Many Nigerians living with persistent joint pain, stiffness, and swelling often turn to painkillers and informal remedies instead of seeking professional medical care. This trend has raised concerns among medical professionals, who warn that delayed diagnosis and self-medication can exacerbate arthritis and other rheumatic disorders. Consultant Rheumatologist and Associate Professor at the Lagos State University Teaching Hospital and Lagos State University College of Medicine, Olaosebikan Hakeem, has sounded the alarm on the growing burden of rheumatic and musculoskeletal diseases (RMDs) in Nigeria.
According to data cited from the Nigerian Orthopaedic Association, over 1.5 million Nigerians receive treatment for or suffer from arthritis annually. However, the actual community burden may be higher due to underreporting and limited access to diagnosis. Hakeem noted that Nigeria faces a severe shortage of specialists, with fewer than 30 to 40 practising rheumatologists serving a population of over 220 million people. The country also has only one paediatric rheumatologist for children with rheumatic and musculoskeletal diseases.
Rheumatic and musculoskeletal diseases comprise over 100 conditions affecting the joints, muscles, bones, ligaments, tendons, connective tissues, and immune system. These conditions include osteoarthritis, chronic low back pain, rheumatoid arthritis, systemic lupus erythematosus, and gout. Contrary to the belief that arthritis is mainly a disease of old age, Hakeem said rheumatic diseases affect people of different ages, including children and young adults.
Osteoarthritis is the most common rheumatic condition in Nigeria, while inflammatory diseases such as rheumatoid arthritis and lupus frequently affect people in their productive years. Hakeem identified obesity, previous injuries, family history, hypertension, diabetes, elevated uric acid levels, physical inactivity, and some occupational activities as risk factors for developing rheumatic diseases.
Inadequate specialist care, limited diagnostic facilities, high treatment costs, late presentation, weak referral systems, and the migration of healthcare professionals have compounded the problem of rheumatic diseases in Nigeria. Patients may initially be treated for malaria or typhoid because symptoms such as joint pain, fatigue, and fever can overlap with common illnesses. Others turn to traditional remedies, bone-setters, faith healing, or patent medicine stores, delaying appropriate care.
Hakeem particularly cautioned against self-medication with over-the-counter painkillers, noting that while they may provide temporary relief, they do not address the underlying disease and can cause complications such as ulcers, kidney and liver damage, and heart problems. He stressed that early diagnosis is crucial in inflammatory arthritis, as the first months after disease onset provide a critical window for disease-modifying treatment to suppress inflammation and prevent or reduce irreversible joint damage.
To address the burden of rheumatic diseases, Hakeem called for increased investment in rheumatology training, better incentives and working conditions to retain specialists, and the integration of basic recognition and referral of rheumatic diseases into primary healthcare. He also advocated for improved diagnostic infrastructure, wider access to essential medicines and monitoring tests, expanded health insurance coverage, and the use of telemedicine and task-shifting to extend specialist support to underserved communities.
Key points
- Delayed diagnosis and self-medication can worsen arthritis and other rheumatic disorders in Nigeria.
- Nigeria faces a severe shortage of rheumatologists, with fewer than 30 to 40 specialists serving a population of over 220 million people.
- Early diagnosis and treatment are crucial in managing rheumatic diseases, particularly inflammatory arthritis.
