Arthritis

Overview

Arthritis is not a single disease but rather an umbrella term for more than 100 different conditions that affect the joints, tissues around joints, and other connective tissues. The term literally means "joint inflammation," though not all types involve inflammation. Arthritis is the leading cause of disability in the United States, affecting more than 50 million adults and 300,000 children. While often associated with aging, arthritis can affect people of all ages, including children and young adults.

The most common types are osteoarthritis (OA), which results from wear and tear on joints, and rheumatoid arthritis (RA), an autoimmune condition where the immune system attacks joint tissues. Symptoms typically include joint pain, stiffness, swelling, and reduced range of motion. These symptoms may come and go, remain stable, or progressively worsen over time. Severe arthritis can result in chronic pain, inability to perform daily activities, and significant changes to joint appearance.

While there's no cure for most types of arthritis, various treatments can help manage symptoms, slow disease progression, and improve quality of life. Treatment approaches vary depending on the type of arthritis and may include medications, physical therapy, lifestyle modifications, and in severe cases, surgery. Early diagnosis and proper management are crucial for maintaining joint function and preventing disability. With appropriate treatment, most people with arthritis can lead active, fulfilling lives.

Types of Arthritis

There are more than 100 types of arthritis and related conditions. Here are the most common:

Degenerative Arthritis

Osteoarthritis (OA)

• Most common form, affecting millions worldwide
• Caused by breakdown of cartilage between bones
• Typically affects weight-bearing joints (knees, hips, spine)
• Develops gradually and worsens over time
• Risk increases with age, obesity, and joint injury

Inflammatory Arthritis

Rheumatoid Arthritis (RA)

• Autoimmune disease affecting joint lining
• Causes painful swelling and eventual joint deformity
• Often affects small joints symmetrically
• Can damage other body systems (skin, eyes, lungs, heart)

Psoriatic Arthritis

• Affects some people with psoriasis
• Causes joint pain, stiffness, and swelling
• Can affect any joint, including spine
• May cause swelling of fingers and toes

Infectious Arthritis

Septic Arthritis

• Caused by bacterial, viral, or fungal infection
• Usually affects a single joint
• Requires immediate medical treatment
• Can cause permanent joint damage if untreated

Metabolic Arthritis

Gout

• Caused by buildup of uric acid crystals in joints
• Causes sudden, severe attacks of pain
• Often affects big toe initially
• Related to diet and genetics

Other Common Types

• Juvenile Arthritis - Affects children under 16
• Ankylosing Spondylitis - Primarily affects spine
• Fibromyalgia - Widespread musculoskeletal pain
• Lupus - Systemic autoimmune disease

Symptoms

Arthritis symptoms vary depending on the type but commonly affect joints and surrounding tissues. Symptoms may develop gradually or suddenly, and can be constant or come and go.

Common Joint Symptoms

Movement-Related Symptoms

• Joint weakness and instability
• Morning stiffness lasting more than 30 minutes
• Decreased range of motion
• Difficulty with daily activities (opening jars, climbing stairs)
• Joint locking or catching sensation

Visible Signs

• Joint swelling and inflammation
• Redness and warmth around joints
• Joint deformity (in advanced cases)
• Bone spurs (bony projections)
• Nodules or bumps near joints

Associated Symptoms

• Muscle pain and weakness
• Back pain (with spinal arthritis)
• Fatigue (especially with inflammatory types)
• Low-grade fever (with inflammatory arthritis)
• Weight loss (with systemic inflammation)
• General feeling of being unwell

Location-Specific Symptoms

• Knees: Pain, swelling, stiffness, grinding sensation
• Hips: Groin pain, limping, reduced flexibility
• Hands: Pain, swelling, difficulty gripping
• Spine: Back pain, stiffness, reduced flexibility
• Shoulders: Pain with overhead activities
• Ankles/Feet: Pain, swelling, difficulty walking

Causes

The causes of arthritis depend on the type. Different forms have different underlying mechanisms:

Osteoarthritis Causes

• Cartilage breakdown: Natural wear and tear over time
• Joint injury: Previous trauma can accelerate degeneration
• Repetitive stress: Overuse from work or sports
• Obesity: Extra weight increases joint stress
• Genetics: Inherited tendency for cartilage weakness
• Bone deformities: Born with malformed joints or defective cartilage

Rheumatoid Arthritis Causes

• Autoimmune response: Immune system mistakenly attacks joint tissue
• Genetic factors: Certain genes increase susceptibility
• Environmental triggers: Smoking, infections, stress
• Hormonal factors: More common in women, suggesting hormonal influence

Other Arthritis Causes

Infectious Arthritis

• Bacterial infections (Staphylococcus, Streptococcus)
• Viral infections (hepatitis, parvovirus)
• Fungal infections (histoplasmosis, candida)
• Lyme disease

Metabolic Causes

• Gout: Excess uric acid forming crystals in joints
• Pseudogout: Calcium pyrophosphate crystals
• Hemochromatosis: Excess iron deposits

Contributing Factors

• Inflammation from other diseases
• Immune system dysfunction
• Metabolic abnormalities
• Inherited cartilage weakness
• Abnormal joint mechanics

Risk Factors

Several factors can increase your risk of developing arthritis:

Non-Modifiable Risk Factors

• Age: Risk increases with age, especially after 45
• Sex: Women more likely to develop RA; men more prone to gout
• Genetics: Family history of arthritis increases risk
• Race: Some types more common in certain ethnic groups

Modifiable Risk Factors

• Obesity: Extra weight stresses weight-bearing joints
• Joint injuries: Previous damage increases arthritis risk
• Repetitive stress: Repeated joint use in work or sports
• Smoking: Increases risk of RA and worsens symptoms
• Infections: Some can trigger reactive arthritis
• Occupational hazards: Jobs requiring repetitive knee bending or squatting

Disease-Specific Risk Factors

Osteoarthritis

• Previous joint injury or surgery
• Joint misalignment or leg length differences
• Muscle weakness around joints
• Certain metabolic diseases

Rheumatoid Arthritis

• Female sex (3x more common)
• Middle age onset (40-60 years)
• Smoking history
• Obesity
• Never giving birth (for women)

Gout

• Male sex
• Diet high in purines (red meat, seafood)
• Alcohol consumption
• Certain medications (diuretics)
• Kidney disease

Diagnosis

Diagnosing arthritis involves a combination of medical history, physical examination, imaging tests, and laboratory work to determine the type and severity.

Medical History

Your doctor will ask about:

• Location, duration, and pattern of joint pain
• Morning stiffness duration
• Activities that worsen or improve symptoms
• Family history of arthritis
• Previous injuries or infections
• Other symptoms (fever, rash, fatigue)

Physical Examination

• Joint inspection for swelling, redness, warmth
• Range of motion assessment
• Joint stability testing
• Checking for joint deformities
• Muscle strength evaluation
• Gait analysis

Imaging Tests

X-rays

• Show bone damage and cartilage loss
• Reveal bone spurs
• Track disease progression

MRI (Magnetic Resonance Imaging)

• Detailed images of soft tissues
• Early detection of joint damage
• Assess cartilage, tendons, ligaments

Ultrasound

• Detect inflammation in joints
• Guide joint injections
• Monitor treatment response

Laboratory Tests

Blood Tests

• Rheumatoid factor (RF): For RA diagnosis
• Anti-CCP antibodies: More specific for RA
• ESR and CRP: Measure inflammation
• ANA: For lupus and other autoimmune conditions
• Uric acid: For gout diagnosis
• Complete blood count: Check for anemia

Joint Fluid Analysis

• Arthrocentesis to extract fluid
• Check for crystals (gout, pseudogout)
• Rule out infection
• Assess inflammation markers

Treatment Options

Arthritis treatment focuses on relieving symptoms and improving joint function. The best approach often combines several treatments tailored to the type and severity of arthritis.

Medications

Pain Relievers

• Acetaminophen: For mild to moderate pain
• Tramadol: For more severe pain
• Opioids: Short-term use for severe pain

Anti-inflammatory Drugs

• NSAIDs: Ibuprofen, naproxen, celecoxib
• Topical NSAIDs: Gels or creams for localized relief
• Corticosteroids: Oral or injected for severe inflammation

Disease-Modifying Drugs (DMARDs)

For inflammatory arthritis:

• Methotrexate
• Hydroxychloroquine
• Sulfasalazine
• Leflunomide

Biologic Response Modifiers

For moderate to severe inflammatory arthritis:

• TNF inhibitors (adalimumab, etanercept)
• Interleukin inhibitors
• B-cell or T-cell inhibitors

Non-Drug Therapies

Physical Therapy

• Exercises to improve flexibility and strength
• Range-of-motion exercises
• Aquatic therapy
• Proper body mechanics training

Occupational Therapy

• Joint protection techniques
• Assistive devices recommendation
• Activity modification strategies
• Splints or braces

Lifestyle Management

• Weight management: Reduce stress on joints
• Regular exercise: Low-impact activities like swimming, cycling
• Healthy diet: Anti-inflammatory foods, omega-3 fatty acids
• Hot/cold therapy: Heat for stiffness, cold for inflammation
• Stress management: Meditation, yoga, counseling
• Adequate sleep: 7-9 hours for healing and pain management

Surgical Options

When conservative treatments fail:

• Arthroscopy: Remove damaged tissue
• Joint replacement: Hip, knee, shoulder replacements
• Joint fusion: For smaller joints
• Osteotomy: Realign bones
• Synovectomy: Remove inflamed joint lining

Complementary Therapies

• Acupuncture
• Massage therapy
• Tai chi or yoga
• Dietary supplements (glucosamine, chondroitin)
• Transcutaneous electrical nerve stimulation (TENS)

Prevention

While not all types of arthritis can be prevented, you can reduce your risk and slow progression:

Primary Prevention

• Maintain healthy weight: Reduces stress on weight-bearing joints
• Stay active: Regular exercise strengthens muscles around joints
• Protect joints: Use proper techniques during activities
• Avoid joint injuries: Warm up before exercise, use protective gear
• Don't smoke: Smoking increases RA risk and severity
• Eat anti-inflammatory diet: Fish, nuts, fruits, vegetables

Workplace Prevention

• Use ergonomic tools and furniture
• Take frequent breaks from repetitive tasks
• Practice proper lifting techniques
• Alternate between sitting and standing
• Stretch regularly throughout the day

Exercise Guidelines

• Low-impact activities: Swimming, walking, cycling
• Strength training: Build muscle to support joints
• Flexibility exercises: Maintain range of motion
• Balance training: Prevent falls and injuries
• Proper form: Learn correct techniques

Secondary Prevention

For those with early arthritis:

• Early diagnosis and treatment
• Regular monitoring
• Medication compliance
• Physical therapy
• Joint protection strategies
• Weight management

When to See a Doctor

Seek Immediate Care

• Sudden, severe joint pain
• Joint that appears deformed or unusable
• Intense swelling or redness
• Fever with joint pain (possible infection)
• Multiple joints affected suddenly
• Signs of infection (warmth, redness, fever)

Schedule an Appointment

• Joint pain lasting more than 3 days
• Several episodes of joint pain within a month
• Joint stiffness, especially in the morning
• Swelling, warmth, or redness around joints
• Difficulty moving joint normally
• Joint symptoms with unexplained weight loss
• Family history of arthritis with new symptoms

Regular Monitoring Needed

If diagnosed with arthritis:

• Regular rheumatologist visits for inflammatory types
• Medication side effect monitoring
• Annual joint assessments
• Bone density testing
• Eye exams (some medications affect vision)

Warning Signs of Complications

• Increasing pain despite treatment
• New joints becoming affected
• Loss of joint function
• Side effects from medications
• Depression or anxiety about condition

Related Conditions

Several conditions are related to or commonly occur with arthritis:

Associated Conditions

• Osteoporosis - Bone weakening from arthritis or treatments
• Carpal tunnel syndrome - From wrist arthritis
• Depression - Common with chronic pain
• Heart disease - Increased risk with RA
• Diabetes - Shared risk factors with OA
• Sleep disorders - From pain and stiffness

Complications

• Joint damage and deformity
• Disability and loss of function
• Chronic pain syndrome
• Increased fall risk
• Social isolation
• Work disability

Frequently Asked Questions