The debilitating condition commonly causes inflammation in the joints, and is also a risk factor for heart disease. By Ng Wan Ching
Photo: Katarzyna BiaÅ‚asiewicz / www.123rf.com
Rheumatoid arthritis is an autoimmune disease that causes pain, swelling and stiffness in the joints. It is different from the aches and pains attributed to rheumatism, which are usually caused by an injury or wear and tear.
Rheumatoid arthritis can lead to joint damage and disability, said Dr Manjari Lahiri, a senior consultant in the division of rheumatology at National University Hospital (NUH). The inflammation is not limited to the joints. It causes tiredness, a feeling of having the flu and, sometimes, loss of appetite and weight, she said.
Contrary to popular belief, anyone can be affected by rheumatoid arthritis; it is not an "old people's disease". There are no known foods that protect people from it or increase the risk of getting it. The average age of patients newly diagnosed with the condition in Singapore is 51 years, though the ages of those affected range from 18 to 80, said Dr Lahiri. Women are more likely to be affected and smoking increases the risk of developing it. Rheumatoid arthritis is also a risk factor for heart disease.
The prevalence in Western countries is about seven cases per 1,000 people every year, but it is likely to be a bit less in Asia, she said. The number of people affected worldwide may be stable or even decreasing, she added. This is likely due to better awareness, early recognition and early treatment with effective drugs, she added.
Foot problems are extremely common in people with the condition, said Ms Kate Carter, a senior podiatrist at NUH Rehabilitation Centre. Patients have heel pain, bunions and flat feet, she said. Symptoms include severe pain and stiffness, which can lead to permanent foot deformity and disability. Early podiatry intervention, she added, helps to improve long-term outcomes.
CARING FOR RHEUMATOID ARTHRITIS
Dr Manjari Lahiri gives tips on what to do if you have rheumatoid arthritis:
•Play an active role in your treatment. Know what medications you are on, ask questions.
•Take your medications as prescribed. Do not mix traditional medicines with them, as they can interact and cause severe harm.
•Eat a balanced diet, maintain an ideal weight.
•Exercise regularly, especially when your disease is well controlled.
•Do not smoke and try to quit if you do.
•Limit the amount of alcohol you take, as some medications interact with alcohol.
•Discuss your plans to start a family with your doctor. Many rheumatoid arthritis medications are harmful for a baby and you need to practise an effective means of contraception while taking them.
PREVENTING FOOT PROBLEMS
Ms Kate Carter gives some tips on how to prevent foot problems:
•Wear good shoes with a firm heel counter, broad outsole and deep and wide toe-boxes. A firm heel counter will increase foot stability, a broad outsole can help to relieve pain and keep you mobile, and a deep and wide toe-box will stop friction on the toes.
•Shoes with fastening across the front of the ankle hold the foot securely within the shoe.
•Wear breathable shoes made of soft material which will keep your feet fresh.
•Insoles are recommended for foot pain, swelling and stiffness.
•Do simple stretching exercises to ease the pressure on painful feet.
•Keep active. It tones up muscles, strengthens the arches and stimulates blood circulation.
A version of this article appeared in the print edition of The Straits Times on October 11, 2016, with the headline 'Arthritis that can lead to joint damage'.