Arthritis: Symptoms, Causes & Treatment

What is arthritis?

Arthritis is an inflammation of the joints. It can affect one joint or multiple joints. There are more than 100 different types of arthritis, with different causes and treatment methods.

Osteoarthritis (OA) is the most common type of arthritis.

Other common types include:

• rheumatoid arthritis (RA)

• psoriatic arthritis (PsA)

• gout

The symptoms of arthritis usually develop over time, but they may also appear suddenly. The typical age for developing rheumatoid arthritis (RA) is between ages 30 and 50. It can, however, affect children, teens, and younger adults.

Osteoarthritis (OA) commonly develops after the age 50 or 60 years, but there are studies that reveal radiographic evidence of OA occurring in women in their 40s. It also tends to be more prevalent in individuals who are overweight.

Symptoms of arthritis?

Symptoms of arthritis include pain and limited function of joints. Joint inflammation from arthritis is characterized by joint stiffness, swelling, redness, pain, and warmth.

• Stiffness of the joint can lead to poor function.

• Tenderness of the inflamed joint can be present with or without pain.

• When large joints are involved, such as the knee, there can be loss of cartilage with limitation of motion from the joint damage.

• When arthritis affects the small joints in fingers, there can be bone growth and loss of hand grip and grip strength of the hand associated with stiffness.

• Arthritis of weight-bearing joints can lead to difficulty walking from poor joint function and arthritis pain.

Many forms of arthritis, because they are rheumatic diseases, can cause symptoms affecting various organs of the body that do not directly involve the joints. Therefore, symptoms in some patients with certain forms of arthritis can also include

• fever,

• gland swelling (swollen lymph nodes),

• weight loss,

• fatigue,

• A grating sensation or “popping” sound when the joint moves,

• feeling unwell, and

• even symptoms from abnormalities of organs such as the lungs, heart, or kidneys.

What causes arthritis?

Arthritis may be caused by:

• wear and tear of a joint from overuse

• age (OA is most common in adults over age 50)

• injuries

• obesity

• autoimmune disorders

• genes or family history

• muscle weakness

Osteoarthritis

Normal wear and tear causes OA, one of the most common forms of arthritis. An infection or injury to the joints can exacerbate this natural breakdown of cartilage tissue.

Cartilage is a firm but flexible connective tissue in your joints. It protects the joints by absorbing the pressure and shock created when you move and put stress on them. A reduction in the normal amount of this cartilage tissue causes some forms of arthritis.

Your risk of developing OA may also be higher if you have a family history of the disease.

Rheumatoid arthritis

Another common form of arthritis, RA, is an autoimmune disorder. It occurs when your body’s immune system attacks the tissues of the body, resulting in inflammation to joints as well as other body organs.

In the joints, this inflammatory response affects the synovium, a soft tissue in your joints that produces a fluid that nourishes the cartilage and lubricates the joints, eventually destroying both bone and cartilage inside the joint.

The exact cause of the immune system’s attacks is unknown. But scientists have discovered genetic markers that increase your risk of developing RA fivefold.

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 involves 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.

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.

Is there an arthritis diet?

For most forms of arthritis, diets play little or no role in precipitating or exacerbating the condition. However, in general, oils of fish have been shown to have anti-inflammatory properties. Some osteoarthritis suffers benefit from omega-3 fatty acid supplements. Some people with osteoarthritis feel they benefit from the curcumin that is present in curry foods.

Gout is a particular type of metabolic arthritis that is clearly diet-related. Foods that are high in purines, especially red meats and shellfish, can worsen the condition. Moreover, certain foods elevate the levels of uric acid, including alcohol (especially beer) and those foods containing high amounts of fructose (such as the corn syrup found in soft drinks). For people with celiac disease, gluten-containing foods (wheat, barley, rye) can worsen joint pains.

At-home exercises you can try include:

• the head tilt, neck rotation, and other exercises to relieve pain in your neck

• finger bends and thumb bends to ease pain in your hands

• leg raises, hamstring stretches, and other easy exercises for knee 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 of 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.

Risk factors

The overall risk factors for arthritis include:

• Obesity. Particularly associated with OA, being overweight puts added stress on weight-bearing joints in the body, such as your knees and hips. Losing excess weight can help reduce your risk of developing arthritis, and it may also help if you already have the condition.

• Age and gender. The risk of developing arthritis increases with age. Also, women are more likely than men to develop most forms of arthritis. The exception is gout, which is more prominent in men.

• Overuse injuries. Repetitive stress injuries incurred during exercise, your job, or other activities may increase your risk of developing OA in the affected joint(s) later in life.

• Your genes. A family history of autoimmune diseases as well as certain inherited genes may increase your risk of RA and other related types of arthritis.

• Smoking. Your risk of developing RA may increase if you smoke, and smoking can in turn make this autoimmune disease worse.

Is it possible to prevent arthritis?

Since most forms of arthritis are inherited to some degree, there is no real way to prevent them. Arthritis that follows joint injury could be prevented by adhering to safety regulations and trying to avoid becoming injured.

Arthritis related to infection (for example, septic arthritis, reactive arthritis, Whipple's disease) could be prevented by not becoming infected with the causative organism. The extent to which this is possible varies depending upon the individual condition.

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.