Health & Living: Information on Living a Healthy Lifestyle
What Is Arthritis?
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Medically reviewed by Anita C. Chandrasekaran, MD
Arthritis is a condition that causes inflammation, swelling, and pain in the joints and surrounding tissues. There are over 100 different types of arthritis, and osteoarthritis is the most common form. Signs and symptoms vary depending on the type of arthritis, but typical symptoms include pain, swelling, and stiffness with decreased ability to move the affected joint.
An estimated 58.5 million Americans have arthritis. While researchers don't know the exact cause of all types of arthritis, certain factors can increase your risk for developing the condition. There are many treatment options available to help ease the pain and slow the progression of joint destruction.
Types of ArthritisArthritis is a general term describing a condition causing pain, stiffness, and swelling in the joints of your body. A joint is an area of the body where two bones make contact to provide movement. There are over 100 types of arthritis, each with a unique cause.
The most common types of arthritis include:
Osteoarthritis (OA): OA is the most common form of arthritis. In OA, the cartilage between joints begin to break down slowly. Over time, the joints become more narrow, causing pain, stiffness, and swelling.
Rheumatoid Arthritis (RA): RA is an autoimmune and inflammatory condition where the body's immune system attacks healthy cells, causing inflammation. Although it can happen in other areas of the body, RA usually affects the joints of the hand, wrists, and knees.
Gout: Gout is an inflammatory arthritis that happens when too much uric acid builds up in the body. It typically affects one joint at a time, and often affects the big toe.
Juvenile arthritis: Also known as childhood arthritis, this type of arthritis affects children. The condition can cause permanent damage to the joints.
Ankylosing spondylitis: This type of arthritis causes inflammation along the joints and ligaments of the spine.
Psoriatic arthritis: Psoriatic arthritis affects the joints and areas where the tendon and ligaments connect to the bone. It's related to psoriasis, an inflammatory disease that can cause raised, scaly patches on the skin.
Reactive arthritis: This condition results from an infection somewhere else in the body. The symptoms usually do not show up until after you have recovered from the initial infection.
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Arthritis SymptomsCommon symptoms of arthritis include swelling, pain, stiffness, and a decreased ability to move the joints. These symptoms can start as mild and become more painful over time. Arthritis symptoms can also come and go. The part of the body where arthritis first appears will depend on the type of arthritis.
Osteoarthritis SymptomsOA will appear as pain or aching in the joints of the hips, hands, and knees. It can also cause swelling and stiffness. As the conditions progresses, it can lead to a decreased range of motion.
Rheumatoid Arthritis SymptomsRA will present as pain, stiffness, tenderness, and swelling in multiple joints. Typically, RA appears in the hands, wrists, and knees. People with RA may also experience weight loss, fever, tiredness, or weakness.
Juvenile Arthritis SymptomsChildren with juvenile arthritis may have joint pain, swelling, stiffness, and fatigue. They might also experience a loss of appetite and difficulty walking, dressing, and playing. The symptoms of juvenile arthritis can flare, meaning there are periods when the symptoms get worse and then periods when they get better.
Gout SymptomsGout symptoms present as swelling, redness, and heat in the affected joints. It usually occurs in the big toe, ankles, and knees.
Gout symptoms usually start suddenly and can last for days or weeks. This can be followed by weeks, months, or even years without any symptoms.
Ankylosing Spondylitis SymptomsPain and stiffness in the lower back and hip are the most common symptoms of ankylosing spondylitis. The pain gets worse with periods of inactivity. Moving and exercising can help to improve the symptoms.
Psoriatic ArthritisThe symptoms of psoriatic arthritis include stiffness, pain, and swelling of the affected joints, as well as swelling of the fingers and toes. Reduced range of motion, nail changes, and eye redness, are also possible symptoms.
People with psoriatic arthritis typically develop psoriasis first, which appears as raised, scaly patches on the skin. However, it is possible to have psoriatic arthritis without developing or seeing symptoms of psoriasis.
The severity of psoriasis symptoms on the skin is not reflective of the severity of the arthritis in the joints.
Reactive Arthritis SymptomsThe symptoms of reactive arthritis include joint pain, swelling, and stiffness of the affected joints. It typically affects joints on one side of the body, and is common in the knees and ankles. Symptoms may also include lower back and buttocks pain, foot and heel pain, and pain and swelling in the fingers and toes.
The symptoms of reactive arthritis can range from mild to severe and will typically start one to six weeks after infection.
What Causes Arthritis?Researchers don't know the exact cause of every type of arthritis. In many cases, arthritis results from inflammation between the areas where two bones meet, also known as your joints. Inflammation can lead to damage and even destruction of the bone.
Certain types of arthritis—such as rheumatoid and psoriatic—can progress into other areas of the body where inflammation can cause damage, such as the eyes, heart, and skin.
Some types of arthritis do have a clear cause. For example, too much uric acid in the body leads to gout, and certain infections can also cause reactive arthritis.
Arthritis is typically more common in the older population. However, it can also develop in younger people and in some cases, children. Arthritis tends to be more common in women than men.
Risk FactorsSome risk factors are beyond your control while others may be modifiable, meaning you may be able to take measures to reduce your risk. Risk factors for arthritis include:
How Is Arthritis Diagnosed?Arthritis comes in many different types, and a diagnosis will usually involve understanding your full medical history. Your healthcare provider will ask questions to determine the onset of symptoms and your family history of illnesses. Next, they will perform a physical exam to look for any fluid around your joints, warmth or redness, or problems with moving your joints.
After this, your healthcare provider might order the following test:
Blood test: This test can help determine specific types of inflammatory arthritis, such as RA.
Fluid tests: In this test, the healthcare provider removes a small amount of fluid from a joint to check for the presence of uric acid. This is also called joint aspiration.
Biopsy: In a skin or muscle biopsy, the healthcare provider will take a sample to test for various forms of arthritic-type conditions.
X-Ray: The healthcare provider will use an imaging test to look for signs of inflammation, erosion, or damage on the joints.
There is no cure for arthritis. The goal of arthritis treatment is to reduce pain and inflammation, improve function, and prevent further joint damage. Each type of arthritis also has unique treatments your healthcare provider will use to treat your condition.
Some standard treatment options for arthritis include:
Exercise with low-impact aerobic programs like walking, strength training, and range of motion exercises.
Physical therapy to improve mobility and restore the use of the affected joint, increase strength, and preserve the ability to perform everyday activities.
Over-the-counter medications like Acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) can help to reduce pain.
Certain prescription medications depending on the type of arthritis, such as steroids, disease-modifying anti-rheumatic drugs (DMARDs), and biologics.
Acupuncture to decrease pain and improve function in people with moderate to severe pain; it may take several weeks to see results.
Massage to relieve pain. This should be performed by a physical therapist who has experience treating people with arthritis.
You can't always prevent arthritis from developing. However, early diagnosis and treatment can prevent or decrease the damage to your joints. You can also take measures to prevent flare-ups, such as avoiding any excessive or repeated movements.
Other measures to prevent or reduce arthritis flares include:
Staying physically active: Periods of inactivity can cause joint stiffness. Staying active will help to prevent stiffness and maintain range of motion. Low-impact activities like walking or swimming are often helpful for arthritis.
Minimizing stress: Practicing relaxation techniques like meditation can help reduce stress, which may help with pain management.
Applying ice and heat: Heat can help decrease joint pain and relax tense muscles. Cold can help to reduce inflammation and ease pain.
Maintaining your optimal weight: Excess weight can cause pressure on your joints, like those of the hips and knees. Keeping a healthy weight can relieve pain and improve joint function.
Conditions can develop with or as a result of arthritis for several reasons. Different types of arthritis can also affect the body in unique ways and lead to other complications.
Conditions people with arthritis may be more likely to experience include:
Osteoporosis. People with inflammatory arthritis are more likely to experience osteoporosis, a condition that causes bone loss and weakness, due to inflammation.
Lung disease. People with RA are more likely to experience lung conditions, including chronic obstructive pulmonary disease (COPD).
Heart disease. People with inflammatory arthritis are more likely to develop heart conditions since inflammation can cause blood vessels to narrow.
Diabetes. People with inflammatory arthritis are more likely to have diabetes, and are also likely to experience diabetic neuropathy, or damage to the nerves.
If you are experiencing joint pain, it's important to see your healthcare provider to talk about your symptoms. Getting an early diagnosis can help prevent joint damage and preserve function and mobility. Your healthcare provider may also refer you to a specialist, such as a rheumatologist or orthopedist.
Arthritis is a chronic condition that can impact your daily life. As the arthritis progresses, you may experience persistent pain and difficulty moving around or performing simple tasks. Certain types of arthritis can lead to long-term health issues.
OA is a progressive disorder meaning it gets worse over time. There is a rapid progression rate in the older population, individuals who are overweight, and those whose disease involves multiple joints. Even though morbidity and mortality are higher in people with RA, the prognosis has increased thanks to the advances in therapy.
There are many ways to manage arthritis and prevent flare-ups through medication and lifestyle changes. Getting regular exercise, reducing stress, and sleeping well can all help reduce flares and pain. Your healthcare provider can help you find a medication that treats your symptoms with minimal side effects.
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Early Signs And Symptoms Of Arthritis
When people hear the term "arthritis," they typically think of osteoarthritis (OA)—likely because it's the most common form of arthritis, affecting 80% of U.S. Adults over the age of 65 . According to Dr. Graham, OA is considered a degenerative disorder caused by trauma or age-related wear and tear on joints over time. "OA is most likely to affect weight-bearing joints, such as the knee, hip, lower spine or big toe, but it can also cause pain and stiffness in the thumb or finger joints."
Osteoarthritis can affect anyone at any age, but it most commonly appears in older adults. This particular type of arthritis affects the cartilaginous portion of the bone (the smooth surface at the end of a bone where it articulates with another bone and forms a joint). The degree of degeneration that occurs at a joint depends on many factors, including lifestyle, weight, medical history and activity level. OA affects people's bodies asymmetrically and usually at specific joints based on a person's lifestyle, profession, sports activities, hobbies and injuries.
Most notably marked by joint pain, inflammation and swelling, OA can have varying presentations and may even be asymptomatic for some people. People often discover they have arthritis incidentally after their health care provider requests medical imaging for another issue. Unfortunately, the effects of this disease can lead to moderate to severe disability, significantly affecting a person's life and often incurring high medical costs.
Early Signs And Symptoms of OsteoarthritisEarly signs and symptoms of OA can vary, but according to Dr. Graham, the earliest signs usually include joint pain or ache, as well as joint tenderness, swelling or stiffness that feels worse in the morning. Untreated pain or stiffness can lead to a limitation in mobility and overall function. While it's estimated that 80% of U.S. Adults ages 65 and older have radiographic evidence of OA somewhere in their bodies, only 60% of those with OA present with symptoms, according to Creighton University researchers Rouhin Sen and John Hurley .
Here's What Causes Gout And How To Treat It
Man with painful and inflamed gout on his foot around the big toe area. Picture: iStock
Gout is a common type of arthritis that can affect anyone. People with gout will experience severe pain, swelling, redness and tenderness in one or more joints, most often in the big toe.
The attack can occur suddenly at night while you're sleeping with the sensation that your big toe's on fire. Symptoms may come and go but there is medication to help you manage the pain and inflammation.
Doctors usually diagnose gout based on your symptoms and the appearance of the affected joint – there are also tests that confirm the diagnosis. Untreated gout can lead to worsening pain and joint damage.
SymptomsThe signs and symptoms of gout include:
Your body breaks down proteins called purines and produces uric acid. Purines are also found in foods including red meat and organ meats such as liver and kidneys.
Purine-rich seafood includes anchovies, sardines, mussels, scallops, trout and tuna. Alcoholic beverages, especially beer, and drinks sweetened with fruit sugar (fructose) promote higher levels of uric acid.
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High uric acid in your blood forms crystals. Gout occurs when uric acid crystals accumulate in your joint, causing inflammation and intense pain of a gout attack.
Factors that increase the uric acid level in your body include:
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ComplicationsUntreated or poorly treated gout will lead to the following complications:
Medication is used to reduce the inflammation and the pain of gout attacks and to prevent complications by lowering the amount of uric acid in your blood.
MedicationNonsteroidal anti-inflammatory drugs include over-the counter options such as brufen, naproxen, indomethacin or Celebrex.
The risk with these is stomach pain, bleeding and ulcers. They should only be used under the guidance of a medical professional.
Colchicine may be recommended because it can effectively reduce gout pain. The risks are side effects such as nausea, vomiting and diarrhoea.
Corticosteroids such as prednisone may control gout inflammation and pain. Side effects of corticosteroids may include mood changes, increased blood sugar levels and elevated blood pressure and therefore should not be over used.
If you have proof of gout damage on joint X-rays or you have tophi, chronic kidney disease or kidney stones, medications to lower your body's uric acid levels may be recommended.
Medications that block uric acid production include allopurinol and febuxostat, which help limit the amount of uric acid your body makes.
Side effects of allopurinol include fever, rash, hepatitis and kidney problems. Febuxostat side effects include rash, nausea and reduced liver function. It may also increase the risk of heart-related death.
Medications that improve uric acid removal such as probenecid help improve your kidneys' ability to remove uric acid from your body. Side effects include a rash, stomach pain and kidney stones.
PreventionDrink water instead of alcoholic beverages and drinks sweetened with fruit sugar.
Avoid foods high in purines. Red meat and organ meats, such as liver, are especially high in purines. Purine-rich seafood includes anchovies, sardines, mussels, scallops, trout and tuna.
Exercise regularly and lose weight. Keeping your body at a healthy weight reduces your risk of getting gout.
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