What Is Arthritis?

Arthritis is an umbrella term for disorders that affect the joints, typically leading to joint pain and inflammation. There are different types of arthritis, and any joint in the body can be affected. Certain types of arthritis affect other body parts as well, such as the eyes or internal organs.

Arthritis is common and is the leading cause of disability in the United States. This article discusses different types of arthritis and its symptoms, causes, diagnosis, and treatment options.

Types of Arthritis

"Arthritis" is a general term that describes around 100 conditions affecting the joints. Of these, osteoarthritis and rheumatoid arthritis are the most common.

Types of arthritis include:

• Osteoarthritis (OA), or degenerative arthritis, occurs when the cartilage that provides cushioning between bones in your joints breaks down. OA is the most common type of arthritis and typically affects the fingers, knees, hips, and spine.
• Rheumatoid arthritis (RA) is an autoimmune disease that causes joint damage when the body mistakenly attacks its healthy tissues, namely the synovial tissue protecting the joints.
• Gout occurs from high levels of uric acid that lead to crystal formation in joints. It typically affects the big toe.
• Psoriatic arthritis develops in people with psoriasis, an autoimmune skin disease.
• Reactive arthritis is caused by a bodily infection.
• Ankylosing spondylitis is a type of autoimmune inflammatory arthritis that affects the spine—most commonly at the joints that join the spine and pelvis together.
  

What Are the Symptoms of Arthritis?

Some symptoms are common to all types of arthritis. These include:

• Joint pain
• Stiffness
• Joint swelling
• Redness and warmth
• Loss of mobility
• Joint deformities
• Fatigue
• Nodules (bumps) under the skin
• Joint instability (joints that give way)

Each type of arthritis has unique symptoms. For example, osteoarthritis can affect a joint on one side of the body, but rheumatoid arthritis causes symmetrical symptoms, often affecting the same joints on both sides of the body at the same time.

Osteoarthritis Symptoms

Osteoarthritis can also cause:

• A grinding sensation in the joints
• Numbness or tingling (if the condition puts pressure on nearby nerves)
• Pain or stiffness that worsens after activity

Rheumatoid Arthritis Symptoms

Rheumatoid arthritis symptoms can include:

• Fever
• Weight loss
• Increased pain and stiffness in the morning or afternoon
• Weakness

What Causes Arthritis?

Some forms of arthritis have a clear cause. For example, gout is caused by high levels of uric acid that lead to crystals forming in the joints. However, in many cases, the exact cause of arthritis is unknown.

Osteoarthritis has long been called wear-and-tear arthritis, although there are also other processes believed to be involved, including inflammation and genetics.

Several types of arthritis, including rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis, and juvenile arthritis, are autoimmune inflammatory diseases. They occur because the immune system mistakenly attacks healthy tissues, resulting in ongoing inflammation and destruction of the joints. As systemic illnesses, they often produce effects in other parts of the body as well.

Certain risk factors can increase your chances of developing arthritis.

Factors that contribute to osteoarthritis include:

• Obesity
• Smoking
• Female sex
• Increased age
• Previous injury to a joint
• Family history of osteoarthritis
• Manual labor jobs that include repetitive squatting

Factors contributing to rheumatoid arthritis include:

• Advanced age
• Sex (females are at an increased risk)
• Smoking
• Obesity
• Genetics (presence of human leukocyte antigen, or HLA, class 2 genotypes)

Although many factors can increase your risk of rheumatoid arthritis, certain characteristics, including having breastfed, can decrease the risk of developing this condition.

How Is Arthritis Diagnosed?

Diagnosis of arthritis begins with a physical exam and a review of your symptoms.

Imaging tests help diagnose arthritis and determine the extent of joint damage. These can include:

• X-rays
• Magnetic resonance imaging (MRI)
• Ultrasound

Blood tests, such as the following, may be performed, which can help determine whether an inflammatory or autoimmune type of arthritis is present:

• Antinuclear antibody levels
• Blood protein levels (complement test)
• Complete blood count
• C-reactive protein
• Rheumatoid factor
• Uric acid levels
• Erythrocyte sedimentation rate (ESR)
• Creatinine

Arthrocentesis—joint aspiration—can also analyze fluid from the affected joints to look for crystals (associated with gout) or bacteria.

How Is Arthritis Treated?

Arthritis is commonly treated with medications, physical therapy, occupational therapy, and in severe cases, surgery. The goal of arthritis treatment is symptom remission, not a quick fix or a cure. Many types of arthritis are progressive. Getting treatment and managing the condition is important for maintaining your mobility and quality of life.

Medications

Various over-the-counter (OTC) medications are available for treating inflammation from arthritis, including nonsteroidal anti-inflammatory drugs (NSAIDs) such as:

• Advil, Motrin (ibuprofen)
• Aleve (naproxen)
• Bayer (aspirin)

Tylenol (acetaminophen) and topical creams such as the NSAID Voltaren (diclofenac) can also decrease pain. For more severe arthritis pain, prescription NSAIDs, oral steroids, or steroid injections might be needed.

In addition to NSAIDs, a flare of gout may be treated with Colcrys (colchicine). Some people with gout may also be treated long-term with medications that reduce uric acid.

Rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and juvenile idiopathic arthritis are also treated with medications such as disease-modifying antirheumatic drugs (DMARDs) and biologics.

Physical Therapy and Occupational Therapy

Physical and occupational therapy can help reduce pain and improve function for people with arthritis.

Physical therapy interventions can include:

• Prescription of assistive devices (such as a cane or walker)
• Exercises to improve range of motion and strength
• Modalities to decrease pain (such as electrical stimulation and ultrasound)

Occupational therapy interventions can include:

• Adaptive techniques and equipment to make daily activities easier
• Modifying tasks to protect affected joints
• Splinting or bracing to support painful joints

Surgery

Depending on the severity of your arthritis, a healthcare provider may consider surgery as a treatment option.

Common procedures include:

• Arthroscopy uses several very small incisions to insert tools and a tiny camera into the affected joint to fix damaged soft tissues and remove cartilage or bone spurs (bony projections that grow along the edges of joints).
• Joint replacement involves removing one or both surfaces in a joint and replacing them with plastic, metal, or ceramic implants.
• Joint fusion (arthrodesis) is reserved for the most severe cases of arthritis. Joint fusion permanently attaches bones to prevent any future movement from occurring at the joint.

Complementary and Alternative Medicine (CAM) for Arthritis

Various complementary and alternative medicine interventions are used to help treat arthritis symptoms. However, more research is needed to prove that these treatments are effective. Examples include:

• Acupuncture
• Turmeric supplements
• Yoga
• Massage therapy

Psychological Effects of Arthritis

In addition to physical symptoms, living with arthritis can lead to mental health challenges, such as depression and anxiety.

Talk to your healthcare provider if you are experiencing symptoms such as:

• Difficulty sleeping
• Restlessness
• Feeling worthless or hopeless
• Changes in appetite
• Decreased interest in hobbies
• Difficulty focusing
• Lack of energy
  

Treatments like therapy and medications can help you cope with these symptoms and improve your overall quality of life. Seek immediate medical attention if you have thoughts of suicide.

Daily Arthritis Management

Arthritis symptoms can fluctuate from day to day. Listen to your body, schedule tasks for the time of day you typically feel the best, and rest when you are tired. Work with a healthcare provider to make a plan for arthritis flares. Strategies could include:

• Apply ice or heat.
• Use a pain-relieving or anti-inflammatory medication.
• Take a warm shower or stretch to relieve stiffness.

Incorporating healthy sleep, nutrition, exercise, and stress management can help you maintain your overall health and reduce the severity of flare-ups when they occur.