Dubai: In January, Dale Rooney, 30, a ‘Dubai 7s’ rugby player and a physical education teacher in the UAE, had the shock of his life. The back pain that had been nagging him for six years was diagnosed as Ankylosing spondylitis, a type of arthritis that causes inflammation in the joints and ligaments of the spine.
“In all honesty, I had never heard of this disease,” the British expat, who was then forced to retire from his favourite game, told Gulf News.
Speaking in view of the World Arthritis Day observed on October 12, Rooney shared how his story could be an eye-opening case of arthritis.
“My pain in my back started about age 24. The back would completely seize up and the tightness in my muscles in general would be from probably before then, but I didn’t really take notice or I made excuses,” he said.
“I did a lot of excusing myself while carrying on playing sports,” said Rooney, who did not think it was possible that someone as active as him and at his young age could have arthritis.
How it hit him
Due to the quick testing ability in the UAE, he said he was able to get a blood test and get diagnosed finally. “I should have gone to the hospital much sooner... Hindsight is a great thing, and I could have saved my body a lot of wear and tear.”
After the diagnosis, Rooney, who used to play for Ras Al Khaimah in Dubai 7s, had to give up playing rugby professionally, which has been difficult as his life revolved around the sport.
“The disease is tough at times, keeping up with medication and hospital visits, always feeling tired. You feel like you are carrying a baggage. Everything is a little bit harder to do because of fatigue. In the morning, your body feels like a barrel of broken biscuits and it’s very sore to walk for the first 15 minutes because the body hurts.”
The mental toll of arthritis
Apart from the pain, it hit him badly mentally as well. “I wanted to leave the UAE to return home last year. But I was newly diagnosed, and I had only just started the biologics. I knew in my country there was a big waiting list of years for biologics, so I had to change my plans... Also explaining to people, some people can find you lazy or don’t understand and it’s hard to keep up with the demands socially and at work.”
“Even career wise, as an international teacher you must think of insurance for medicines. Some jobs won’t officially say it but with the disease, you’re less likely to get a job. And mentally, it’s the unknown of what’s to come, or how you will be in years’ time and the doubts that surround that.”
Having decided to stay put here, Rooney is keeping up his exercise.
“Movement has worked better than any medicine hands down which is hard to get your head around, I know. I have been playing gaelic football and training for the 5k Dubai Run and hopefully the Ras Al Khaimah half marathon.”
In his message to the public, Rooney said: “If you have constant pain, go and get checked out. If it’s bad news, then do your research, get treatment and keep moving.”
Arthritis and sports persons
Generally, exercise is said to help relieve arthritis pain. But people who are physically active and even sports persons like Rooney have been diagnosed with arthritis. Why does this happen?
Dr Humeira Badsha, consultant rheumatologist and founding member of Middle East Arthritis Foundation (MEAF), said: “Arthritis is a genetically predisposed autoimmune disease, so if anyone, including those who exercise regularly, has the gene passed down — it can be triggered at any point,” she said.
“Additionally, many sports people end up with long-term injuries due to their heavy activity and stress on the body along with long training hours. Their muscles and joints are used much more than the average person. So, the wear and tear happen much quicker too, especially with high-contact sports like rugby.”
Dr Badsha said common sports injuries that can cause early on-set arthritis are ligament injuries, joint dislocations, fractures near the joints, and direct injury to the cartilage.
“Regular checks, warm-ups and cool downs before and after heavy workouts, use of a spotter to ensure you’re using the right technique are some ways to curb arthritis,” she advised.
If one experiences joint pain after overuse or stiffness with inactivity, they should get checked, she added.
Who else can get arthritis?
Who else can get arthritis and who is more prone to get this disease that covers more than 200 types of conditions?
Dr Ghita Harifi, consultant Rheumatologist and long-time active member of MEAF, said: “Most people associate arthritis as only a part of the ageing process and this is not true. Most inflammatory types of arthritis are autoimmune diseases. This can happen at any age to anyone.”
“However, there are several types that can affect both children and young adults. Rheumatoid arthritis is more common among women. Other types of arthritis such as gout and Ankylosing spondylitis affect men more frequently,” said Dr Harifi.
Osteoarthritis (OA) is the most common form of mechanical arthritis and affects up to 30 per cent of the population worldwide. Rheumatoid arthritis (RA) is the most prevalent form of inflammatory arthritis, with around 14 million people around the world being afflicted by it.
Prevalence of arthritis in UAE
“In the UAE, the prevalence of RA is 0.6 per cent according to a study conducted in the country’s primary healthcare centres. This is very similar to the prevalence reported in other countries worldwide which is between 0.5 and one per cent. The prevalence of osteoarthritis (the form of arthritis that is related to an ageing process of the cartilage) is much higher and is estimated at 20 per cent of the general population.”
The cause of arthritis is not known. However, it is known that genetic background plays an important role.
“Environmental factors such as viral and bacterial infections and smoking have been found to trigger the autoimmune reaction leading to arthritis. Moreover, the link between hormonal changes and arthritis is now well established since arthritis is more common postpartum, during menopause etc.,” she explained.
Pain in one or multiple joints that last for a few weeks is the main symptom to look for.
“Stiffness especially if it occurs in the morning and lasts for more than 30 minutes and tenderness and swelling in more than one joint are common symptoms,” said Dr Harifi.
Some forms of arthritis can have more than joint manifestations and may result in fever, skin rash, mouth ulcers, muscle weakness, fatigue and tiredness, she added.
How can one tackle arthritis?
Maintaining a healthy weight and exercising regularly is essential to tackle arthritis, said Dr Badsha.
“Exercise is essential to keep muscles strong, reduce joint pain and stiffness and increase flexibility, cardiac fitness and endurance. When carrying something heavy ensure you use the proper technique to avoid unnecessary stress on your joints. A good rule of thumb is to lift with your legs and carry heavy objects close to the body.”
“Depending on which joints are involved and their inflammation, some types of potential exercises include range-of-motion (e.g. dance), strengthening (e.g. weight training), and aerobic or endurance exercise (e.g. bicycle riding). If none of the above suits then low-impact exercises like walking, swimming and yoga are good options.”
“Get adequate calcium in your diet and sun exposure for vitamin D. Scientists suggest that meditation, talking therapies and counselling could help retrain the brain to reduce the chronic agony felt by millions of arthritis sufferers,” added Dr Badsha.
Eating tips for patients
Recent studies have revealed that genetics only play a role in 30 per cent of all autoimmune conditions like arthritis. The remaining are triggered by the surrounding environment, poor lifestyle, bad habits and gut imbalances by consuming processed oily and refined foods.
Dr Nasr Al Jafari, a functional medicine practitioner, specialising in gut health in Dubai, said these imbalances cause disturbances in the gut lining, causing increased ‘permeability’, which in turn affects the immune system ultimately triggering conditions like arthritis.
He advised to cultivate the following eating habits:
• Eat as ‘close to nature’ as possible
• High intake of polyunsaturated Omega-3 fats that are present in various seafood, nuts and seeds
• High intake of plant-based food, especially cruciferous veggies like arugula, broccoli, cabbage etc.
• Intermittent fasting: Eat for 8 hours of the day and fast for the remaining 16 hours
• Avoid processed foods that have no fibre or nutrition, but are addictive with high sugar content, refined oils, additives, toxins and pesticides.
Support on World Arthritis Day
The World Arthritis Day is celebrated on October 12 to spread knowledge and awareness of the disease so that people recognise the symptoms early on.
In the UAE, the Middle East Arthritis Foundation is championing this with its full-day free-to-attend community event in honour of the day on October 15.
“Anyone can attend and benefit from the informative sessions by our various health experts,” said Dr Badsha.
Attendees can also get several free arthritis tests done — ultrasound scanning of the hands for OA, bone density scan and Vitamin D tests — which are all usually expensive when conducted at a hospital.
The updates are available on the Facebook page of Emirates Arthritis Foundation and registration can be done through its website.