Bath Rog (बाथ रोग): What It Is, Types, Symptoms and Treatment in Nepal
By Dr. Krishna Adhikari, Consultant Rheumatologist
MBBS, MD (Internal Medicine), Fellowship in Clinical Rheumatology
Bath rog (बाथ रोग) is the everyday Nepali name for a whole family of diseases that cause pain, swelling and stiffness in the joints, muscles and bones. It is not one illness with one cure: osteoarthritis, rheumatoid arthritis, gout, lupus and ankylosing spondylitis are all called bath rog in ordinary speech, and each one is treated differently. The doctor who specialises in these conditions is a rheumatologist, or बाथ रोग विशेषज्ञ.
What does "bath rog" mean in English?
In medical English the same group is called rheumatic disease or arthritis: pain, swelling and stiffness in one or more joints. Because many different diseases cause that, the word alone does not tell you what is wrong or what will help. Putting a specific name to the disease is the main job of the first visit.
In English, bath rog (बाथ रोग, also written baath rog or bathrog) means arthritis or rheumatic disease; some people type it as "bath disease". Arthritis is the word often used for any disorder that affects the joints. Rheumatic disease is the wider medical term for diseases that usually affect the joints, tendons, ligaments, bones and muscles; some, such as lupus, also affect organs.
Arthritis in Nepali (बाथ / गठिया)
In Nepali, arthritis is usually called बाथ (baath) or बाथ रोग; some people also say गठिया (gathiya).
आर्थराइटिस (arthritis) लाई नेपालीमा बाथ वा बाथ रोग भनिन्छ; कतिपयले गठिया पनि भन्छन्। आर्थराइटिस भनेको एक वा बढी जोर्नी दुख्ने, सुन्निने र कडा हुने अवस्था हो, जसले गर्दा जोर्नी चलाउन गाह्रो हुन सक्छ। ओस्टियोआर्थराइटिस, रुमाटोइड आर्थराइटिस (गठिया बाथ) र गाउट यसका केही प्रकार हुन्।
The main types of bath rog
Osteoarthritis (ओस्टियोआर्थराइटिस)
A degenerative joint disease in which the tissues inside the joint break down over time. It most often affects the knees, hips, hands, neck and lower back, and becomes more common with age. Pain comes on with use and settles with rest, and stiffness in the morning or after resting usually lasts less than 30 minutes.
Rheumatoid arthritis (रुमाटोइड आर्थराइटिस)
An autoimmune disease: the immune system attacks the lining of the person's own joints. It usually begins in the small joints of the hands and feet, often on both sides at once, and morning stiffness lasts longer than half an hour. It can also bring tiredness, fever and weight loss, and affect the eyes, lungs and heart. Women are affected two to three times more often than men. More in our guide to rheumatoid arthritis.
Gout (गाउट)
Urate builds up over a long period and forms needle-shaped crystals in and around a joint. The pain arrives suddenly and is severe, usually in the big toe, though ankles, knees, hands, wrists and elbows can also be hit. It is more common in men and usually develops in middle age. See our guide to gout and high uric acid, including what the evidence says about daal.
Lupus (लुपस)
A long-lasting autoimmune disease that can affect many parts of the body: skin, joints, heart, lungs, kidneys, blood cells and brain. Symptoms vary between people, from mild to severe. Women get lupus about nine times more often than men, usually between the ages of 15 and 45. More in our guide to lupus.
Ankylosing spondylitis (एन्काइलोजिङ स्पोन्डिलाइटिस)
A type of arthritis that inflames the joints and ligaments of the spine. The usual symptom is lower back or hip pain with stiffness, and it tends to first develop in teenagers and young adults; most people develop symptoms before the age of 45. Persistent back pain in a young adult should be shown to a doctor, not treated as an ordinary strain. More in our guide to ankylosing spondylitis.
Symptoms of bath rog
The main symptoms of bath rog (arthritis) are pain, swelling and stiffness in one or more joints, which can make them hard to move. You may also notice:
tenderness when the joint is touched
warmth or redness over the joint
less movement in the joint than usual
flare-ups, when symptoms suddenly get worse for several days
in some types, tiredness, fever or a rash
Any joint can be affected. Dr. Krishna Adhikari explains the symptoms in his video Rheumatic Disease: Symptoms | बाथ रोगका लक्षणहरु.
Get medical help straight away if one joint suddenly becomes very painful, swollen, hot or red, or if painful joints come with a fever or you feel hot, cold or shivery. This can be a joint infection (septic arthritis), which needs treatment as soon as possible.
Is arthritis a serious problem?
It can be. Symptoms range from mild to severe and can come and go or get worse over time. Some types cause lasting joint damage, and some also affect the heart, eyes, lungs, kidneys or skin. Treatment depends on the type: it aims to control symptoms and, in inflammatory types, to limit joint damage, which is why a named diagnosis matters.
How bath rog is diagnosed
For most of these diseases there is no single test, and the pattern matters more than how bad the pain feels. A rheumatologist takes a medical history, examines the joints and watches how you move, then orders laboratory tests and imaging. Which joints are involved, whether both sides hurt, how long morning stiffness lasts and whether there are symptoms away from the joints all point in different directions. Blood tests used in rheumatoid arthritis include rheumatoid factor (RF) and anti-CCP antibody. In gout, the most definite test is taking fluid from the swollen joint with a fine needle and looking for urate crystals under a microscope. Ultrasound and MRI can pick up changes early, when X-rays are still normal.
How bath rog is treated
Treatment depends on which disease it turns out to be, so what follows is what a doctor may consider, not a prescription. In osteoarthritis, care centres on pain control, exercise and joint protection. In rheumatoid arthritis, a doctor may prescribe disease-modifying antirheumatic drugs (DMARDs) and, if those are not enough, biologic medicines; the aim is remission. In gout, anti-inflammatory medicines settle an attack while urate-lowering medicines prevent the next one. Lupus is treated with medicines that calm the immune system.
Diet and home care
The NHS lists things you can do to ease arthritis symptoms: regular low-impact exercise such as walking, swimming or yoga, a healthy, balanced diet, keeping to a healthy weight, not smoking and not drinking too much alcohol. These help alongside treatment, not instead of it. In gout, a type of bath rog linked to high uric acid, some foods and drinks can raise the risk: see our guide to gout and high uric acid, and our Nepali food list.
Rheumatologist or orthopaedic surgeon: who treats bath rog?
If you see an orthopaedic surgeon first for an injury or a fracture, that is the right choice. The American College of Rheumatology draws the line this way: an orthopaedic surgeon's role is to perform surgery on bones and joints, while a rheumatologist's role is to work out which musculoskeletal disease a person has and treat it without surgery. If no injury lies behind the pain, if it has lasted weeks, if several joints are involved, or if it comes with rash, fever or fatigue, a rheumatologist is the right starting point.
बाथ रोग: नेपालीमा संक्षेप (bath rog in Nepali)
बाथ रोग भनेको जोर्नी, मांसपेशी र हड्डीका धेरै किसिमका रोगहरूलाई जनाउने सामान्य नेपाली शब्द हो। मुख्य लक्षणहरू जोर्नी दुख्ने, सुन्निने, कडा हुने र चलाउन गाह्रो हुने हुन्। यसका मुख्य प्रकारहरूमा ओस्टियोआर्थराइटिस, रुमाटोइड आर्थराइटिस, गाउट, लुपस र एन्काइलोजिङ स्पोन्डिलाइटिस पर्छन्। हरेक प्रकारको उपचार फरक हुने भएकाले सही रोग पहिचान गर्नु जरुरी छ। जोर्नी दुख्ने वा सुन्निने समस्या लामो समयदेखि छ भने बाथ रोग विशेषज्ञ (रुमाटोलोजिस्ट) लाई देखाउनुहोस्। कुनै जोर्नी अचानक धेरै दुखेर सुन्निएको, तातो वा रातो भएको छ, वा जोर्नी दुख्दा ज्वरो आएको छ भने तुरुन्तै डाक्टरलाई देखाउनुहोस्।
When to see a rheumatologist
Consider an appointment if joint pain or swelling has not settled, if morning stiffness lasts more than 30 minutes, if the same joints hurt on both sides, if back pain and stiffness began before the age of 45 and have run for months, or if joint pain comes with rash, mouth sores, hair loss or weight loss. If a joint suddenly becomes red, hot and very painful, or painful joints come with a fever, get medical help straight away. In rheumatoid arthritis, early diagnosis and management can reduce symptoms, slow the disease and prevent disability, so waiting carries a real cost.
Bath rog treatment in Kathmandu Valley
Rheumatology care at Tulsi Multi Speciality Clinic is provided by Dr. Krishna Adhikari, consultant rheumatologist and Lecturer in Internal Medicine at Patan Academy of Health Sciences (Patan Hospital), NMC No. 13049. He consults Sunday to Friday from 4:00 PM at AVM Chowk, Manbhawan, Lalitpur-5, Kathmandu Valley. See our rheumatology service and Dr. Krishna Adhikari's profile, book an appointment, or call +977-1-5914294. This article is general information, not a substitute for a consultation.
Sources
Rheumatology care at Tulsi Multi Speciality Clinic · Dr. Krishna Adhikari, consultant rheumatologist
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