Most people who complain of joint pain do not take their symptoms seriously unless they are severe. They usually prefer to monitor their symptoms thinking that it may be related to some activity, bad sleeping position, a “strain” and various other reasons. They may try using various pain killers based on previous experience or advice from friends or family. The risk involved with this is that some medications may not be appropriate or should not have been used because of other underlying diseases or use of other medications.

Any patient suffering from joint pain, swelling or stiffness should have an early assessment. This assessment would usually involve a detailed history of the complaints and an examination of affected areas. This would usually be followed by requests for investigations, if thought to be necessary. Initial investigations would most likely be in the form blood tests or x-rays. Sometimes the results of the initial tests lead to additional tests being requested or a referral to a specialist such as a rheumatologist.

This initial assessment can be performed by a General Practitioner or Family Doctor. If the patient does not have a doctor that they normally attend to, they should locate one and schedule a visit. For patients who cannot afford private healthcare, there are several Local Health Centers scattered throughout the country which are easily accessible. In cases of an emergency with severe joint pain, swelling or stiffness, patients can visit the nearest Accident and Emergency Facility. Some patients may choose to visit a rheumatologist directly for their initial assessment.

For certain conditions such as rheumatoid arthritis early diagnosis and early treatment is crucial in preventing long-term damage to joints. Most of the medications used for rheumatoid arthritis are slow to act so the sooner patients are diagnosed and started on specific treatment, the earlier these medications would be able to have their effect on the underlying disease. In the early stages of treatment these medications must be used together with pain killers and even steroids.

Another condition which benefits from early intervention is the diagnosis of gout. Most patients who suffer from gout have episodes of joint pain which settles for long periods. The patients therefore use painkillers as necessary and do not feel to need to have formal evaluation and treatment. If left untreated, gout can cause long term damage to the joints with significant deformities.

Even with common conditions such as osteoarthritis, early diagnosis allows for intervention by way of referral for physiotherapy and advice about exercises, footwear, proper sitting posture etc. This early intervention could help slow down the progression of the disease and lead to improvement in the patient’s quality of life.

Targeted treatment in the early stages of the disease is therefore important for long-term management. This highlights the need for early assessment.

Dr Haramnauth Dyaanand
Rheumatologist