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Arthritis

  1. What is arthritis?
  2. Types, symptoms, causes and treatment
  3. Diagnosis
  4. Treatment
  5. FAQs

What is arthritis?

Arthritis is a painful inflammation of one or more joints. By far the most common types of arthritis are osteoarthritis and rheumatoid arthritis.

The key arthritis symptoms include pain, stiffness and swelling. Arthritis can be localized to one joint or it can affect many joints, and can affect different structures inside a joint, such as the joint lining known as the synovium, bones, cartilage, or supporting tissues. The symptoms can also vary in severity and frequency. Some forms of arthritis are short-term conditions, while others are long-term and may permanently damage joint function. The Ada app can help you check your symptoms. Download the free app.

Arthritis is a very common condition. According to the Centers for Disease Control, about one in four adults have some kind of arthritis.[1]

Most forms of arthritis predominantly affect older people, though it can affect people at any age. There are some conditions, generally rare, that cause arthritis in children and teenagers.

Arthritis has many possible causes, such as age-related wear and tear, autoimmune conditions, infections and injuries.

A range of treatment options are available for arthritis, with the chosen option dependent on the type of arthritis and its causes. Some types of arthritis respond well to treatment, while other types are harder to control.

Different types of arthritis: Symptoms, causes and treatment

There are many different types of arthritis and related chronic conditions of the joints – some sources estimate over 200 – with differing causes and symptoms.[2]

Most, though not all, types of arthritis can be sorted by cause into two categories:

Inflammatory arthritis: All arthritis is characterized by inflammation, which is part of the body’s healing process. However, in the case of inflammatory arthritis, inflammation generally occurs for no obvious reason. This is known as an autoimmune condition, in which the immune system is overactive. The most common form of inflammatory arthritis is rheumatoid arthritis.

People affected by inflammatory arthritis generally feel stiffness in the joints following rest, such as just after getting out of bed in the morning.

Degenerative or mechanical arthritis covers types of arthritis in which there is damage to the joints through wear and tear. The most common form of degenerative arthritis is osteoarthritis.

Symptoms of degenerative arthritis tend to get worse with movement or weight bearing i.e. when the person stands up, but improve after rest. Degenerative arthritis tends to be more common in older people.

Types of degenerative arthritis tend to affect joints asymmetrically, meaning they don't appear in the same joints on both sides of the body.

The most common types of arthritis include:

Osteoarthritis

Osteoarthritis is the most common form of arthritis, with more than 30 million adults in the U.S affected by the condition.[3] It is a degenerative arthritis, most often causing arthritis of the hand, the knee, and the hips.

The main symptoms of osteoarthritis are deep, achy joint pain that worsens with activity, decreased range of movement and stiffness during rest, known as gelling. It generally affects several joints. It is most common in women leading up to and after menopause.[4] Athletes are also at increased risk of osteoarthritis, due to repeated use of particular joints.

The condition is caused by damage to or breakdown of joint cartilage, a connective tissue that covers the ends of long bones at the joints, as well as other areas of the joint.[5] In normal joints, cartilage acts as a shock absorber and allows bones to slide over one another. Osteoarthritis damage may occur as a result of joint injury or overuse.

Treatment includes regular exercise, hot or cold compresses, working towards a healthy weight if overweight, physical and occupational therapy, and pain medication. In severe cases, surgery may repair, strengthen or replace a damaged joint. Surgical intervention is common with osteoarthritis that affects the knee and hip.

Rheumatoid arthritis

Rheumatoid arthritis (RA) is the second most common type of arthritis and the most common type of inflammatory arthritis.

Rheumatoid arthritis symptoms occur in flare-ups, when symptoms of pain and swelling are worse, and periods of improved or no symptoms. It usually causes arthritis in the hands, feet and wrists. Rheumatoid arthritis treatment aims to slow down the overactive immune system.

Read more about Rheumatoid Arthritis »

Gout

Gout, also known as gouty arthritis, is an inflammatory arthritis causing attacks of pain and inflammation in the joints. It tends to start with severe pain in one joint, often that of the big toe, where it is known as podagra.

Gout is generally caused by too much uric acid in the blood. Uric acid is a chemical that is increased in the body by ingesting certain foods, including:

  • Oily fish
  • Red meat
  • Organ meats such as liver or kidneys
  • Alcohol

Other reasons uric acid might develop include:

  • High blood pressure
  • Obesity
  • Taking certain medications
  • Older age
  • Being male
  • Having gone through menopause
  • Insulin resistance, such as in type 2 diabetes

Read more about Podagra »
Read more about Gout »

Psoriatic arthritis

Psoriatic arthritis is a long-term inflammatory arthritis that is associated with psoriasis. Psoriasis is a skin condition that causes red, flaky, crusty patches of skin with silvery scales, known as plaques.

About one or two in every five people with psoriasis will develop psoriatic arthritis.[6] Some people with psoriatic arthritis, however, will never develop the skin condition.

Psoriatic arthritis is an autoimmune condition thought to be triggered by a combination of genetic, immune and environmental factors, such as certain infections and joint injury.[7]

The condition is progressive, damaging the joints over time. However, with medication, it is possible to slow down the progression of the arthritis and minimize joint damage. Psoriatic arthritis varies widely in severity, tending to occur in flare-ups and periods of improved or no symptoms.

There are various typical patterns of joints affected by psoriatic arthritis, most often the distal joints, the end joints of the fingers and toes. Most commonly, psoriatic arthritis is asymmetric, not affecting the same joints on both sides of the body, and causes symptoms in several joints at once. Some people also have psoriatic arthritis symptoms in their fingernails or eyes.

Psoriatic arthritis is treated with medications which suppress the immune system, called disease-modifying antirheumatic drugs (DMARDS). Over-the-counter medications, such as ibuprofen, can reduce pain and swelling. Ideally, one medication should be taken to treat both psoriasis and psoriatic arthritis when both conditions are present together.

People with other types of arthritis, such as rheumatoid arthritis or osteoarthritis, may also have psoriasis without the two conditions being linked.

Septic arthritis

Septic arthritis is an infection in a joint causing inflammation. This condition can affect anyone, but most commonly occurs in association with prosthetic joints, such as knee and hip replacements, and other joint surgeries.

Septic arthritis causes severe pain, swelling, redness and heat in affected joints. The symptoms usually develop quickly, over a few hours or days. Without prompt treatment, septic arthritis may lead to permanent joint damage and can be life-threatening.

Read more about Septic Arthritis »

Reactive arthritis

Reactive arthritis (ReA), formerly known as Reiter’s syndrome is a short-term, inflammatory arthritis that develops as a reaction to certain bacterial infections.

Typically, ReA is triggered by chlamydia, but can also be brought on by other infections, such as food poisoning.

Read more about Reactive Arthritis ».

Ankylosing spondylitis

Ankylosing spondylitis is a lifelong inflammatory arthritis of the back. The word ankylosing means joining together or fusing, and spondylitis means inflammation of the spine.

The condition causes the affected spine joints to fuse together into one bone. Inflammation causes the bone-making cells to grow bone within the ligaments, which then may form bony bridges between the vertebrae of the spine. The condition mainly affects the lower back, but can spread up the spine, causing arthritis of the neck and other joints.

The cause of the condition is unknown, but there is normally a genetic component. Smoking is known to make the disease more severe.

Symptoms usually include back pain and stiffness, inflammation in other joints, and extreme tiredness. Onset normally occurs gradually in early adulthood, between the ages of 20 and 30.[8] Severity of symptoms varies widely. It is associated with a serious but treatable eye condition called uveitis.

Treatment involves physiotherapy and exercise, painkillers such as non-steroidal anti-inflammatory drugs (NSAIDs), and medication to suppress the immune system.

Secondary arthritis

Arthritis is treated within the medical field of rheumatology. Rheumatology is the study of conditions marked by inflammation and pain in the joints, muscles or fibrous tissue. Some rheumatic conditions may commonly cause the symptoms of arthritis, even if the condition does not predominantly affect the joints. These include:[9][10]

Systemic lupus erythematosus (SLE), also known as lupus, is a long-term autoimmune condition that may cause inflammation in almost every part of the body, commonly including joint pains, as well as skin rashes and tiredness.

Paget’s disease of bone is a condition in which the normal cycle of bone renewal is disrupted, which can weaken the bones and in some cases cause them to become deformed. Osteoarthritis is a common complication of Paget’s disease.

Viral arthritis is inflammation of a joint caused by a viral infection. Some viruses have a tendency to affect the joints, such as dengue fever and mumps. This type of arthritis is normally self-limiting and requires no specific intervention.

Juvenile idiopathic arthritis

Juvenile idiopathic arthritis (JIA), previously known as juvenile rheumatoid arthritis, is a chronic inflammatory arthritis, that occurs in children under 16 years old.

It is not known exactly what causes the autoimmune condition, but it is associated with inherited factors and may be triggered by infection.[11] Many children will grow out of JIA, though it is not possible to accurately predict this.

Read more about Juvenile Idiopathic Arthritis »

Diagnosis

In order to receive appropriate treatment, it is important to fully describe the nature of joint pain to the doctor, making sure to include information such as:

  • How long the joint inflammation and pain has been noticeable
  • The location and severity of the pain
  • If any family members have experienced arthritis or autoimmune conditions
  • Whether there are other symptoms

Following the investigation of a person’s medical history, a doctor will typically perform a physical exam to check for swollen joints or loss of motion, and use blood tests and X-rays to confirm a diagnosis and distinguish the type of arthritis.[12]

Treatment

It is always important to seek prompt diagnosis and treatment of arthritis, as well as any other associated conditions. Early intervention helps to prevent joint damage, which can lead to physical disability. Arthritis treatment will vary, depending on the type of arthritis, but generally may include:

  • Rest
  • Exercise
  • Medication
  • Occupational or physical therapy
  • In some cases, surgery

FAQs

Q: How many types of arthritis exist?
A: Some sources estimate that there are over 200 different types of arthritis and related conditions. Arthritis can range from mild to severe. Causes are normally either degenerative wear-and-tear of cartilage, such as with osteoarthritis, or inflammatory conditions such as rheumatoid arthritis. Together all of these forms of arthritis make up the most chronic illness in the U.S. It is important to find out which type of arthritis is present, as each condition will have a different underlying cause, progression and treatment.

Q: Are there home remedies for arthritis?
A: Yes, there are a number of home remedies for arthritis, which may help to relieve symptoms, but will not have a significant impact on the progress of the disease. Some of the most regularly cited include:

  • Using heat pads or ice packs
  • Swimming
  • Omega-3, which is found in fish, canola oil and supplements

However, if arthritis is suspected, professional medical attention should always be sought.

Q: What are some risk factors for arthritis?
A: Although it depends on the type of arthritis, some factors increase the risks of several different types. Arthritis risk factors include:[13][14]

  • Smoking tobacco
  • Being overweight
  • Certain inherited traits, such as HLA-B27, a gene associated with autoimmune conditions
  • Increasing age
  • Joint injury or certain repetitive movements

Q: Can Tylenol be taken as pain relief for arthritis?
A: Tylenol, which has acetaminophen as its active ingredient, may be suitable to treat pain caused by some types of arthritis, but not for others. Acetaminophen works best for pain that is not specifically from arthritis, such as pain from osteoarthritis. It is important to consult a doctor before taking Tylenol for arthritis, to devise the best treatment plan.

Q: What is the ESR test?
A: In cases where inflammatory arthritis is suspected, a blood test known as the erythrocyte sedimentation rate (ESR) test may be done to show whether there is inflammation and to what degree. However, these markers are not always present alongside inflammation.

Q: Can arthritis be cured or go away on its own?
**A: There is no cure for most types of arthritis. Exceptions include septic arthritis, which may be cured with antibiotics. Some types of arthritis can go away on their own, such as reactive arthritis and juvenile idiopathic arthritis. Symptoms of inflammatory arthritis, such as rheumatoid arthritis, can get better or go away altogether during periods known as remission. There are also many treatments that can help slow down the condition.

Q: Is arthritis hereditary?
A: Certain risk factors may increase the chance of developing arthritis. Genetic factors and family history are among the risk factors for many types of arthritis, including rheumatoid arthritis and osteoarthritis. There are specific genes associated with certain types of arthritis, such as HLA-B27 and HLA-DR4. Some types of arthritis are considered to be caused by a result of interactions between genetic factors and environmental factors.


  1. CDC. "Arthritis in America - Vital Signs." 7 March 2017. Accessed 5 June 2018.

  2. ScienceDirect Topics. "Arthritis - an overview." Accessed 5 June 2018.

  3. CDC. "Osteoarthritis (OA) | Basics | Arthritis." 3 April 2018. Accessed 5 June 2018.

  4. Taylor and Francis. "A diagnostic approach to the common arthritic conditions." Accessed 5 June 2018.

  5. Medscape eMedicine. "Osteoarthritis." 14 March 2018. Accessed 5 June 2018.

  6. NHS.UK "Psoriatic arthritis." Accessed 5 June 2018.

  7. UpToDate. "Patient education: Psoriatic arthritis (Beyond the Basics)." 5 February 2018. Accessed 5 June 2018.

  8. UpToDate. "Patient education: Axial spondyloarthritis, including ankylosing spondylitis (Beyond the Basics)." Accessed 5 June 2018.

  9. UpToDate. "Overview of the clinical manifestations of systemic lupus." 8 January 2018. Accessed 5 June 2018.

  10. Patient.info. "Fibromyalgia | Causes, Symptoms and Treatment | Patient." 17 April 2018. Accessed 5 June 2018.

  11. JIA-at-NRAS. "Juvenile Idiopathic Arthritis." Accessed 5 June 2018.

  12. WebMD. "Arthritis Diagnosis and Treatment." Accessed 5 June 2018.

  13. CDC. "Risk Factors | Arthritis." 2 July 2018. Accessed 14 July 2018.

  14. NCBI - NIH. "Characteristics and risk factors of rheumatoid arthritis in the United States." 24 November 2017. Accessed 14 July 2018.