Are You Living with Chronic Pain?

There are more than 100 types of rheumatic diseases, including rheumatoid arthritis, gout and lupus. These diseases can greatly impact a person’s ability to move without pain.

Osteoarthritis Rheumatoid Arthritis
Usually in only one joint Symmetrical, affecting joints on both sides
(e.g. both hands)
Pain or stiffness is low in the mornings,
and gets worse throughout the day
Wake up in pain or with joint stiffness that
tends to get better as the day goes on
Most common in the knees, hips,
lower back and the base of the thumbs
Most common in small joints
(like fingers and wrists)
Mostly affects those over age 50 More common in women, with peak incidence
in those age 30-40 but can happen at any age
Develops over years Can happen suddenly; for example, one morning
your ring no longer fits

Rheumatic diseases cause more disability than heart disease, cancer or diabetes, according to the American College of Rheumatology, but rheumatic diseases tend to be much less understood than the big name, high-profile diseases. Through practice and education, UCF Health elevates the care of rheumatic diseases to give patients a better quality of life.

“Patients often go months or even years in pain before they are accurately diagnosed,” says Dr. Shazia Bég, a rheumatologist at UCF Health. “There are efforts being made within the rheumatology profession to increase awareness of rheumatic diseases among primary care providers so patients get proper care in a timely manner and thereby have better outcomes. This is especially important in diseases such as rheumatoid arthritis and psoriatic arthritis where the first six months of symptoms can lead to joint damage if not treated.”

For some, the struggle with rheumatic disease begins at a young age and arthritis is often overlooked. This can make accurate diagnoses a struggle for many patients, a number of whom spend years seeking an explanation for their symptoms. Misdiagnoses are not only frustrating, but there can be long-term effects when diseases go untreated.

Managing a disease like rheumatoid arthritis to prevent joint damage and other systemic complications, like early heart disease, requires a partnership between the patient, the rheumatologist, the primary care physician and sometimes other specialists like cardiologists. Although there are several treatment options for people with rheumatic diseases, medications can have different effects on different patients. What works for one person might not work for another.

“The medications we have today offer patients a much improved quality of life,” says rheumatologist Dr. Neha Bhanusali. “But finding the best medication that controls their symptoms with minimal to no side effects can take some trial and error.”

The rheumatologists at UCF Health incorporate the latest medical literature in treatment and prevention and customize treatment plans based on the patient’s history, goals, concerns and values to find the best fit for arthritis medications.

“This is a highly individualized disease, and therefore treatment should always be highly individualized,” says Dr. Bhanusali.

Improving the clinical skills of medical professionals is especially important for the diagnosis and treatment of rheumatic diseases since symptoms can differ widely from person to person, making diagnosis difficult. In addition to treating patients, the UCF Health rheumatology team also teaches at the UCF College of Medicine, elevating the awareness of rheumatic diseases among the medical students and residents. Through the med students’ required course work, they gain exposure to elements of rheumatology, which not only helps decrease misdiagnoses, and therefore shortens the gap between symptom onset and treatment, but can also encourage more students to join the subspecialty.


Meet The UCF Health Rheumatology Team

Shazia Bég, M.D. – Dr. Bég works with patients to manage pain and mobility issues commonly associated with rheumatic diseases, improving their quality of life and overall health. She is actively involved with the Arthritis Foundation and the Lupus Foundation of Florida to improve education and awareness of these diseases. Dr. Bég’s research projects include managing chronic RA pain with a multidisciplinary team that includes physical therapists, psychologists and physicians, and finding possible environmental and microbial triggers for autoimmune rheumatic diseases.

Neha Bhanusali, M.D. – Dr. Bhanusali’s areas of specialization include inflammatory arthritis, lupus, osteoarthritis, advanced biologic therapies and osteoporosis. As a believer in the benefits of an active lifestyle, especially when it comes to arthritis management, she works closely with her patients to develop strategies for increasing mobility and improving their quality of life. Dr. Bhanusali’s research has examined the effects of yoga on myositis patients and better approaches to patient care in managing RA.

Nausheen Hassan, M.D. – Dr. Hassan decided to specialize in rheumatology to help people have better functionality and therefore a better quality of life. She is especially interested in helping patients with rheumatoid arthritis and lupus.


Spotting the Symptoms of Rheumatoid Arthritis
If your joints are stiff or hurting, you should never assume it’s just the aging process. Similarly, you should not assume your child’s joint pain is “growing pains” or that they are just too lazy to move. If inflammatory arthritis is not detected and treated early, it can lead to permanent joint damage, which is why it is important to discuss your symptoms with your primary care physician who can assess the need for referral to a rheumatologist.

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Written by Megan Pabian

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