World Arthritis Day, being marked today, is an opportunity for people with rheumatic and musculoskeletal disorders to make their voices heard

Arthritis is an umbrella term for around 200 rheumatic and musculoskeletal diseases (RMDs) that commonly affect the joints, but can also affect the muscles, other tissues and internal organs.

Affecting both children and adults, RMDs are usually caused by problems of the immune system, inflammation, infections or gradual deterioration of joints, muscle and bones.

Many of these diseases are long term and worsen over time. They are typically painful and limit function. In severe cases, RMDs can result in significant disability, having a major impact on both quality of life and life expectancy.

A survey carried out by the Health Information Directorate in 2013 revealed that 60,000 people in Malta suffered from arthritis – 50,000 from osteoarthritis and 10,000 from rheumatoid arthritis, the two most common and worst forms of this chronic condition. Figures today are probably higher.

“Arthritis is a lifelong and life-threatening condition which, if not taken care of, can cause serious consequences to internal organs and complications that could lead to deformities and physical impairment,” says Mary Vella, president of the Association of Rheumatoid Arthritis – Malta (ARAM), which was set up in 2007.

In the EU alone, over 120 million people are living with a rheumatic disease, with many cases undetected

“That same year, my rheumatologist worked hard to introduce a rheumatology unit at St Luke’s Hospital. Now based at Mater Dei, the unit is run by a multidisciplinary team of six consultant rheumatologists, a rheumatologist specialised in young patients, a rheumatology nurse, a physiotherapist, an occupational therapist and a podiatrist,” says Vella, who was diagnosed with rheumatoid arthritis in 2001.

“Naturally, the next step was to set up an association led by arthritis patients themselves. It was at that time that I was approached to run the association,” she explains.

The cause of arthritis is still unknown, although various factors can play a role, namely genetic predisposition, smoking, high levels of alcohol consumption, as well as an unhealthy lifestyle.

The onset of arthritis may vary from one individual to another.

“If a person starts to feel pain and stiffness, especially first thing in the morning, and that pain persists daily for at least a week, you immediately need to seek advice from your family doctor,” Vella points out.

Once a person is diagnosed with arthritis, they are immediately prescribed medication to prevent further damage and any other negative consequences that could further debilitate them. The medi­cation prescribed will be decided on by the consultant rheumatologist and an explanation will be given to the patient.

“The consultant and patient will together decide the way forward and discuss medication options. Generally, the patient will be put on corticosteroids, anti-inflammatory drugs, biologic injections and, recently, biosimilar medications,” says Vella.

Diagnosing signs and symptoms of arthritis at an early stage will cause less damage and, subsequently, less suffering from pain will be experienced. Early diagnosis also helps prevent depression, with the patient affected more likely to remain stable, thus being able to keep up a healthy lifestyle, stay in employment and feel independent.

Campaign focuses on entering, staying at the workplace

Malta, through the Association of Rheumatoid Arthritis, will be joining the Don’t Delay, Connect Today campaign by the European League Against Rheumatism (EULAR), the European umbrella organisation representing scientific societies, health professional associa­tions and organisations for people with rheumatic musculoskeletal disorders.

EULAR aims to reduce the burden of RMDs on individuals and society and to improve treatment, prevention and rehabilitation. To this end, it fosters excellence in education and research in the field of rheumatology, promotes the translation of research advances into daily care and fights for the recognition of the needs of people with RMDs by the EU institutions through advocacy action.

RMDs are among the main causes of physical disability and keep an estimated one million Europeans out of work every day, and millions more globally, representing substantial productivity costs for companies and society.

‘Don’t Delay, Connect Today’ unites the voices of its three pillars, patient organisations, scientific member societies and health professional associations – as well as its international network – with the goal of highlighting the importance of early diagnosis and access to treatment. In the EU alone, over 120 million people are currently living with a rheumatic disease, with many cases undetected.

For this year’s World Arthritis Day, EULAR’s campaign with the theme Time2Work aims to dispel misconceptions about RMDs and shows how employers can best support people who live and work with the conditions.

While some RMDs are long term and worsen over time, many can be effectively managed through early intervention, minimising symptoms and an improved working environment. Delays in treatment, however, can result in significant disability, including irreversible damage to joints, tissues and organs, as well as decreased life expectancy.

“Employers can support the well-being of people with RMDs; work is a critical part of building self-esteem and it’s a tragedy that so much talent is lost from the workforce,” said Iain McInnes, president of EULAR and chair of the International League Against Rheumatism.

 In many of the 73 countries of the Asia-Pacific region, where 70 per cent of the world’s population lives, the number of rheumatology specialists is not sufficient to meet needs.

“We are working to expand access of people with RMDs to evidence-based treatment,” said Syed Atiqul Haq, president of the Asia Pacific League of Associations for Rheumatology. “The best strategy for all people with RMDs is to obtain care from a specialist as soon as possible.”

ARAM will be working with various stakeholders, including EULAR delegates, the Rheumatology Department at Mater Dei Hospital, Malta College of Family Doctors, Commission for the Rights of Persons with Disability, Employers’ Association, trade unions and MPs, during a discussion at the House of Representatives on October 21 that will focus on work issues rheumatoid arthritis patients face.

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