Knee Osteoarthritis: What Works Before You Consider Surgery
Knee pain in Indian adults often starts a decade earlier than in Western populations. Most patients can delay or avoid replacement — but not by resting the knee.
Read articleRheumatoid arthritis is an autoimmune disease in which the body's own immune system attacks the lining of joints, causing pain, swelling and, if untreated, permanent deformity. Early treatment changes the long-term outcome dramatically.
Symptoms
Not everyone gets every symptom, and the pattern can differ in older people, in people with diabetes and in children. These are the ones most often reported.
- Pain and swelling of the small joints of the hands and feet, usually on both sides
- Morning stiffness lasting more than an hour
- Warmth and tenderness over affected joints
- Fatigue, low-grade fever and loss of appetite
- Difficulty gripping, opening jars or wringing clothes
- Deformity of the fingers in long-standing untreated disease
When to see a doctor
Do not wait these out
If any of the following applies, arrange to be seen the same day. For anything sudden or severe, call 9281862028 or come straight to the emergency department at SIMS — it is open 24 hours and does not need an appointment.
- Joint swelling with prolonged morning stiffness lasting more than six weeks
- Symmetrical small-joint pain in the hands and feet
- New breathlessness, dry eyes and mouth, or numbness in a diagnosed patient
- Fever with a hot swollen joint, which may indicate infection
Tests that may be advised
Your consultant will order only the investigations that change the plan. Most of the following are available on the SIMS campus, so results usually come back the same visit.
- Rheumatoid factor and anti-CCP antibody
- ESR and C-reactive protein
- Complete blood count, liver and kidney function before starting treatment
- X-rays of hands and feet
- Screening for tuberculosis and hepatitis before immune-modifying therapy
How it is treated
Treatment is decided case by case — by how advanced the problem is, what else you are being treated for, and what you can realistically sustain. Broadly, it involves the following.
- Disease-modifying medication started early, with regular blood monitoring
- Short courses of anti-inflammatory treatment for flares
- Physiotherapy and occupational therapy to preserve joint function and grip
- Joint protection techniques and assistive devices for daily tasks
- Long-term follow-up, since stopping treatment when the patient feels well causes relapse
This page is general information, not a diagnosis
Rheumatoid Arthritis can look like several other conditions, and the reverse is equally true. Nothing here can replace an examination, your test results and the judgement of the doctor treating you — and no medicine mentioned by name to a friend or relative should be started on the strength of this page. If you recognise yourself in it, book a consultation with the General Medicine department. If a symptom is sudden or severe, call 9281862028.