Painful joints often lead to arthritis: Dr. Pispati

crop1_240x240_7thoct14Dr. Prakash Pispati is the Director of Rheumatology at Jaslok Hospital & Research Centre.He has been a past President at the Indian Rheumatology Association. He has 50 years of experience in Medicine and 40 years experience in Rheumatology. He has been acknowledged with the IBMS (International Board Of Medicine and Surgery) Lifetime Medical Achievement Award this year.

He has published the first Manual of Rheumatology in India. He has also conducted free rural Arthritis camps treating 6,400 patients gratis.

Dr. Pispati answered Sify readers’ queries related to the above in an exclusive chat. Read the transcript below.

Hello dr. my wife is taking folitrax,folvite, saaz,hqs teblets madicine for treating Rheumutride, these are sufficient or not or any bad effect in using these medicine?
These medications are appropriate for RA but dosage schedules, duration have to be tailor made. Your Rheumatologist is the best judge who may consider biotechnolgy medicine to cut short patient’s persistant problems.

My fingers ache evry day in the morning and slowly gets better as the day goes….it is also slightly swelled…WHAT COULD BE THR REASON
Morning stiffness may be the first sign of rheumatoid arthritis .Please consult an expert.

Dear sir my mom suffering from knee she had also operation of knee but now doctor said replace the knee but she dont want so tell me which knee clipper product is suit for my mom please reply im so much in tenstion im very thankful to u
Your doctor should be able to advise on medications, external assist appliances as required.

Hello dr. 8 weeks ago i had severe hip bursitis n i was in pain with anti inflammatorys. 2 weeks ago i took cortisone shot. For a week i had less pain but now pain is back. I was never pain free. Pls advise what do i do? Thanks
Your orthopaedic surgeon/ rheumatologist would have made a specific diagnosis with x-ray/ MRI as required. Specific treatment accordingly.

i have pain in right knee pain from the hip joint itself. i dont know want to do kindly advice me something to relive from this.
Establish precise diagnosis by consulting your doctor. With specific treatment to follow…

MY WIFE IS IN TREATMENT FOR SLE POSITIVE I SHE IS 57 YEARS,. SHE IS TAKING HYDROQUIN 200 MG,AND OTHER STEROID SHE IS IN HYGENIC LIFE STYLE BUT AFFECTED BY S L E WHAT ARE THE CAUSES
There are newer medicines available to include biotechnology populations eg: Rituximab to control SLE. Please consult a Rheumatologist.

I am suffering from Sjogrens syndrome & having joint pain. What is the remedy?
Besides painkillers, steroids, disease modifying drugs specific medications can help overcome the dryness of mouth/eyes. Please consult your doctor.

I am 42 years old and been arthritic for 12 years now. i am not able to bend two of my fingers and my doctor suggested that i take a steroid injection to release the fingers. Can you please inform if it is safe to take this injection?
Everything Depends on the exact diagnosis … and status of arthritis… multiple treatment options are available. Specific Consultation is required.

Is there any other hope besides the knee surgery for my aunt to get cured of osteoarthritis and start walking straight, as she limps while walking?
If all vital systems are functioning normally, persuade her to go for knee surgery, medical options may include joint injections with steroids, though not repeatedly or with lubricating fluid.

What are the risks that are generally involved in a knee surgery?
Commonest is Infection, a competent orthopedic team would know to avoid stroke minimised risk

Also please give some suggestions on how can an osteoarthritis patient lose excess body weight as she cannot exercise standing?
Consult a dietician’s advise, if followed may help.

What are the chances for knee surgery to go wrong? Or is it 100 percent safe?
Nothing is 100 percent in medicine but knee replacement surgery is technically advanced to be almost error proof.

My aunt aged 61 is suffering from osteoarthritis. She is mostly in pain and cannot indulge much in physical activities.She is very scared to go for a knee surgery. How to convince her Sir Prakash.
If all vital systems are functioning normally, persuade her to go for knee surgery, medical options may include joint injections with steroids, though not repeatedly or with lubricating fluid.

I have heard that even knee injuries can lead to osteoarthritis. Is this true?
Yes.

How much does heart health assist preventing arthritis because most of the arthritis patients have heart diseases too?
Regardless of any direct connection its always good to maintain all systems within functional limits.

Does losing excess body weight minimize the chances of getting arthritis?
Not exactly arthritis but can lead to weakness therefore dampening mobility.

Is numbness and stiffness, indications for arthritis?
Possible…. Consult your doctor before too late.

Do painful joints often lead to arthritis?
Yes.

Does improving our flexibility also add to improving our joint health?
Yes…. therefore regular exercise is important.

What is the right (maximum) duration for which a person can stand without straining the joints?
Depends on the individual and the need for the task.

pls give some easy to adapt tips for good joint health?
Look at my write up on simple tips to keep moving attached also if accused on my website www.arthritisrheumatologistindia.com

When is surgery considered the only option for osteoarthritis?
When medications fail or when mobility is restricted compromising normal life.

Can you give some most common symptoms of osteoarthritis so that it could be diagnosed and treated early?
Persistent pain in a joint especially on movement , with or without swelling, restriction of mobility, changes visible on x-ray.

Are there possibilities of developing other types of arthritis along with osteoarthritis?
Possible though generally not, as osteoarthritis is more in the elderly age group (degenerative)

I rarely visit Mumbai. Can I write to you regarding a patient’s case history? Do you offer guidance to an arthritis patient online?
Generally I like to help patients though a personal consult is always advisable to avoid errors. Please check out my website for details. www.arthritisrheuma

Does rheumatoid arthritis indicate immobilty for lifetime dr. Pispati?
The objective of treatment is to prevent hindrance to normal activities….Albeit to the limitations depending on the patients. For eg: the walking stick to assist walking.

My grandmother-67yrs is suffering from arthritis. Apart from medication what can be done on her part to reduce the pain. Pls help.
Does she have osteoarthritis of knees, or the hips. Treatment will depend on the diagnosis and status of the patient. Where the the drugs can’t help surgery including joint replacement may be the answer.

Are stretching exercises best for arthritis patients?
Exercise in any form is useful, has to be designed to match individual problems.

What can aggravate Rheumatoid arthritis?
Delayed treatment, Inappropriate treatment, incomplete treatment.

crop4_240x240_7thoct14Is Rheumatoid Arthritis more serious when compared to the common arthritis Sir?
Yes and No! Yes because rheumatoid arthritis if not controlled lead to serious complications, Lupos, Vasculitis can be more serious, at times fatal.

Sir I want to know about the treatment available for Rheumatoid Arthritis. My mother-in-law is suffering from it.
Firstly assess the stage of Rheumatoid arthritis with specific problems identified, in general, minimum intake of painkillers( Ansaid) steroids (Cortisone) with well defined role by the doctor, disease modifying drugs ( eg: Hcq, methotrasate or similar in combinations) as prescribed by physician Rheumatologist, biotechnological medicines if so determined by Rheumatologist.

Are there any lifestyle changes that you would like to suggest?
Control of body weight, to be ship-shaped, regular exercises, ideally a combintion of indoor /outdoor ideally to include a sporting activity. avoiding over indulgence of alcohol, with NO! to tobacco in any form.

How much is lifestyle responsible for Arthritis?
To a significant extent. Since our increasing dependence on gadgets implies lesser physical activity, obesity, lack of exercise increase sinful dietary habits like over consumption of alcohol, tobacco, smoking lack of exercise increase proneness to arthritis directly, also secondary to other diseases like diabetes, heart disease.

Is arthritis more common to people who don’t exercise and have a less calcium intake?
This is correct. But do not forget that there are 108 types of arthritis.

Sir my sister is 32yrs who always gets this crackling sound from her knees whenever she sits on the floor. Hope this is not serious. Please advise.
If this occurrence is without pain or hindrance to mobility as it seems, can be regarded insignificant to be ignored for the present.

Can Arthritis also be life threatening?
Sure. Eg: Lupos(SLE) Vasculitis, to name a few.

Is arthritis common to those with family history of the same disorder?
To an extent yes. To not such a strong association as witnessed for diabetes.

Can arthritis set in at any age?
Yes indeed. Any age group especially elderly( for degenerative arthritis), inflammatory, child bearing age group( metabolic middle age), and trauma (any age group).

What is the general age group which catches up with arthritis?
Any age group especially elderly( for degenerative arthritis), inflammatory, child bearing age group( metabolic middle age), and trauma (any age group).

As there are so many kinds of arthritis so are there different causes for the different types?
Yes. Basically causes may fall into category aging (degenerative), inflammatory, infective (germs), metabolic, (eg: gout), trauma, miscellaneous.

What actually leads to arthritis in women?
Arthritis by definition means inflammation meaning pain swelling leading to structural damage inside the joint which may affect synovion cartiliage bones surfaces leading to deformities.

Are there ways to prevent Arthritis?
Control body weight, keep exercising regularly, observe hygienic measures eg: a clean mouth always, beyond this arthritis cannot be prevented so get it diagnosed and treated asap.

Hello Doctor. Is Arthritis more common in women?
Sure. About three to seven times more in females.

Are there any negative effects of taking Ibandronic acid injection for arthritis?
Ibandronic acid and related drugs are for the prevention of fractures in osteoporosis. They are not meant for other types of arthritis. Such medicines for osteoporosis are generally safe though must be administered under medical supervision.

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