Arthritis

Arthritis is the swelling and tenderness of one or more joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The most common types of arthritis are osteoarthritis and rheumatoid arthritis.

Osteoarthritis causes cartilage — the hard, slippery tissue that covers the ends of bones where they form a joint — to break down. Rheumatoid arthritis is a disease in which the immune system attacks the joints, beginning with the lining of joints.

Uric acid crystals, which form when there’s too much uric acid in your blood, can cause gout. Infections or underlying disease, such as psoriasis or lupus, can cause other types of arthritis.

Treatments vary depending on the type of arthritis. The main goals of arthritis treatments are to reduce symptoms and improve quality of life.

Types

Ankylosing spondylitis
Gout
Juvenile idiopathic arthritis
Osteoarthritis
Psoriatic arthritis
Reactive arthritis
Rheumatoid arthritis
Septic arthritis
Thumb arthritis

Symptoms

The most common signs and symptoms of arthritis involve the joints. Depending on the type of arthritis, signs and symptoms may include:

Causes

The two main types of arthritis — osteoarthritis and rheumatoid arthritis — damage joints in different ways.

Osteoarthritis

The most common type of arthritis, osteoarthritis involves wear-and-tear damage to a joint’s cartilage — the hard, slick coating on the ends of bones where they form a joint. Cartilage cushions the ends of the bones and allows nearly frictionless joint motion, but enough damage can result in bone grinding directly on bone, which causes pain and restricted movement. This wear and tear can occur over many years, or it can be hastened by a joint injury or infection.

Osteoarthritis also causes changes in the bones and deterioration of the connective tissues that attach muscle to bone and hold the joint together. If cartilage in a joint is severely damaged, the joint lining may become inflamed and swollen.

Rheumatoid arthritis

n rheumatoid arthritis, the body’s immune system attacks the lining of the joint capsule, a tough membrane that encloses all the joint parts. This lining (synovial membrane) becomes inflamed and swollen. The disease process can eventually destroy cartilage and bone within the joint.

Risk factors

Risk factors for arthritis include:

Family history. Some types of arthritis run in families, so you may be more likely to develop arthritis if your parents or siblings have the disorder.
Age. The risk of many types of arthritis — including osteoarthritis, rheumatoid arthritis and gout — increases with age.
Your sex. Women are more likely than men to develop rheumatoid arthritis, while most of the people who have gout, another type of arthritis, are men.
Previous joint injury. People who have injured a joint, perhaps while playing a sport, are more likely to eventually develop arthritis in that joint.
Obesity. Carrying excess pounds puts stress on joints, particularly your knees, hips and spine. People with obesity have a higher risk of developing arthritis.

Complications

When left untreated, symptoms of arthritis may worsen and affect your day-to-day life. Below are some of the possible complications associated with this condition:

Reduced mobility. As arthritis progresses, you may experience less comfortable movement. This can interfere with your daily routine and may keep you from your favorite activities as well as socializing.
Possible weight gain. This is attributed to decreased movements, as well as discomfort that keeps you from exercising.
Increased risk of metabolic disorders. Being overweight with an inflammatory condition like arthritis may increase your chances of developing type 2 diabetes, high blood pressure, high cholesterol, and heart disease.
Inflammation in other areas of your body. If your arthritis is attributed to an autoimmune disease like with RA, the inflammation can spread and affect your skin, eyes, blood vessels, and lungs.

Risk of falls. According to the Arthritis Foundation, people with OA are more likely to experience falls and possible fractures. This is primarily caused by related muscle weakness, but dizziness from pain medications can also lead to falls.
Decreased ability to work. The Centers for Disease Control and Prevention (CDC) estimates that about 60 percent Trusted Sourceof people with arthritis are working age. Arthritis may affect your ability to move around in the workplace or even get from your mode of transportation to your job site.
Effects on mental health. Arthritis may increase the risk of anxiety and depression due to ongoing pain, inflammation, and social isolation.

What is the long-term outlook for people with arthritis?

While there’s no cure for arthritis, the right treatment can greatly reduce your symptoms.

In addition to the treatments your doctor recommends, you can make a number of lifestyle changes that may also help you manage your arthritis.

How is arthritis diagnosed?

Seeing your primary care physician is a good first step if you’re unsure who to see for an arthritis diagnosis. They will perform a physical exam to check for fluid around the joints, warm or red joints, and document the range of motion in the joints. Your doctor can refer you to a specialist if needed.

If you’re experiencing severe symptoms, you may choose to schedule an appointment with a rheumatologist first. This may lead to a faster diagnosis and treatment.

Documenting inflammation levels in your blood and aspirating and analyzing joint fluids, if present, can help your doctor determine what kind of arthritis you have.

Blood tests that check for specific types of antibodies like anti-cyclic citrullinated peptide (CCP), rheumatoid factor (RF) and antinuclear antibody (ANA) are also common diagnostic tests.

Doctors commonly use imaging scans such as X-ray, MRI, and CT scans to produce an image of your bones and cartilage. This helps them rule out other causes of your symptoms, such as bone spurs.

How is arthritis treated?

The main goal of treatment is to reduce the amount of pain you’re experiencing and prevent additional damage to the joints. You’ll learn what works best for you in terms of managing pain.

In general, treatment for arthritis involvesTrusted Source a combination of:

medications and supplements
physical therapy
occupational therapy
nutrient-rich diet
regular exercise
weight loss, if needed
heat and cold compresses
mobility assistance devices, such as canes or walkers

Improving your joint function is also important. Your doctor may prescribe a combination of treatment methods to achieve the best results.

Medications

A number of different types of medication treat arthritis:

Analgesics, such as hydrocodone (Vicodin) or acetaminophen (Tylenol), are effective for pain management, but do not help decrease inflammation.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and salicylates, help manage pain and inflammation. Salicylates can thin the blood, so they should not be used with additional blood thinning medications.
Menthol or capsaicin creams. These creams block the transmission of pain signals from your joints.
Steroids, like prednisone, help reduce inflammation but should be used cautiously and for brief periods of time.
Immunosuppressants and biologics. Immunosuppressants and biologics are prescribed for moderate to severe inflammatory arthritis like RA.

If you have RA, your doctor may recommend corticosteroids or disease-modifying antirheumatic drugs (DMARDs), which suppress your immune system.

DMARDs and biologics are being prescribed earlier in the course of RA. Methotrexate is now a first-line drug for treatment.

There are also many medications to treat OA available over the counter or by prescription.

Supplements

While clinical evidence and safety dataTrusted Source are lacking for many herbs and supplements marketed for arthritis, there are a few supplements that may be beneficial. For example, avocado and soybean unsaponifiables (ASU) may help OA symptoms. Fish oil and turmeric supplements may help reduce inflammation in RA.

However, you should talk with your doctor before taking any supplements for arthritis to make sure they are safe for you and will not interact with any medications you’re currently taking.

Surgery

Surgery to replace your joint with an artificial one may be an option. This form of surgery is most commonly performed to replace hips and knees.

If your arthritis is most severe in your fingers or wrists, your doctor may perform joint fusion. In this procedure, the ends of your bones are fused, eliminating the joint and therefore eliminating the site of inflammation.

Physical Therapy

Physical therapy involving exercises that help strengthen the muscles around the affected joint is a core component of arthritis treatment.

Outside of your appointments, your physical therapist will likely recommend a plan of care that includes daily movement along with exercises you can complete on your own at home. Collectively, these can help build strength, flexibility, and balance to improve mobility while also preventing falls.

What lifestyle changes can help people with arthritis?

Losing any excess weight and maintaining a moderate weight reduces the riskTrusted Source of developing OA and can reduce symptoms if you already have the condition.

Eating a nutrient-dense diet is important for weight loss. Choosing a diet with lots of antioxidants, such as fresh fruits, vegetables, and herbs, can help reduce inflammation. Other inflammation-reducing foods include fish and nuts.

Foods that should be limited or avoided if you have arthritis include:

Some researchTrusted Source also suggests that gluten antibodies may be present in people with RA. A gluten-free diet may improve symptoms and disease progression. A 2015 studyTrusted Source also recommends a gluten-free diet for all people who receive a diagnosis of undifferentiated connective tissue disease.

Regular exercise can keep your joints flexible. Swimming is often a good form of exercise for people with arthritis because it does not put pressure on your joints the way running and walking do. Staying active is important, but listening to your body when it’s signally resting and avoiding overexerting yourself are just as essential.

At-home exercises you can try include:

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