When Arthritis Causes Joint Pain on One Side of the Body

Joint pain on one side of the body may be an indication of arthritis. Arthritis refers to a group of diseases that cause inflammation and swelling of one or more joints. There are more than 100 types of arthritis, with the most common types being osteoarthritis, rheumatoid arthritis, and psoriatic arthritis.

Symptoms vary depending on the type of arthritis but usually include joint pain and stiffness. Joint pain can either occur symmetrically, affecting both sides of the body, or asymmetrically, causing unilateral symptoms, which only affect one side of your body.

This article explains the types of arthritis that cause asymmetric joint pain, diagnostic criteria and tests, as well as treatment and management options.

Types of Arthritis That Cause Asymmetric Joint Pain

You may have arthritis on one side of your body if the muscles on that side are weaker and cannot adequately support your joints, leading to increased joint pressure and cartilage breakdown. Alternatively, arthritis may also develop on one side of your body if you repetitively use one side more than the other, especially your dominant hand, since repetitive activities put chronic stress on joints that can wear down cartilage over time.

Osteoarthritis

Osteoarthritis (OA), also called degenerative joint disease, affects more than 30 million Americans. While many people associate OA with the wear and tear that the body’s joints endure over time with aging, more than half of Americans affected by OA are under the age of 65.

OA can affect any joint, although it is most common in the back and spine, hips, knees, neck and shoulders, and fingers and hands. Anyone who overuses their joints, including athletes, military personnel, and those with physically demanding jobs, may be at an increased risk of developing arthritis.

Cartilage is a form of connective tissue that covers the end of each bone in the body and provides cushioning and shock absorption to the joints, allowing them to move smoothly. In OA, cartilage breaks down over time, causing pain and increased difficulty moving the joints.

Bones may begin to break down with worsening arthritis, resulting in painful bone growth called bone spurs, or osteophytes, which can cause further damage to the cartilage.

In severe OA, the cartilage wears down so much that bone rubs directly against bone with movement of the joints, causing increased pain, inflammation, and joint damage.

Psoriatic Arthritis

Most people notice symptoms of psoriasis, particularly dry, scaly skin plaques, before experiencing psoriasis-related joint pain. About 30% of patients diagnosed with psoriasis will develop psoriatic arthritis, an autoimmune, inflammatory form of arthritis where the body produces autoantibodies that attack its own joints. Of these cases, asymmetric psoriatic arthritis, also called asymmetric oligoarthritis, makes up about 60% of all cases of psoriatic arthritis.

If you have already been diagnosed with psoriasis, the first signs of psoriatic arthritis typically include joint pain, warmth, and swelling, especially in the hands and feet; nail changes such as pitting and separation; and accompanying fatigue. Psoriatic arthritis can affect the joints of the entire body and result in permanent joint damage if left untreated.

Symptoms of psoriatic arthritis can be either symmetric or asymmetric, and joint pain most commonly occurs in the hands, feet, and low back. Sometimes symptoms start on one side and then progress to affect both sides of your body.

Medications may help reduce symptoms of psoriatic arthritis like joint pain and inflammation and prevent disease progression. Treatment is aimed at promoting remission and preventing joint damage.

Reactive Arthritis

This form of arthritis occurs as a reaction to something else, such as a bacterial infection in the digestive or urinary tract or the genitals. You usually won't start to have symptoms of reactive arthritis until after you've healed from the infection. You may get one or more of the following symptoms if you develop reactive arthritis:

• Joint inflammation, usually on one side of the body
• Inflammation of the eyes
• Inflammation of the urinary tract

The knee and ankle joints are most commonly affected by reactive arthritis. Some people may have pain in the sacroiliac joint in the lower back as well. Foot pain in reactive arthritis is usually caused by inflammation of entheses—the places where tendons or ligaments attach to bones.

Diagnosing Joint Pain on One Side of the Body

The prognosis for those diagnosed with arthritis becomes worse the longer your condition goes untreated, so it is important to seek medical attention if you think you have symptoms of arthritis.

Inflammatory arthritis like psoriatic arthritis, ankylosing spondylitis, and rheumatoid arthritis are treated by a rheumatologist. Osteoarthritis treatment can be from multiple providers in areas such as primary care, rheumatology, orthopedic surgery, and physiatry.

Diagnostic Tests

A physical exam combined with a review of your medical history, symptoms, and X-ray imaging are used to confirm a diagnosis of arthritis and identify the affected joints. MRIs can give your healthcare provider a clearer look at your cartilage and other parts of the affected joints.

Your healthcare provider may perform joint aspiration, where a needle is inserted into the joint to extract synovial fluid, a thick liquid between your joints. The results of this test can help rule out other conditions or forms of arthritis.

Your provider may check for symptoms of psoriasis to determine if you have psoriatic arthritis. Signs of psoriasis often appear on the skin first before joint symptoms begin and include:

• Scaly, itching skin patches
• Nail changes
• Pain and swelling within joints
• Tendon and ligament pain
• Chronic fatigue
• Inflammation of the eyes called uveitis
• Digestive symptoms, such as abdominal pain, bloating, constipation, and diarrhea
• Organ damage from inflammation of the heart, lungs, or kidneys

Blood tests that examine your erythrocyte sedimentation rate and levels of C-reactive protein can help confirm a diagnosis of psoriatic arthritis since these markers are typically elevated with this condition.

You may also have bloodwork that examines your rheumatoid factor to rule out a diagnosis of rheumatoid arthritis, an autoimmune type of arthritis that usually occurs symmetrically on both sides of the body.

You may be referred to a rheumatologist, a specialized internal medicine doctor who treats inflammatory conditions of the joints if psoriatic arthritis or rheumatoid arthritis is suspected.

Difference Between Psoriatic Arthritis and Rheumatoid Arthritis

Both conditions are autoimmune, inflammatory types of arthritis. Psoriatic arthritis, however, develops only in patients who also have psoriasis, an inflammatory condition of the skin that causes dry, scaly plaques. Psoriatic arthritis also often affects your nails, eyes, and tendons.

Unlike psoriatic arthritis, rheumatoid arthritis often causes elevated levels of rheumatoid factor in the blood. Rheumatoid arthritis is symmetric. You'll have the same symptoms of rheumatoid arthritis on both sides of your body, like both hands or both knees.

Treating Asymmetric Arthirits

Symptoms of arthritis can worsen over time if left untreated. If you have been experiencing chronic joint pain, stiffness, decreased mobility, or swelling for more than three months, seeing a healthcare provider to address your symptoms is important.

Management of your condition is crucial to preventing disease progression and worsening of symptoms, which can significantly impact your ability to move your joints and complete your day-to-day activities.

Psoriatic Arthritis Doctor Discussion Guide

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Treatment options for managing your arthritis symptoms include:

• Rest: Resting your arthritic joints by limiting activity and avoiding repetitive movements can help ease pain and inflammation. 
• Immobilization: Wearing a hand splint to immobilize the finger joints can reduce pain and inflammation with arthritis of the hands and fingers, especially if it is aggravated by activity.
• Heat: Heat therapy is best used for chronic arthritis to help loosen and relax tight muscles and stiff joints.
• Ice: Applying ice to arthritic joints can help relieve pain and inflammation, especially if swelling is present.
• Medication: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help with symptoms and pain.
• Topical pain relievers: Over-the-counter creams and ointments, especially those containing capsaicin, an extract derived from chili peppers, can be applied topically to joints to help relieve pain by decreasing the intensity of pain signals sent along nerve pathways.
• Paraffin: Warm paraffin wax application to the hands and fingers can help decrease arthritis pain and joint stiffness.
• Exercises: Stretches and exercises can help ease pain, improve range of motion and joint mobility, and increase strength of the muscles surrounding your joints.
• Prescription medication: Higher-strength medications may be prescribed to reduce pain and inflammation, including disease-modifying antirheumatic drugs (DMARDs) and biologics like TNF-inhibitors if you have psoriatic arthritis. 
• Rehabilitation: Your healthcare provider may refer you to physical or occupational therapy to improve the mobility of your joints, increase the strength and flexibility of surrounding muscles, and apply therapeutic modalities to alleviate pain, stiffness, and swelling.
• Corticosteroid injections: Your healthcare provider may suggest administering a corticosteroid injection into your arthritic joints to help decrease inflammation and relieve pain if other methods are not effective at improving symptoms.
• Surgery: Surgery is used as a last resort to manage severe arthritis when other methods have failed to relieve symptoms. Arthroscopies, commonly called “scopes,” may be used to debride joints (remove damaged tissue) and torn pieces of cartilage. When severe arthritis has significantly worn away cartilage, especially in the hips, knees, or shoulders, joint replacement surgery may be considered to reduce pain and improve your overall level of physical functioning.

Managing Joint Pain on One Side of the Body

Aside from treatment options that can be performed at home or under the care of a healthcare provider, maintaining healthy lifestyle habits can help manage your arthritis symptoms by decreasing inflammation throughout your body and promoting a healthy environment for healing.

Tips for a healthy lifestyle include:

• Prioritizing getting enough sleep at night—at least seven to eight hours—to promote healing
• Eating a healthy diet and managing a healthy weight
• Staying adequately hydrated
• Maintaining a positive attitude and learning how to cope with and manage stress
• Following an exercise program as prescribed by a physical therapist
• Exercising and staying active

Summary

Some forms of arthritis cause asymmetric symptoms. Osteoarthritis, psoriatic arthritis, and reactive arthritis can all cause joint pain and stiffness on one side of your body, sometimes progressing to both.

For osteoarthritis, you may develop symptoms on the side of your body that you use more often, like your dominant hand, because the condition is caused by repetitive overuse of your joints. For psoriatic arthritis, symptoms may start on one or both sides of your body. Reactive arthritis occurs after an infection and is typically asymmetric as well.

Strengthening the muscles surrounding arthritic joints is essential for decreasing strain on your joints and preventing arthritis from progressing. It is important to seek medical attention if you have been experiencing joint pain, stiffness, or swelling for more than three months. In addition to medical treatment, healthy lifestyle habits can help you reduce inflammation and manage symptoms.