Patients from Tier-2 and Tier-3 regions reach Bengaluru at advanced stages due to limited diagnostic access, Rheumatology Awareness Month highlights need for early detection
The increase in autoimmune conditions and rheumatology diseases is observed in Bengaluru as well as a number of cases when patients come to Bengaluru from Tier-2 and Tier-3 cities are reported as those whose symptoms have already developed to an advanced stage. Early symptoms such as joint pain, fatigue, or stiffness are frequently managed symptomatically, leading to progression of disease. By the time patients reach tertiary centres in Bengaluru, many already experience severe mobility challenges or organ involvement, making treatment more complex.
For Meera*, in Bengaluru, her recurring back pain was attributed to the time she spent seated at her desk. However, it took over two years of progressively worsening back stiffness for her to seek specialist attention and appropriate tests leading to a diagnosis of ankylosing spondylitis. Her experience represents a trend seen in Bengaluru, wherein back pain is wrongly thought to be linked to posture problems.
The month of April is observed as Rheumatology Awareness Month. This month highlights the rise in the prevalence of autoimmune diseases and the need for early diagnosis. Autoimmune diseases are characterized by an immune response against one’s bodily organs. The disease may affect the joints, skin, kidney, lungs, eyes, and hormone levels.
“In Bengaluru, it is common to find instances where patients suffer from autoimmune conditions like continuous back ache, joint pains and knee pains that are mistaken for orthopedic problems. They tend to seek treatment through orthopedic experts or simply medicate themselves using pain killers, under the assumption that their problem is lifestyle or work-related. This may cause delay in consulting rheumatologists and hence, delay in treatment. The problem might even progress to cause permanent damage in the joints of the body or other parts.
“Bengaluru is seeing a noticeable rise in autoimmune and rheumatological disorders, particularly among working-age adults, and increasingly in younger populations. A significant concern is that many patients travelling from Tier-2 and Tier-3 regions reach the city only after symptoms have progressed considerably. Limited awareness, delayed referrals, and lack of access to specialised rheumatology care and diagnostic facilities often result in patients presenting at advanced stages, sometimes with severe joint damage or systemic involvement.
We regularly diagnose conditions that are very common such as rheumatoid arthritis, systemic lupus erythematosus, psoriatic arthritis, and ankylosing spondylitis but we are also reaching out to the rarer ones such as myositis. Moreover, we are noticing that autoimmune diseases are occurring in children as young as 10 years. The most common among them is juvenile idiopathic arthritis where prolonged joint stiffness, swelling, and fatigue not only limit the child's physical activities but also affect the child's school attendance “, said Dr. Vijay KR Rao, Medical Director and Consultant Rheumatologist, Divisha Arthritis and Medical Centre Bangalore.
Another key challenge with autoimmune diseases is the significant overlap in symptoms, which often makes diagnosis complex and time-consuming. This is why it is essential to carry out specific laboratory tests in close consultation with a clinician to arrive at an accurate diagnosis.
Targeted testing plays a critical role in rheumatology, both in confirming clinical suspicions and in differentiating between conditions that present with similar features. Tests such as rheumatoid factor, anti-CCP antibodies, ANA by immunofluorescence, ANA profile, HLA-B27, etc are invaluable in guiding accurate diagnosis and enabling timely initiation of treatment. At the same time, these investigations must always be interpreted in conjunction with a thorough clinical evaluation. Test results in isolation can sometimes be misleading, particularly in autoimmune conditions where presentation can vary widely.
The recommended approach for autoimmunity testing is to begin with screening tests such as ANA performed using indirect immunofluorescence method. However, these tests should only be conducted when there is a strong clinical indication, since a proportion of healthy individuals may also test positive. Therefore, a positive ANA result alone does not confirm diseases such as lupus or other connective tissue disorders.
In cases where the screening test is positive, a confirmatory test called ANA profile (Line immunoassay) is performed to identify specific antibodies, allowing for a more precise and clinically meaningful diagnosis. Ultimately, the relevance of any laboratory result depends on how well it correlates with the patient’s symptoms and overall clinical assessment.”, said Dr. Swathi Kulkarni, Consultant Pathologist and Head, Department of Immunopathology, Neuberg Anand Reference Laboratory, Bengaluru.
Factors contributing to the increasing burden of these diseases are chronic stress, poor sleep, lack of physical activity, obesity, and the consumption of processed food. Early symptoms such as persistent joint pain, stiffness after getting up in the morning, or inflammatory back pain are usually either ignored or treated symptomatically. Only through targeted diagnostics which are carried out after a clinical evaluation will be able to confirm the disease, tell apart different diseases that have the same symptoms, and start treatment in time in order to prevent permanent disability. They exhibit signs like joint pain and stiffness for more than 45 days, swollen knees and/or feet, morning stiffness, fatigue, fever, loss of appetite, inability to go to school or play. Experts say that these are caused by the excessive use of electronic gadgets, pressures at school, lack of physical activities, intake of junk food, and obesity during childhood. Early detection of such conditions will allow treatment, which will enable patients to resume their normal lives in several months.
In conclusion, this Rheumatology Awareness Month serves as a timely reminder that persistent joint pain or prolonged morning stiffness should never be ignored. Early diagnosis through the right laboratory tests and clinical evaluation can make a critical difference—especially for patients in Tier-2 and Tier-3 regions, where delays are more common. Recognizing symptoms early and seeking expert care can help prevent long-term disability and ensure a better quality of life.
About Neuberg Diagnostics
Neuberg Diagnostics, headquartered in Chennai, is one of India’s leading diagnostic service providers, with a presence across India, UAE, South Africa, and the USA. With 200+ CAP and NABL-accredited laboratories, Neuberg has emerged as one of the fastest-growing and most trusted diagnostic chains in India.
The group offers over 6,000 varieties of pathological and radiological investigations and processes over 30 million tests annually. With a strong focus on advanced diagnostics, genomics, and personalized medicine, Neuberg is committed to delivering accurate, accessible, and science-led healthcare solutions across 250+ cities globally, supported by a robust home collection network spanning 5,500+ pin codes.
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