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i was diagnoised with lupus in 1997.......i have tried many different meds........and the pain is the worse........but it dosent seem to get better only worse.......do you think my enviorment has something to do with it?........i live in a big city


Sometimes it may take a while before an effective regimen can be found for an individual patient. Rheumatologists are now able to achieve disease and pain control in most patients. Regarding the big city and lupus, I am not aware of any major conclusive research that suggests that lupus may be much more severe or remain uncontrolled in big cities. Having said that, the big cities do bring their own set of problems -long commute, auto pollution, industrial pollution, sometimes not-so-pleasant neighborhoods, etc. - all of which could have an aggravating effect on lupus or other chronic diseases. Many studies have suggested that smoking can be associated with increased risk of developing antibodies that are believed to cause tissue damage in lupus. Additionally, I am aware of one study from India, where lupus was found to be relatively common in Delhi - a big city, compared to rural India. The study was relatively small and has not been repeated in another population, to my knowledge.

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Response by:

Ram Raj   Singh, MD Ram Raj Singh, MD
Associate Professor of Clinical Medicine
College of Medicine
University of Cincinnati