‘I Kept Asking, Why Me?’: Young Women With Rheumatoid Arthritis on How They Cope

"I used to work out and had a pretty good lifestyle. So I couldn't understand why it happened to me."

Tarika, a 29-year-old lawyer, was 23 when she first started noticing a persistent pain in her leg.

"Initially, I brushed it off. I thought maybe it was because of the cold, exhaustion, or the shoes I was wearing."

Fast forward a few months and the pain had rapidly spread to her other joints. 

"It got so bad that I couldn't hold my toothbrush," she tells FIT.

This is when she consulted a doctor who ran some tests and told her she had rheumatoid arthritis.

"It was a complete shock to me. It took me some time to come to terms with it," says Tarika.

Rheumatoid Arthritis (RA) is an autoimmune condition that mainly affects young women.

It's fairly common, can be diagnosed with a test, and has an effective treatment that can help control it. Yet, getting the diagnosis at the peak of your youth can be a hard blow to bounce back from.

Especially, since not enough patients are talking about it.

"I remember feeling so lonely at the time because I didn't know anyone else who could understand what I was going through."

Tarika, 29

Is It Just Growing Pains, or Is It RA?

But, isn't arthritis that 'old people problem' that causes joint pain?

"There are many different kinds of arthritis. RA is an inflammatory kind of arthritis that generally occurs in young populations below 40 years of age," says Dr Priyanka Kharbanda, Senior Consultant, Rheumatology, Fortis Hospital, Delhi.

She adds, "RA is very common in the Indian population. Especially, in young women who are of childbearing age."

"Men can also get it, but the ratio is 9:1 (for every man who has RA, 9 women have it)."

Dr Priyanka Kharbanda

Some symptoms to look out for include:

• Pain in the small joints, especially of the hands and feet

• Swelling in the joints

• Stiffness in the hands and the joints when one wakes up

In more severe cases:

• Dry eyes and dry mouth

• Skin rashes

• Ulcers in the mouth

• Interstitial lung diseases (ILD)

According to Dr Kharbanda, symptoms of RA can appear without any preamble.

The Onset Of RA: It Comes Without a Warning

29-year-old Shreya, who was diagnosed with RA back in August 2023 says it started one day out of the blue.

"I felt a strange tightness in my fingers and then other parts of my hand for about a week straight," she says, adding, "and then my toe joints also started hurting, especially when I would wake up. It started suddenly. There were no telling symptoms leading up to it."

At a young age, one doesn't expect random aches and pains to be anything serious.

This is why many tend to ignore the signs, like both Tarika and Shreya did at first.

"Initially, the thought of RA hadn’t even crossed my mind. When I finally showed it to a doctor and was diagnosed with RA, I couldn't reconcile with it," says Shreya.

'Feels Likes Being Given a Life Sentence'

The way Tarika and Shreya describe their journey after being diagnosed with RA is similar to what one goes through in the various stages of grief.

• Denial

Tarika says, "I just didn't think it would be this serious. I wasn't ready to accept it. I kept thinking, Why me? Why me? Why me?"

"I've had a routine of working out, doing yoga, and I’ve been eating healthy too for the past two years, and have a pretty good lifestyle so the diagnosis came to me as a shocker," says Shreya.

• Fear and Depression

"Initially it was hard for me to overcome my fear of doing physical activity. I was very scared of jogging, or jumping, or doing any activity," says Tarika.

She goes on to say that it was also an extremely lonely time.

"When I was diagnosed, it wasn't easy. I remember not wanting to leave my room and not wanting to speak to anyone."

Tarika

She says she was even met with apathy from the people around her. That made her clam up even further. "A boy in my college said to me, 'Well, you know my father has arthritis. He’s 60. You’re an oldie. Aren’t you embarrassed?' Perhaps he thought joking about it would make me feel better. It didn't."

• Stress

Adjusting your life around this new condition can be an extremely overwhelming ordeal too.

For Shreya, the time she got diagnosed was also a time of major changes. "I was supposed to move to the US in August. So for me it was very stressful with moving countries all by myself, the harsh winters there, the whole healthcare system there, and how I would manage my illness alone."

"I had so many apprehensions and questions. But speaking to people who have had this experience before gave me some confidence."

Shreya Shrivastava

This is why doctors say, patient counselling is very important during and after the diagnosis.

• Acceptance

"Eventually I had to have a conversation with myself to accept that this is just another circumstance that life has thrown at me and I can't choose to give up," says Tarika, adding that seeing a difference with medication helped further.

But, she says, acceptance is a continuous process. "Even now, I find it hard to admit it to others that I have this condition."

Doctors Want You to Know It Can Be Controlled, But You Must Act Fast

According to the experts that FIT spoke to, some conditions that can worsen RA are:

• Change in season

• Moisture in the air and humidity

• Cold weather

• Some viral and bacterial infections like COVID

• Smoking

And what can help alleviate it?

• Drier, warmer environments

• Exercising regularly, stretching in the morning

• Heat compression

• Regular and timely medication

"Now we have disease modifying drugs that not only stops the progression of the disease but can also, to some extent, reverse the severity," says Dr Sanjay Agarwala, DPS (Medical Director), Hinduja Hospital, Mumbai.

He adds, "So, it is possible to control the disease and have a totally normal life. Just like in the case of diabetes, high blood pressure, etc."

Dr Kharbanda adds, "There is a window of time of within two years of the first symptoms. If left untreated, the patient will develop deformities which cannot be then rectified. So, it is very important that the treatment is started as early as possible so that the deformities can be halted."

"Patients also have myths like we have to avoid sour foods, curd, or rice. No. During the treatment of arthritis, there is no food restriction required. But you have to take your drugs regularly on time."

Dr Priyanka Kharbanda

There is no permanent cure for RA – but early and aggressive treatment gives these young women the hope of remission.

Both Tarika and Shreya were able to bring their conditions into remission with timely treatment – they rarely experience symptoms and no longer need regular medication.

But this also does not mean that the symptoms cannot come back.

"They eventually will at some point," explains Dr Agarwala. "But as long as you keep up with medication, you can keep it under check, and live a full life without restrictions."