Study reports shortage of rheumatologists in India, highlights the need for awareness on Ankylosing Spondylitis
Study reports shortage of rheumatologists in India, highlights the need for awareness on Ankylosing Spondylitis
- Ankylosing Spondylitis, a painful inflammatory disease affecting the spine and other joints, is becoming increasingly prevalent in young Indians
- Treatment is often delayed due to frequent misdiagnosis as common back pain and is further compounded by the massive shortage of rheumatologists in India
- Fixing these gaps will allow patients to access advanced treatment options in the forms of lifestyle changes and biologics that can improve their life quality and lower the risk of comorbidities
Bangalore, Nov 22nd, 2021: Many young Indians today, wake up with severe back or thigh pain. This is usually ignored or is addressed with temporary solutions in the form of balms, or painkillers which helps in getting prepared for another day of work. This is the trigger point for Ankylosing Spondylitis, a condition that is often misrepresented as a “regular backache”. However, it is an inflammatory condition that affects the joints of the spine, reducing its flexibility, damaging the posture, and poses the risk of loss of mobility.
It is imperative to seek medical attention if one has a low back or buttock pain that comes on gradually and is worse in the morning or awakens you from sleep. If AS, is not treated properly and in time, it can affect the entire spine, leading to functional disability. Most of the time, the diagnosis is delayed due to late referrals to the Rheumatologist, the specialist who helps with diagnosis and management of systemic autoimmune conditions such as AS. Basis reports, in India, 69% of patients received an incorrect treatment and diagnosis before consulting a rheumatologist2. Misdiagnosis or delayed diagnosis impede treatments such as biologics that can help in slowing down the structural damage progression caused by AS and aim at preventing bone fusion.
Dr. B. G. Dharmanand, Consultant Rheumatologist, Vikram Hospitals, said, “Sometimes patients and even general doctors find it difficult to distinguish the most common initial symptom of Ankylosing Spondylitis (AS) which is back pain from other common causes for back pain. This usually leads to a delay in diagnosis. A lot of youngsters suffer from AS and it is an important cause of disability in this population. So, treatment for this condition must be taken seriously. Around 10 patients are diagnosed with AS each week in a rheumatology clinic, with a male to female ratio of about three to one.”
In India, another challenge is limited patient understanding and wrong references, as people opt for orthopedic treatments. This can lead to disease progression which can eventually lead to a total fusion of the spine if not given proper media attention. While AS is irreversible, its progress can be significantly slowed with daily exercises, the right treatment, and timely help. Hence seeking medical aid and attention from specialists in the field i.e., rheumatologists becomes imperative.
“When it comes to treatment, biologics are currently very effective in resolving symptoms and delaying progression. As doctors, we try and generate more awareness around this disease. Early diagnosis leads to correct and prompt treatment which will lead to better outcomes.”, he added
Lack of awareness along with a limited number of Rheumatologists in India will result in added burden on the healthcare system. Currently, there are only 1500 practicing rheumatologists which causes a delay in diagnosis. For AS, the patient needs to work closely with a doctor/specialist to find a treatment plan that best addresses the discomfort and difficulties experienced. There are also patient support groups where attendees can engage in confidential, non-judgmental interactions with peers who know what it feels like to live with AS. Right treatment and support can help one lead a normal, productive life, despite the diagnosis.