Dubai Health Authority arthritis
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Arthritis is a condition that causes inflammation or swelling of the joints. There are more than 100 variations of arthritis but the two most common are osteoarthritis and rheumatoid arthritis.

Dr Manoj Kumar Nair, Senior Specialist Physiatrist and Senior Registrar, Dubai Physiotherapy and Rehabilitation Centre (DPRC), Dubai Health Authority (DHA), says that arthritis can affect single joints and that it can also cause pain in multiple areas of the body. “Arthritis is an umbrella term used to denote a lot of conditions, whether it’s a seropositive arthritis or seronegative arthritis,” he says.

“It can be a type of arthritis that affects the knee joints or can be a wider case of arthritis that affects different parts of the body.”

Physiotherapy can focus on strengthening the main muscles of the body and improving the movement of the joints.

- Dr Manoj Kumar Nair, Senior Specialist Physiatrist and Senior Registrar, ubai Physiotherapy and Rehabilitation Centre (DPRC), Dubai Health Authority (DHA)

He says that the majority of cases are osteoarthritis, which mainly affects older people and that there are distinct differences to rheumatoid arthritis. “The most common form in the general population, which mainly affects people of old age, is osteoarthritis. It affects the knee joint and can cause difficulty in walking and bending. People with unhealthy lifestyles or health issues can develop osteoarthritis in their early forties.

“Rheumatoid arthritis is a different inflammatory and autoimmune disease, which is present in around one per cent of the population. It can be a very painful condition that affects multiple joints – mainly the small joints such as the hands.”

Early intervention

Dr Nair says that if detected early, there are number of steps than can be taken to slow the progression of arthritis as rheumatoid arthritis can be a debilitating disease. “Around five years after diagnosis for rheumatoid arthritis, 50 to 60 per cent of patients have some form of disability where they are not able to carry out their daily activities. After around 20 years, around 80 per cent of rheumatoid arthritis patients have a moderate to severe disability.

“There are a lot of medications available for managing arthritis, especially rheumatoid arthritis, and although the medications won’t cure the condition, they can prevent a worsening of the disease, which is one of the reasons why early intervention is very important.”

He also says that DHA takes a multidisciplinary approach to treating patients and that programmes are created based on their individual needs and conditions. “The patient’s drug management will be carried out by the rheumatologist and we provide rehabilitation for the patients. At DPRC, there is a multidisciplinary approach by a team of specialists. The team will include a physician, a physiotherapist, an occupational therapist and ergonomic advisers.

“The ergonomic advisers are very important in the case of arthritis because they can suggest modifications in the patients’ workplace. For example, if someone is working in a workshop and they have severe arthritis of the hand where they are not able to use any tools, we would need to talk to the workplace’s management about this issue and find out how to rehabilitate the patient and place them in other areas of work. Work modifications are very important for these kinds of patients.”

Specialists can also include social workers if needed and Dr Nair says that each member of the team can play an important role. “Occupational therapists are also very important for arthritis patients as they give lots of advice on joint protection and modifications for daily activities.

“Physiotherapy can focus on strengthening the main muscles of the body and improving the movement of the joints. This can help patients to minimise the symptoms and pain from their condition. We also teach patients hand exercises for the small muscles of the hands, so they maintain a proper length. Additionally, the physiotherapy can improve patients’ exercise capacity and strength.”

The team will also treat patients using target-based programmes, where they are encouraged to reach attainable results. “The patients’ needs vary depending on each individual. For example, if the patient leads a very active lifestyle then we will need to look into maintaining that aspect of their lifestyle. We take a goal-orientated approach to each patient’s treatment.”

Aside from medication, DPRC also offers additional therapies that can help reduce pain and swelling in arthritis patients. “We can also use electrical nerve stimulation and thermotherapy to help to control arthritis pain and also hydrotherapy (water therapy). Hydrotherapy is an excellent treatment for patients that affects multiple joints because being inside the pool is relaxing for the patient and it can reduce the pain and swelling,” says Dr Nair.