Arthritis literally means “inflammation of the joints”. Additionally, the term describes nearly 200 conditions affecting the joints, tissues surrounding the joints, and other connective tissues. The CDC estimates that 54.4 million adults have “doctor-diagnosed arthritis.”
Arthritis is considered a rheumatic condition. The two most common types of arthritis are osteoarthritis (OA) and rheumatoid arthritis (RA). Other rheumatic conditions related to arthritis include gout, fibromyalgia, and systemic lupus erythematosus.
Arthritis is also one of the costliest medical conditions to treat. In fact, its most common form OA — affecting more than 30 million Americans — is the second most costly health condition treated at U.S. hospitals.
Signs and Symptoms
The most common signs and symptoms of arthritis involve the joints. The cardinal symptoms of arthritis, which may occur in one or more joints in the body, include:
- Intermittent or constant pain;
- Swelling with associated redness of the skin surrounding the joint;
- Stiffness, and;
- Decreased range of motion.
Other signs and symptoms of arthritis to be on the lookout for may include:
- Joint deformities;
- Grinding noises/sensations;
- Locking or sensation of joint(s) giving way;
- Lumps or bumps around joints, such as rheumatoid nodules, Heberden’s nodes, or Bouchard’s nodes.
Other less commonly encountered — but still important and typically more sinister — signs and symptoms of arthritis may include:
- Weight loss;
- Anemia, and;
- Lymph node swelling.
Types of Arthritis
As you now know, there are upwards of 200 types of arthritis. These types may be categorized into six main groups.
1. Inflammatory Arthritis
This type of arthritis is characterized by high levels of inflammation. It can be acute or chronic.
Acute causes of inflammatory arthritis include:
- Tendinitis, and;
- Infections like Chlamydia.
Chronic causes of inflammatory arthritis include:
- Polymyalgia rheumatica;
- Psoriatic arthritis, and;
- Ankylosing spondylitis.
2. Degenerative/Mechanical Arthritis
This type of arthritis results from general wear and tear. OA, the most well-known and most common type of arthritis, is a member of this group.
3. Soft Tissue Musculoskeletal Pain
This category is composed of pain syndromes arising from musculoskeletal disorders. These syndromes can lead to the development of arthritis.
The pain syndromes found in this category include:
- Rotator cuff tendinopathy;
- Biceps tendinopathy;
- Olecranon bursitis;
- Lateral epicondylitis, which is more commonly known as tennis elbow;
- Medial epicondylitis, which is more commonly known as golfer’s elbow;
- Trigger finger, and;
- Plantar fasciitis.
4. Connective Tissue Disease
This category is attributable to autoimmune conditions, in which the body attacks its own tissues. Autoimmune conditions found in this category include:
- Scleroderma, and;
- Sjögren’s syndrome.
5. Infectious Arthritis
The two major forms of infectious arthritis are septic arthritis and reactive arthritis. Septic arthritis is caused by an actual infection in the joint. Reactive arthritis is where an infection in another part of the body — such as the intestines, genitals, or urinary tract — triggers an inflammatory response in the joints.
In addition to these two major types, there are several kinds of systemic infections that can trigger arthritis. This includes:
- Lyme disease;
- Fifth disease;
- German measles, and;
- Rheumatic fever.
6. Metabolic Arthritis
The quintessential example of this group is gout. Gout is characterized by high levels of uric acid that build up and form needle-shaped crystals in the joints, resulting in sudden bouts of extreme joint pain.
Possible risk factors for arthritis include:
- Family History/Genetics: If someone in your family — especially siblings or parents — has arthritis, it may put you at increased risk for the development of arthritis. In fact, the likes of RA, lupus, and ankylosing spondylitis have been linked to certain genes.
- Advancing Age: It is well-known that the risk of some types of arthritis increase with age.
- Gender: Some forms of arthritis affect one gender more commonly than another. For example, women are more likely than men to develop RA. However, men are more likely than women to develop gout.
- Joint Injuries: A prior joint injury may make you more susceptible to the development of arthritis in that particular joint.
- Obesity: Extra weight puts undue stress on joints, especially the knees, hips, and spine. As such, it puts you at a higher risk of developing arthritis.
- Infection: Whether they be bacterial, viral, or fungal, microorganisms can infect joints and spark inflammation.
- Work/Occupation: If your job or vocation is hard on your joints — particularly if in the form of repetitive knee bending and squatting — you may be more likely to develop OA of the knee and/or hip.
- Smoking: This risk factor has been linked not only to the progression of arthritis but also to the severity of RA and lupus.
Screening and Prevention
Currently, there is no medical society or organization that recommends routine screening for arthritis. Arthritis can’t always be prevented, as some of the most influential risk factors are out of your control.
Despite this, there are some preventative measures that can be taken in an effort to avoid achy joints. This includes:
- Increasing Your Fish Intake: Fish are rich in omega-3 fatty acids, which have potent anti-inflammatory properties. As such, you should strive to eat fatty fish, such as salmon, sardines, and trout, at least two times per week.
- Losing Weight: Overweight women are almost four times more likely to get knee OA as compared to women of normal weight.
- Avoiding Joint Injuries: As you now know, previous joint injuries increase your risk of developing arthritis, so it’s best to avoid injuries altogether.
- Exercising Regularly: At least 30 minutes of moderate physical activity for at least five days per week is recommended. In addition to helping you lose weight, it can strengthen muscles, which decreases your risk of progression to arthritis.
When to See a Doctor
It’s common to have occasional pain in the muscles or joints, especially after taking part in strenuous activity. Arthritis signs and symptoms have the potential to cause permanent joint damage if treatment is delayed. This makes seeing a doctor imperative. Especially if you are experiencing any of the following:
- Gradual joint pain and stiffness;
- Joint pain, swelling, or redness that does not resolve;
- Sudden joint pain presenting and accompanied by fever and/or weight loss, and;
- Visible joint deformities or loss of range of motion in one or more joints.
You should not ignore joint pain. Depending on the type of arthritis, the joint damage may be irreversible, even with appropriate treatment.
Many types of arthritis are diagnosed with only a thorough medical history and physical examination and looking for signs.
Your primary doctor will likely ask you the following questions:
- When did you notice the start of your joint symptoms?
- What specific joints are painful to you?
- Does activity relieve the pain or make it worse?
- Do you have a relative with an autoimmune disorder or another arthritis-related disease?
If needed — especially if your primary doctor suspects that you may have a more serious form of arthritis — you will be referred to a specialist called a rheumatologist.
Common diagnostic laboratory blood tests, such as a complete blood count and specific types of antibodies, may be ordered by your primary doctor or a rheumatologist. Additionally, analysis of different types of body fluids — most commonly blood, urine, and joint — can lead to a definitive diagnosis as to the type of arthritis. If fluid surrounds or is indeed within a joint, your doctor may choose to obtain a sample of your joint fluid by aspiration.
Doctors commonly have access to a variety of imaging studies to help with the diagnosis of arthritis. These include:
- X-rays: May reveal loss of cartilage, bone spurs, or bone damage. Plus, it may be used to track the progression of some forms of arthritis.
- Ultrasound: Uses sound waves to acquire images of soft tissues, cartilage, and bursae. It can help guide needle placement for joint aspirations and injections.
- Computed Tomography Scan: Can visualize cross-sectional images of both bone and the adjacent soft tissues.
- Magnetic Resonance Imaging: Produces highly detailed cross-sectional images of soft tissues such as cartilage, tendons, and ligaments.
As OA and RA are the most common forms of arthritis, this section will concentrate on the possible complications of these two disorders.
For many individuals, OA can lead to chronic pain that can be exhausting and decrease the quality of life. There are also links to anxiety and depression. Furthermore, knee OA is a leading cause of disability among adults.
Other possible complications of OA may include:
- Death of bone;
- Stress fractures;
- Joint infections, and;
- Loss of joint stability due to deterioration or rupture of the adjacent tendons and ligaments.
RA is an autoimmune form of arthritis and possible complications may include:
- Carpal tunnel syndrome;
- Pulmonary fibrosis;
- Sjögren’s syndrome;
- Joint damage;
- Cardiovascular disease, and;
- Cervical myelopathy.
Additionally, severe arthritis can make it difficult for you to do your typical activities of daily living. This includes:
- Personal hygiene;
- Ability to properly use the bathroom;
- Feeding, and;
- Ability to walk independently.
In some cases of severe arthritis, joint deformities may develop.
Arthritis has the potential to progress in an individual after its diagnosis. As a result, the treatment of arthritis has three overarching goals
- Control pain;
- Prevent or minimize joint damage, and;
- Improve or maintain quality of life.
Depending on the type, the treatment of arthritis may involve multiple modalities, including medications, physical therapy (PT), occupational therapy (OT), alternative treatments, and surgery.
For the treatment of pain and inflammation associated with arthritis, you may use medications such as:
- Nonsteroidal anti-inflammatory drugs (NSAIDs);
- Disease-modifying antirheumatic drugs (DMARDs), and;
NSAIDs combat both inflammation and pain. Examples are:
- Ibuprofen (Advil and Motrin);
- Naproxen (Aleve);
- Indomethacin (Indocin);
- Piroxicam (Feldene), and;
- Meloxicam (Mobic).
Oral NSAIDs may cause stomach irritation and ulcers, along with increase your risk of heart attack or stroke.
Painkillers only address pain. Examples include acetaminophen (Tylenol) and prescription opioids such as:
- Tramadol (Ultram);
- Oxycodone (Percocet and OxyContin), and;
- Hydrocodone (Vicodin, Lortab).
Chronic use of opioids may result in physical dependence/addiction.
Corticosteroids are potent inhibitors of inflammation and the immune system. These are the two driving forces behind most forms of arthritis. Examples include prednisone (Deltasone) and cortisone (Cortef).
Counterirritants come in the form of topical creams or ointments containing menthol or capsaicin. They may ease your achy joints as these compounds disrupt the transmission of pain signals within the body.
DMARDs can slow or prevent your immune system from mistakenly attacking your joints. As such, they are often used to treat RA. Examples are methotrexate (Trexall) and hydroxychloroquine (Plaquenil).
Biologics are another class of drugs used to treat RA. Adalimumab (Humira), infliximab (Remicade), and etanercept (Enbrel) are examples of biologics.
PT and OT can be helpful for dealing with arthritis. A PT program can strengthen the muscles surrounding your joints and improve the range of motion in your joints. On the other hand, OT can help you adapt to the pain or disability of arthritis that is negatively affecting your job or educational routine.
Plus, a PT or OT specialist can recommend splints, braces, and/or assistive devices to make life a little easier.
As of late, there has been a resurgence in the interest of alternative treatments or natural remedies for arthritis. These include:
- The supplements glucosamine and chondroitin;
- Massage, and;
- Mind-body techniques, such as tai chi, yoga, and meditation.
It should be kept in mind that there is insufficient scientific evidence to support the use of many of these alternative treatments.
Surgery is typically a last resort in the treatment of arthritis. It may consist of one of the following:
- Joint Fusion: This procedure fuses one or more joints in areas such as the back, neck, fingers, wrist, or ankle to provide pain relief and stability with loss of flexibility/mobility.
- Joint Repair: This procedure typically entails smoothing or realigning a joint to provide pain relief and improve function.
- Joint Replacement: This procedure involves the replacement of a worn-out natural joint with an artificial one; the hip and knee are the most commonly replaced joints.
Living with Arthritis
Living with arthritis can be very challenging. It makes everyday tasks increasingly difficult, especially if the arthritis is progressive. The good news is there are changes that you can make to slow or prevent the progression of arthritis.
Most of the lifestyle changes needed when living with arthritis are interrelated. They include:
- A healthy diet;
- Regular exercise, and;
- Assistive devices.
A healthy diet is one of the cornerstones of weight loss.
When picking a diet, you should choose a variety of whole grains, nuts, fresh fruits and vegetables, and lean cuts of meat and fish. These will provide vitamins and minerals that have the potential to reduce inflammation.
Conversely, you should minimize or avoid fried/greasy foods, highly processed foods, milk/dairy products, and fatty cuts of meat. These are potent inducers of inflammation.
Furthermore, if you have RA, a gluten-free diet and omega-3 fatty acids may improve symptoms and possible disease progression. Diet is a key component in the management of gout as foods high in purines, alcohol, and sugar should be limited in individuals with the disease. Also, consider eating smaller portions and drinking a glass of water before each meal.
Regular exercise is another cornerstone of weight loss. Especially since it will help to keep your joints limber.
Swimming and other water sports/activities are excellent choices. This is since the buoyancy of the water drastically reduces the stress on weight-bearing joints such as the hips and knees.
As previously noted, you should strive for at least 30 minutes of moderate physical activity five days per week. Other tips to help with exercise include:
- Taking a 20- to 30-minute walk after meals;
- Using the stairs instead of the elevator, if possible, and;
- Counting your steps with a pedometer.
Remember to consult your doctor, physical therapist, or occupational therapist before starting a regular exercise regimen. This will help you avoid overexertion.
Don’t be afraid to ask for help with specific tasks and keep an open mind with regard to assistive devices. Everyone wants to maintain their independence, but it may be foolish and painful to ignore your physical limitations resulting from arthritis.
Assistive devices include:
- Shower seats, and;
- Raised toilet seats.
These devices may help to protect your joints and improve your ability to perform activities of daily living.
Arthritis is the leading cause of disability among U.S. adults. In fact, by the year 2040, it will grow to affect more than 78 million Americans.
For many individuals, arthritis has the potential to become a source of chronic pain with associated depression and/or anxiety. Moreover, arthritis is pretty common in individuals with other chronic medical conditions (i.e., 49 percent of adults with heart disease, 47 percent of adults with diabetes, and 31 percent of adults with obesity).
Fortunately, early diagnosis and treatment with multiple effective techniques can prevent or slow the progression of this all too common disease.