The key facts
- Afnan Shanavas's symptoms since age 16 were mistakenly interpreted as stress and psychosomatics
- The diagnosis of inflammatory polyarthropathy and ankylosing spondylitis was made 10 years later
- Doctors emphasize: arthritis also occurs in young people, early diagnosis is important
Ten Years Without a Diagnosis
UAE resident Afnan Shanavas, now 26, was diagnosed with arthritis only ten years after her first complaints. At 16, she sought medical help due to pain, but her symptoms were attributed to stress. During school exams it became painful for her to write, and she constantly felt fatigued, but specialists only prescribed painkillers and recommended rest. According to her, one doctor suggested she was under too much pressure due to her success in studies and sports, and she was even referred to a psychologist, who considered her pain psychosomatic.
An Alarming Episode and a Turning Point
At 17, in the 12th grade, she suffered a severe attack — her neck locked, and she was hospitalized with a suspected stroke, which was later ruled out. While in intensive care, she decided to study psychology to better understand the connection between the brain and physical health. The cause of her symptoms could not be established despite consultations with doctors in the UAE and India. The turning point was a small cut on her finger that would not heal: in Sharjah, she was given an antinuclear antibody (ANA) test. The result was positive, although a number of other markers were negative. After becoming pregnant, she postponed further examinations, but after childbirth her symptoms worsened, and the diagnosis was then made: inflammatory polyarthropathy and ankylosing spondylitis.
What the Diagnoses Are
Inflammatory polyarthropathy is an autoimmune condition causing inflammation of five or more joints. Ankylosing spondylitis is a type of arthritis that usually affects the spine and pelvis, reduces mobility, and leads to stiffness and a stooped posture. According to the publication, such conditions in people under 45 are usually diagnosed after three months of chronic pain and an in-depth examination: analysis of medical history, physical examination, imaging, and blood tests. “It was a huge surprise — I thought it was an illness of the elderly,” Shanavas said.
Living with an 'Invisible' Illness
Shanavas now heads the inclusion and wellbeing department at The Oxford School in Dubai. Her treatment includes a biologic injection every two weeks that suppresses her overactive immune system, as well as probiotics, supplements, and corticosteroid creams during flare-ups. She keeps a diary about her experience over the decade and hopes to publish it. According to her, the hardest part is the invisibility of the illness to others: “I may look perfectly healthy. People don't always understand why I need a day off. They don't see the pain or fatigue.”
Doctors' Opinion
Arthritis in young people remains relatively rare; it is an umbrella term for more than 100 joint diseases, some forms of which begin in childhood or early adulthood. Dubai rheumatologist Dr. Humaira Badsha noted that treatment is shifting from general pain relief to precision medicine: therapy is increasingly targeted at specific inflammatory pathways of each patient, and before prescribing a new drug, a thorough baseline medication review and regular monitoring are needed. According to her, arthritis can appear at any age — depending on the classification of the disease; GLP-1 therapies for weight loss may help by reducing the load on overburdened joints. Orthopedist Dr. Oussama Hassan Saleh from Medcare Orthopaedics and Spine Hospital in Dubai added that some forms of arthritis have a hereditary component, but a family history does not mean the disease will inevitably develop — lifestyle and environmental factors also play a role. Early symptoms include joint pain, stiffness, swelling, and difficulty moving; early consultation with a doctor helps determine the type of arthritis and start treatment in a timely manner.
