints and stokes inflammation in the joint linings. The lining thickens due to inflammation and destroys the cartilage and the bones in the underlying joint. As the health of the cartilages and bones deteriorate, the tendons connecting the bones to the muscles become weak. This makes the joint lose its shape and alignment and thereby precipitates deformity in the joints.

However, doctors are not yet sure of the reasons for the autoimmune disorder.

Symptoms of Rheumatoid Arthritis

If someone is suffering from this disease, then he / she might experience the following in the affected joints:

Swollen, tender and warm

Stiff and painful. The stiffness and pain may become worse in the morning.

One may also suffer from fever, fatigue or weight loss.

Risk factors

Although the causes of Rheumatoid Arthritis are unknown, there are certain risk factors.

 1. Gender

More women suffer from this disease than men.

2. Age

It can occur at any age, but it is more common among adults between the ages of 40 and 60 years.

 3. Heredity

If one or more members of the family has or had suffered from Rheumatoid Arthritis, he/she is at an increased risk.

4. Smoking

Smoking not only increases the susceptibility to Rheumatoid Arthritis but also the severity of the disease. Over and above, if a person is genetically predisposed to this disease, smoking multiplies the risk.

5. Certain Exposure

Exposure to certain stuff like silica, asbestos etc increases the risk of Rheumatoid Arthritis.

6. Obesity

It has been observed that people who are obese are more likely to suffer from Rheumatoid Arthritis.

Treatment of Rheumatoid Arthritis

Doctor can treat the condition only after he has diagnosed the condition. People suffering from Rheumatoid Arthritis rarely show any distinctive symptoms, at least in the early stages. Many of the symptoms mimic the symptoms of other diseases. There is no confirmatory blood or any other test. The doctor has to depend on physical examination and some concomitant tests to confirm the diagnosis. This is why the disease is often diagnosed at an advanced stage. However, as soon as the disease is diagnosed, the doctor may prescribe strong anti-rheumatic drugs. This can bring down the symptoms and pain to some extent.

3906 people found this helpful

Arthritis - Daily Hand Exercises That Can Vanish Your Pain!

MBBS, MS - Orthopaedics, Fellowship in Hand Micro Surgery
Orthopedic Doctor, Ahmedabad
Arthritis - Daily Hand Exercises That Can Vanish Your Pain!

Arthritis is a type of pain in your bones and joints. It is mostly caused over the age when your joints and bones start to grow weaker. In some cases, it is likely to happen earlier as well. However, there are certain ways with which you can cure arthritis pain.

There are some exercises that can help you reduce the pain and improve your range of motion. Before you start up with your exercise, soak your hands in a warm bowl of water as it reduces the amount of stress in the joints. Here are a few exercises:

  1. Make a fist: Making a fist with your fingers can help you improve the stretching capacity and flexibility of your bones. Try to stretch till the point where you start to feel the tightness. You will not feel any kind of pain. However, your goal is to get rid of the tightness step-by-step. Remember to wrap your thumb around the fingers as you do so.
  2. Stretch your fingers: You need to try this stretch in order to improve the movement and the range in which your fingers move. Place your hand on a flat surface with your palm down. Now straighten your fingers as far and as flat as you can without putting any force on your joints to do so. Repeat this procedure 10 to 15 times in two sets.
  3. Claw stretch: Hold out your hand in front of yourself with the palm facing you and bend the tips of your fingers down so that they touch the base of each finger joint. Your hand should be looking like a claw while you do this exercise.
  4. Strengthen the grip: This exercise makes it easier for you to open bottles, doorknobs and hold things properly without being afraid of dropping them. Take your palm and make a soft fist then squeeze it as hard as possible. Now hold it for a few seconds and release.
  5. Strengthen the pinch: This exercise makes your finger muscles stronger. It can help you in your daily chores like opening food packets and turning the keys. All you need to do is try and pinch a softball made of foam with the tip of your fingers. Now hold this position for about 30 to 60 seconds and then let go. Repeat this five to six times.
  6. Finger lift: This helps to increase the flexibility in your fingers. Place your hand flat on a table and then lift one finger at a time. Repeat this 10 times.
  7. Thumb extension: Strengthening thumb muscles helps you lift heavy things. Wrap a rubber band around at the base of your finger joints and place it flat on a table. Now gently try to pull your thumb away from the rest of the fingers.
  8. Flex your thumb: Place your palm up with the hand in front of you. Stretch the thumb away from the rest of the hand. Then bend it across the palm so that it touches the base of your little finger.
1311 people found this helpful

High Heel And Its Menace

Dr.Abhishek Vaish 88% (11ratings)
MBBS Bachelor of Medicine and Bachelor of Surgery, MS - Orthopaedics, MCh (Ortho), DNB (Orthopedics)
Orthopedic Doctor, Delhi
High Heel And Its Menace

Top 5 problems with high heels:

1. Claw toes
2. Early small joint arthritis
3. Alteration of weight-bearing axis and biomechanics of the body.
4. Excessive forefoot loading
5.40% increased the chances of sustaining falls.

2 people found this helpful

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