Yoga may enhance mobility and spiritual strength among patients of autoimmune arthritis

Dr Humeira Badsha, Founder of Emirates Arthritis Foundation & consultant rheumatologist recommends yoga to her patients

With the World Autoimmune Arthritis Day on May 20, Bandana Shah of Yoga & Wellness interviews Dr Humeira Badsha, the founder of Emirates Arthritis Foundation and consultant rheumatologist, to discuss the disease that affects more than 20% of the UAE’s population

1. Which age group or gender is more prone to arthritis?

There are more than 50 types of autoimmune arthritis, so it can affect anyone from a child to a nonagenarian. Different types of arthritis may affect different age groups. In terms of gender, it also depends on the type of arthritis. For example, more women suffer from rheumatoid arthritis (RA) – the main autoimmune arthritis. Around 70% of rheumatoid arthritis patients are women. Men are more prone to ankylosing spondylitis - a type of autoimmune arthritis affecting the spine. In some types, such as psoriatic arthritis, the chances of both men and women being affected are the same.  

2. What are the most common causes for autoimmune arthritis?

The most common factor is genetic predisposal. Though most patients point out that no one in their family has arthritis, they might not be aware that they carry it genetically. It is some factors or conditions such as infections that trigger the disease. Any of the below factors could trigger the illness in your body:

  • Infection: Even if you get affected by a common virus or bacteria, the body thinks it’s under attack and the immune system gets over-activated and starts attacking your own body. Instead of taking care of the infection and shutting down, it stays active.
  • Injury: Wounds sustained after falling or after a surgery.
  • Foreign elements: Any implants in the body such as metals (plates, screws, nails and wires fitted to repair fractured bones or knee replacement), silicon breasts and dental fillings.
  • Environment: Mold, extreme weather conditions
  • Gut microbiome: The quantity of bacteria in the body overpowers the amount of human cells and genes. We carry many silent organisms within us. This could lead to an imbalance. For example, people get various types of bacteria in their mouth. Particularly, gingivalis bacteria triggers rheumatoid conditions. The imbalance can also be caused by wrong medication or food.
  • Stress: Severe degrees of stress such as chronic and acute could be a result of an event. I have had a patient who got lupus when her son was sent to war, another one got RA after the death of a loved one.
  • Smoking: A person who has a genetic predisposition and smokes has a 20 times higher risk of developing RA than a non-smoker.
  • Obesity: One of the big factors that can trigger arthritis.

3. What are the symptoms of autoimmune arthritis?

The initial symptoms are joint pain and swelling. A person suffering from RA may get pain and stiffness in the fingers, stiffness in the morning which lasts more than half an hour and swelling in the joints.

Those suffering with ankylosing spondylitis may have back pain and stiffness, which is usually worse in the morning or after sitting or resting rather than when they are active.

Other types of autoimmune arthritis such as systemic lupus give the patient a facial rash, severe hair loss and joint pain.

Sometimes patients do not know that their eye inflammation and back pain are linked. Similarly, some have skin rashes, as well as joint pain that point to psoriatic arthritis.

4. How will patients suffering from a skin rash or a swollen eye know that their symptoms are that of arthritis?

If they visit an ophthalmologist or a dermatologist and they diagnose any autoimmune condition, the next step is to visit a rheumatologist.

5. Are RA patients prone to other diseases?

Yes, people with autoimmune arthritis are more predisposed to coronary artery disease like heart problems. Those with psoriatic conditions may also have diabetes and high blood pressure.

6. How does arthritis affect the patient’s daily life?

A person with RA suffers not only from pain but also stiffness and has difficulty in moving their joints. This affects their work. If they aren’t treated, they could get disabled. The disease also makes patients fatigued. A sum of all these can lead to depression as one may feel like giving up.

7. How can patients help themselves?

First of all, visit a rheumatologist and build a good relationship with your doctor. Once you trust your doctor, you can share how the illness is affecting you and your life – work and family.

You also need to have a good support structure around you. A supportive family, friends and other patients who can understand you. Find a group of people to exercise with. The Emirates Arthritis Foundation members, too, have formed a group and do a lot of positive activities that has made a big impact on each of their lives.

8. How can spouses and children play a part in helping their dear ones suffering with arthritis?

The disease is not visible. Many of my patients feel bad because they think no one understands them. The spouses think they are making a fuss and children are engrossed in their own lives. Patients also feel frustrated for not being able to give 100% towards their family. They require a lot of understanding and support. Accompany the patient for doctors’ visits, so that the doctors can tell you what is wrong with your spouse or your parent. A lot of my patients come alone as they feel they can take care of themselves or their family members are busy. It is true that people get busy, but they should at least sometimes accompany their near ones to the hospital.

9. Your patients divulged that you are a big proponent of yoga. Could you elaborate?

I believe in a 360-degree approach. Medications must be continued. Physiotherapy is specific. Suppose you have a neck pain which needs intervention for pain relief, you need physiotherapy. Regular, low impact workouts like swimming, yoga and walking. With yoga, the benefits are beyond the physical. There is a meditative and calming aspect. People with disease related to the immune system really need to calm down.

There’s now empirical evidence on the benefits of yoga for people with arthritis. We have conducted the first ever research in the UAE and published a study titled ‘The benefits of yoga for rheumatoid arthritis: results of a preliminary, structured 8-week program’. We focused on swelling of joints, tender joints and the ESR blood test which shows inflammation. All results were better and the overall score including the quality of life improved.

This became a foundation for further research in the USA where studies were conducted with a bigger group of people. It was revealed that those who practiced yoga compared to regular exercise benefitted more because it’s not a hard exercise for the joints and the breathing techniques of yoga help calm the immune response. Breathing influences the brain chemistry and immune system.

10. What changes can patients bring to their lifestyle?

Diet: Certain foods such as sugar, dairy products, gluten, red meat and eggs influence the gut bacteria and should be avoided or minimized. Though I don’t preach that the patients should opt for vegetarian meals, it is important they include a lot of fresh vegetables in the diet. Try to opt for a plant-based diet and avoid processed food. Have good proteins like fish or chicken.

Medications and Vitamin D are important for the immune system.

Yoga or other light exercises are also a must.

  • I had RA since childhood but it got worse in the 2000s due to my weight among other factors. Due to the limitations posed by RA, I could not work out in a gym. Having left with three options - yoga, swimming and walking - I opted to do yoga in 2008, even before I was under Dr Humeira’s care. However, it was Dr Humeira who pushed me to do practice regularly. Yoga helps me with my mobility and flexibility and improved my condition. Now I do hatha yoga twice a week and also try to participate in yoga events in the city.

    - Priya Ranjan

  • I was diagnosed with RA about two years ago. It has been a year since I started doing yoga twice a week. Though I’m on medications as well, yoga helps me work on different areas of my body and contributes to my overall health and wellbeing.

    - Aylene (name changed for privacy reasons)

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