Rheumatology

You should see a rheumatologist if you experience joint pain (jorni dukhai) lasting more than 6 weeks, morning stiffness for over 30 minutes, joint swelling or warmth, sudden severe pain in the big toe or ankle (possible gout), unexplained fatigue with joint symptoms, skin rashes with joint pain, or if blood tests show high uric acid, positive RA factor, or positive ANA. Early consultation prevents permanent joint damage. Book a rheumatology appointment at Tulsi Multi Speciality Clinic via WhatsApp, Viber, or by calling our Kathmandu clinic.

A rheumatologist treats joint and muscle conditions caused by inflammation, autoimmune disease, or metabolic problems — such as rheumatoid arthritis, lupus, gout, and Bath Rog — using medication and long-term management. An orthopedic doctor focuses on injuries, fractures, mechanical joint problems, and surgical treatments like joint replacement. If your joint pain comes with stiffness, swelling, fatigue, or affects multiple joints, you should see a rheumatologist. If your pain is from an injury, accident, or needs surgery, you should see an orthopedic specialist. Our rheumatologist at Tulsi Multi Speciality Clinic will refer you to the right specialist if needed.

High uric acid is treated through a combination of medication and dietary changes. Your rheumatologist may prescribe uric-acid-lowering medications such as allopurinol or febuxostat, along with anti-inflammatory drugs during gout attacks. Dietary changes include reducing red meat, organ meats, seafood (especially sardines and anchovies), alcohol (especially beer), and sugary drinks, while increasing water intake and consuming low-fat dairy and cherries. At Tulsi Multi Speciality Clinic in Kathmandu, we provide personalized treatment plans for gout and high uric acid based on your blood test results, lifestyle, and overall health. Regular follow-up monitoring is essential to prevent kidney damage and joint deformity.

Rheumatoid arthritis (RA) is not currently curable, but it is highly manageable with modern treatment. Early diagnosis and proper care with disease-modifying anti-rheumatic drugs (DMARDs), biologics, and lifestyle changes can put RA into remission — meaning little to no symptoms and no further joint damage. The key is starting treatment early. Many patients at Tulsi Multi Speciality Clinic live active, full lives with well-controlled RA. Delaying treatment, however, can lead to permanent joint deformity. If you suspect RA, book a consultation with our rheumatologist in Kathmandu as soon as possible.

If you have gout or high uric acid (uric acid badeko), avoid or limit foods high in purines, including red meat (mutton, beef, pork), organ meats (liver, kidney, brain), seafood (sardines, anchovies, mackerel, prawns), alcohol (especially beer and spirits), sugary drinks and sodas, and high-fructose corn syrup. Reduce intake of lentils (daal), spinach, cauliflower, and mushrooms in large quantities. Increase water intake, eat low-fat dairy products, cherries, vitamin C-rich fruits, whole grains, and most vegetables. At Tulsi Multi Speciality Clinic, your rheumatologist will provide a personalized diet plan tailored to your uric acid levels and Nepali eating habits.

Lupus, or Systemic Lupus Erythematosus (SLE), is a chronic autoimmune disease where the immune system mistakenly attacks healthy tissues, affecting the skin, joints, kidneys, blood, brain, and other organs. Common symptoms include persistent fatigue, joint pain and swelling, a butterfly-shaped rash across the cheeks and nose, sensitivity to sunlight, hair loss, mouth ulcers, fever, and chest pain. Lupus is more common in women, especially aged 15–45. Early diagnosis is critical to prevent organ damage. Our rheumatologist at Tulsi Multi Speciality Clinic, Kathmandu, provides specialized testing (ANA, anti-dsDNA, complement levels) and long-term lupus management.

No, this is a common misconception. While osteoarthritis is more common with age, many forms of arthritis affect young adults and even children. Rheumatoid arthritis often starts between ages 30–50. Ankylosing spondylitis (back arthritis) commonly affects men in their 20s and 30s. Lupus mostly affects women aged 15–45. Juvenile arthritis affects children under 16. Gout often appears in middle-aged men. If you're young and have persistent joint pain or stiffness, don't ignore it — early diagnosis at Tulsi Multi Speciality Clinic can prevent lifelong joint damage.

Diagnosing rheumatic conditions usually requires a combination of clinical examination and laboratory or imaging tests. Common tests include blood tests for inflammation (ESR, CRP), autoimmune markers (RA factor, anti-CCP, ANA, anti-dsDNA), uric acid levels, complete blood count, kidney and liver function, and sometimes joint fluid analysis. Imaging tests like X-rays, ultrasound, or MRI may be ordered to assess joint damage. At Tulsi Multi Speciality Clinic in Kathmandu, our rheumatologist will recommend only the tests necessary for your specific symptoms and guide you through the entire diagnostic process.

Most rheumatic conditions are chronic, meaning they cannot be permanently cured — but they can be controlled extremely well with proper treatment. Many patients achieve full remission with no symptoms. For conditions like gout, controlling uric acid levels prevents future attacks. For rheumatoid arthritis and lupus, early treatment with modern medications can stop disease progression. For osteoarthritis, treatment focuses on pain relief, joint protection, and improving function. The goal at Tulsi Multi Speciality Clinic is long-term symptom control, prevention of joint damage, and helping you live a pain-free, active life.

Many patients with Bath Rog, arthritis, and joint conditions report that their symptoms worsen during cold weather — particularly in Nepal's winter months (December to February). Cold and damp weather can increase joint stiffness, pain, and inflammation, especially in rheumatoid arthritis and osteoarthritis. While cold weather doesn't cause the disease, it can trigger flare-ups. Tips include keeping joints warm with layered clothing, gentle indoor exercise, warm compresses, staying hydrated, and not skipping your prescribed medication during winter. At Tulsi Multi Speciality Clinic, we help patients prepare for seasonal flare-ups with adjusted treatment plans.

Booking a rheumatology consultation at Tulsi Multi Speciality Clinic, Kathmandu, is quick and easy. You can book via WhatsApp, Viber, by calling the clinic directly, or by filling out the appointment form on our website. We accept walk-in patients during clinic hours, but booking in advance is recommended to reduce waiting time. For urgent joint pain, sudden gout attacks, or autoimmune flare-ups, contact us immediately on WhatsApp or Viber for the fastest response. Our rheumatologist consults during regular clinic hours, Sunday through Friday.

Tulsi Multi Speciality Clinic offers expert Rheumatology care in Kathmandu, Nepal — providing accurate diagnosis, advanced treatment, and long-term management for arthritis, Bath Rog (बाथ रोग), joint pain (jorni dukhai), gout and high uric acid, lupus, autoimmune diseases, and musculoskeletal disorders. Our experienced rheumatologist helps patients manage symptoms like joint pain, swelling, morning stiffness, fatigue, and inflammation through personalized, evidence-based treatment plans designed to improve mobility, comfort, and overall quality of life.

Your visit at Tulsi Multi Speciality Clinic begins with a thorough consultation. Our rheumatologist will carefully review your medical history, listen to your symptoms, and perform a detailed clinical examination of your joints, muscles, range of motion, and overall musculoskeletal health. Depending on your condition, diagnostic tests such as blood work (uric acid, RA factor, anti-CCP, ANA, CRP, ESR), imaging (X-ray, ultrasound, MRI), or specialized autoimmune panels may be recommended to confirm diagnosis. After assessment, you will receive a clear, personalized treatment plan that may include medication management, lifestyle and dietary guidance, joint injections, physiotherapy referrals, and structured follow-up monitoring to track your progress.

- Bring previous medical records, lab reports (blood tests, uric acid, RA factor, ANA, CRP, ESR), X-rays, MRI scans, or any imaging from past consultations - Make a list of all current medications, supplements, and any allergies - Write down your symptoms — when they started, which joints are affected, time of day they're worst, and what makes them better or worse - Note any family history of arthritis, gout, lupus, psoriasis, or autoimmune disease - For suspected gout: try to recall recent diet changes (red meat, alcohol, seafood) and previous uric acid levels - Wear loose, comfortable clothing that allows easy examination of affected joints (knees, ankles, wrists, fingers) - Arrive 10 minutes early to complete new-patient registration - Inform us in advance if you are pregnant, breastfeeding, or have kidney, liver, or heart conditions - Bring a family member or friend if mobility is difficult or if you'd like support during the consultation

Rheumatic and autoimmune conditions are typically chronic and require ongoing monitoring, not just one-time treatment. After your initial consultation at Tulsi Multi Speciality Clinic, your rheumatologist will schedule regular follow-up visits — usually every 4 to 12 weeks initially, then less frequently once your condition is stable. Follow-ups include reviewing your response to medication, monitoring side effects, repeating relevant blood tests (such as uric acid, liver and kidney function, inflammatory markers), and adjusting your treatment plan as needed. For gout patients, dietary follow-up and uric acid monitoring are essential. For autoimmune conditions like lupus and rheumatoid arthritis, long-term disease monitoring helps prevent flare-ups and joint damage. Contact our clinic immediately if you experience sudden severe joint pain, new swelling, fever, rash, breathing difficulty, or side effects from medication. Booking via WhatsApp or Viber is the fastest way to reach us for urgent concerns.

Rheumatology is provided by Krishna Adhikari (MBBS, MD (Internal Medicine), Fellowship in Rheumatology). All doctors at Tulsi Clinic are registered with the Nepal Medical Council (NMC).

You can book Rheumatology online through our website, call us, or message us on Viber or WhatsApp. Appointments are confirmed within 24 hours.

All doctors providing Rheumatology at Tulsi Clinic are registered with the Nepal Medical Council (NMC). You can verify their registration on nmc.org.np.

Our doctors and staff at Tulsi Clinic speak Nepali, English, and Hindi. You can request your preferred language when booking.