Arthritis

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What is arthritis?

Arthritis is a general term for more than 100 diseases that cause inflammation, pain, stiffness and swelling in joints, resulting in joint damage and loss of mobility.

According to the Centers for Disease Control and Prevention, an estimated 50 million U.S. adults (about 1 in 5) report doctor-diagnosed arthritis. The most common types of arthritis are osteoarthritis, which results from wear and tear on the joints over time, and rheumatoid arthritis, an autoimmune condition in which the body’s immune system attacks healthy tissue in the joints.

Cartilage is a durable, resilient connective tissue that covers the surface of a bone at a joint. It helps reduce the friction of movement within a joint. In osteoarthritis, the cartilage in the joint wears down. As a result, the bone ends may thicken, forming bony growths or spurs that interfere with joint movement. In addition, small fragments of bone and cartilage may float within the joint space, and fluid-filled cysts may form in the bone, limiting joint movement. Although osteoarthritis can occur in any joint, it usually affects the hands, knees, hips, or spine.

Osteoarthritis occurs in most people as they age, but it also may occur in young people as a result of injury or overuse. It can be classified as primary or secondary. Primary osteoarthritis has an unknown cause, while secondary osteoarthritis is caused by another disease, infection, injury or deformity.

Rheumatoid arthritis also affects the joints, but can have a systemic impact on other areas of the body, including the eyes, heart, kidneys, lungs and skin.

Complications of all forms of arthritis can be serious and include destruction of the joints, leading to disability. Rheumatoid arthritis and septic arthritis (which can result from infection of a joint) can also lead to serious or life-threatening complications that can affect almost any organ in the body.

Seek prompt medical care if you have symptoms of arthritis, such as inflammation, pain, stiffness, and swelling of joints. Early diagnosis and treatment can minimize discomfort and reduce the risk of serious complications.

Seek emergency care (call 911) if you have arthritis and experience symptoms or events that may indicate serious, even life-threatening complications, including fever of 100.4°F or higher or fever that has lasted more than 48 hours; fracture, particularly after a severe fall; immobility in the fingers, toes, hands and feet; severe stomach pain; spots that appear around the nails, on either the fingers or toes; sudden chest pain; or shortness of breath.

What are the different types of arthritis?

There are more than 100 conditions that fall under the umbrella of arthritis. Generally, most include pain, stiffness and inflammation in one or more joints, but individual symptoms can differ across different arthritis types.

The most common types of arthritis are:

  • Osteoarthritis affects more than 30 million American adults. It is a degenerative joint disease that results in the breakdown of cartilage over time, causing pain, inflammation, and loss of mobility in the affected joint(s). Osteoarthritis most often occurs in joints that bear weight, particularly the knees, hips and spine.

  • Gout is caused by an excess of uric acid crystals that build up in a joint, most often the big toe, causing painful swelling. Symptoms occur during gout “flares,” which can be triggered by factors including diet. An estimated 8.3 million Americans live with gout.

  • Fibromyalgia, which affects up to 5 million people in the U.S., is marked by generalized pain throughout the body, particularly at “tender points” that can radiate pain when touched. Symptoms during fibromyalgia flares can also include severe fatigue, insomnia, difficulty concentrating, and emotional stress.

  • Psoriatic arthritis (PsA), an autoimmune disease in which the body’s immune system attacks healthy joint tissue, causing damage. Psoriatic arthritis can form on its own, but most often coincides with psoriasis, a condition that causes red, scaly patches of skin due to an autoimmune response. About 30% of people with psoriasis develop psoriatic arthritis, or just over 2 million Americans.

  • Rheumatoid arthritis (RA), similar to psoriatic arthritis, is an autoimmune condition that affects about 1.5 million Americans. Joints affected by RA become swollen, resulting in pain, loss of mobility, and joint damage. Rheumatoid arthritis is a systemic disease that can also affect organs including the heart, lungs and eyes.

  • Lupus, or systemic lupus erythematosus (SLE), affects at least 1.5 million people in the U.S., and many more may be undiagnosed. SLE is the most common form of this autoimmune arthritis that causes chronic inflammation in the joints, skin and kidneys. 

  • Ankylosing spondylitis causes inflammation in the spine that, left untreated, can result in some vertebrae becoming fused together. This leads to pain, poor posture, and even difficulty breathing. An estimated 1 million Americans have ankylosing spondylitis. 

  • Juvenile (childhood) arthritis, an umbrella term for arthritis that develops in children under 16 years of age. The most common childhood arthritis is juvenile idiopathic arthritis (JIA), also referred to as juvenile rheumatoid arthritis. About 300,000 children in the U.S. live with juvenile arthritis, which can affect the joints, skin, eyes, and internal organs, including the digestive tract, lungs and heart.

What are the symptoms of arthritis?

The types and severity of symptoms of arthritis can vary depending on the specific type of arthritis. The hallmark symptoms of all forms of arthritis include:

Additional symptoms of osteoarthritis include:

  • Crunching, crackling or grating sound or sensation in the affected joint

  • Symptoms affecting weight-bearing joints (including knees and hips)

  • Joint deformity in later stages of the disease

  • Joint pain that becomes worse with time and can lead to difficulty moving and immobility

  • Joint pain that increases with or is aggravated by certain types of activities, including excessive exercise or excessive inactivity

Additional symptoms of rheumatoid arthritis include:

  • Fatigue

  • Joint destruction that develops within 1 to 2 years after the onset of the disease

  • Loss of appetite

  • Muscle achiness throughout the body

  • Stiffness that lasts more than one hour after rising in the morning

  • Symmetric joint swelling and deformity

  • Weakness

Additional symptoms of fibromyalgia include:

  • Extreme fatigue or tiredness

  • Full body pain and “tender points”

  • Insomnia or difficulty sleeping

  • Mental health issues, such as anxiety and/or depression

  • Difficulty with memory or concentration

  • Digestive issues, such as bloating, constipation, or stomach pain

  • Headaches, including migraine

Additional symptoms of lupus include:

  • Chest pain, including when taking deep breaths

  • Fatigue

  • Fever

  • Hair loss

  • Rash, particularly a “butterfly rash” on the face that covers the cheeks and bridge of the nose

  • Raynaud’s disease, a condition in which the fingers and toes turn blue or white and become numb when the affected person feels cold or is experiencing stress

  • Sensitivity to light, particularly sunlight or fluorescent light

  • Shortness of breath

  • Skin issues, including sores in the nose or mouth

Septic arthritis is a rare type of arthritis in which a joint becomes infected, either from a direct injury, such as a traumatic cut, an animal bite or from germs that travel from elsewhere in the body. Additional symptoms of septic arthritis include:

  • Chills

  • Fever

  • Severe tenderness

  • Marked redness and swelling

Serious symptoms that might indicate a life-threatening condition

Autoimmune types of arthritis, particularly rheumatoid arthritis, can cause systemic symptoms, such as organ damage, that become life-threatening.

Seek emergency care (call 911) if you have arthritis and experience any of these symptoms or events:

  • Fever of 100.4°F or higher, or a fever that has lasted more than 48 hours. This can indicate an infection caused by complications of arthritis or from arthritis medications that suppress the immune system.

  • Fracture, particularly after a severe fall that may have broken a joint bone such as the hip

  • Immobility in the fingers, toes, hands and feet, which may be caused by limited blood supply to nerves caused by cardiovascular inflammation

  • Severe stomach pain, a possible sign of bleeding ulcers caused by long-term use of arthritis medication

  • Spots (which can be red or black) that appear around the nails, on either the fingers or toes. These can be a sign of tissue death due to blood vessel inflammation.

  • Sudden chest pain or shortness of breath, which can be a sign of a heart attack or other cardiovascular condition resulting from inflammation caused by rheumatoid arthritis

What causes arthritis?

The underlying cause of arthritis varies depending on the specific type:

  • Osteoarthritis is caused by injury or wear and tear of the cartilage over time. Cartilage is a smooth, slippery tissue that protects the ends of bones and helps bones to move easily without damaging bone tissue. OA tends to run in families, so there may be a genetic risk factor for the disease.

  • The exact causes of rheumatoid arthritis, gout, lupus or psoriatic arthritis are not known, but these conditions are classified as autoimmune diseases. In an autoimmune disease, the body’s immune system mistakes healthy tissues as dangerous to the body and attacks them. This results in inflammation that eventually can destroy the affected joints and damage blood vessels and organs. Certain triggers, including diet, environmental elements, or stress can trigger flares of these types of arthritis. Having certain variations in genes may increase the likelihood of developing an autoimmune disease.

  • Septic arthritis is caused by an infection of a joint by microorganisms, such as bacteria or fungi. Septic arthritis can occur when microorganisms enter a joint through a wound in the skin. Septic arthritis can also be caused by microorganisms that spread to a joint from another infection elsewhere in the body, such as the lungs (pneumonia), kidney (pyelonephritis), or intestinal tract.

What are the risk factors for arthritis?

A number of factors may increase your chances of developing some form of arthritis. Some risk factors are beyond your control, such as age, sex, or family history. Others can be minimized through healthy lifestyle choices.

Not all people with risk factors will develop arthritis, and not all people with arthritis have risk factors.

Arthritis risk factors include:

  • Being a woman

  • Being obese or overweight

  • Being older than age 45 for osteoarthritis and between 25 and 45 years old for rheumatoid arthritis

  • Having a boil, tuberculosis or cellulitis for septic arthritis

  • Having a family history of osteoarthritis, rheumatoid arthritis, or autoimmune disorders

  • Having a previous joint injury

  • Leading a sedentary lifestyle

  • Smoking

Reducing your risk of arthritis

You can lower your risk of developing arthritis by:

  • Eating an anti-inflammatory diet

  • Maintaining a healthy weight

  • Not smoking

  • Participating in a regular exercise program

  • Seeking regular medical care and following your treatment plan for joint injuries and infectious diseases, such as a boil, tuberculosis and cellulitis

  • Washing your hands often

  • Wearing recommended gear that protects joints during contact sports and dangerous activities

How do you prevent arthritis?

While it is not possible to definitively prevent arthritis, you can take steps to reduce your risk and, if you do develop arthritis, to slow the progression of the disease. By identifying flare triggers, you can work to avoid these situations and minimize the frequency and severity of your symptoms.

Steps to manage and ease arthritis symptoms include:

  • Eating an anti-inflammatory diet, which helps reduce inflammation in the joints that leads to pain and stiffness

  • Exercising with low-impact activities, such as swimming or cycling, that minimize pressure on the joints

  • Getting adequate sleep

  • Limiting alcohol

  • Maintaining a healthy blood sugar, as high glucose levels are linked to inflammation that can damage cartilage in joints

  • Managing stress

  • Protecting your joints by avoiding heavy lifting, intense activity, or long periods of sitting

  • Quitting smoking

Talk to your doctor before making any major changes to your diet or starting any new exercise regimen. Discuss your individual risk factors and symptoms so you can work together to develop a treatment plan and lifestyle modifications that are right for you.

What are the diet and nutrition tips for arthritis?

There is no diet that can cure arthritis. However, certain foods can help reduce triggers and ease arthritis symptoms. Eating a balanced diet is also essential to maintaining a healthy weight, which is important for people with arthritis. Excess pounds put extra pressure on weight-bearing joints, particularly the knees and hips, which can increase joint damage and worsen arthritis symptoms.

An anti-inflammatory diet high in vitamins and nutrients can help reduce pain and stiffness, while also building healthy tissue in your joints. Foods to add to an arthritis diet include:

  • Berries, including blackberries, blueberries, boysenberries, pomegranates, raspberries and strawberries, all of which have natural antioxidants and vitamin C, which promotes healthy joints

  • Dark chocolate, in small portions, with at least 70% or higher cocoa content, which can satisfy sweet cravings while providing healthy antioxidants

  • Dark, leafy greens, such as broccoli, Brussels sprouts, collard greens, kale and spinach, which all contain anti-inflammatory nutrients

  • Fish high in omega-3 fatty acids, including mackerel, salmon, sardines and tuna. If purchasing canned fish, choose lower-sodium options.

  • Garlic and onions, which also help improve immunity

  • Ginger and turmeric, which have anti-inflammatory properties and also provide a healthier way to flavor food instead of adding salt

  • Green tea, which contains natural antioxidants that reduce inflammation

  • Nuts, including almonds, hazelnuts, pecans and walnuts, which can also help maintain cardiovascular health in people with rheumatoid arthritis

  • Olive oil, which also contains heart-healthy fats and can help prevent bone loss when combined with vitamin D

  • Whole grains, such as bulgur, farro and quinoa, which provide natural fiber and offer a healthier side option than white rice or pasta

Certain foods can also increase inflammation, trigger flares, or worsen arthritis symptoms. Foods to avoid with arthritis include:

  • Alcohol

  • Dairy products, particularly full-fat options

  • Fried foods

  • Packaged foods that are high in salt, sugar and fat

  • Processed meats, including deli meats, sausages or hot dogs

  • Red meat, particularly organ meats, such as kidney or liver for people with gout

  • Refined carbohydrates, including white bread, white rice, and white pasta

How do doctors diagnose arthritis?

Everyday aches and pains are common, but if your pain persists, does not respond to over-the-counter pain relievers, or interferes with your daily activities, it’s time to see a doctor. Your healthcare provider will evaluate your symptoms and family history, along with possible image testing, to confirm an arthritis diagnosis.

To diagnose your condition, your doctor or licensed healthcare practitioner will ask you several questions related to your symptoms, including:

  • What symptoms are you experiencing? How long have you had these symptoms?

  • In which joints or areas of the body are you feeling pain or stiffness?

  • Has your range of motion been affected? What types of activities cause pain?

  • When do your symptoms occur? Do they come on suddenly or gradually?

  • Have you had any recent injuries?

  • Do you have a family history of any types of arthritis?

  • What type of diet do you eat? Do you drink or smoke?

Your doctor will perform a physical exam, paying close attention to affected joints for redness, swelling or warmth. He or she may ask you to move your arms or legs to check your range of motion and see which movements cause pain.

Imaging tests to diagnose arthritis

You may undergo image testing to look for signs of joint damage or inflammation. Tests doctors use to diagnose arthritis include:

  • X-rays, the most common image test for arthritis

  • Ultrasound

  • CT (computed tomography)

  • MRI (magnetic resonance imaging)

Your doctor may also recommend a bone scan or nerve test to check for damage to bone growth or nerve function.

Blood tests to diagnose arthritis

Certain types of inflammatory arthritis can have indicators that show up in the blood. Doctors may use blood testing to diagnose arthritis or monitor your treatment and progression.

Blood tests for arthritis include:

  • Antinuclear antibody (ANA), which looks for antibodies that could indicate lupus or rheumatoid arthritis (RA)

  • Anti-cyclic citrullinated peptide (anti-CCP), which screens for a type of antibody found in 60 to 80% of people with RA

  • Rheumatoid factor (RF), which looks for an antibody that is typically present in people with RA and not present in people with psoriatic arthritis

  • Uric acid, to measure levels that may indicate gout

Doctors may also use joint fluid tests, in which a small amount of joint fluid is removed and examined for the presence of infection or gout crystals. Skin or muscle biopsies may also help diagnose lupus, psoriatic arthritis, or damage to blood vessels and muscle tissue.

What are the treatments for arthritis?

Arthritis treatment plans are multifaceted and individualized to the specific type of arthritis and the stage of advancement of the disease, as well as your age, medical history, and coexisting diseases or conditions.

There is no cure for osteoarthritis or rheumatoid arthritis, but with early recognition and treatment, it is possible to minimize or delay joint damage and complications, such as chronic pain and disability.

Medications and treatments that are commonly used to treat most forms of arthritis include:

  • Acetaminophen (Tylenol)
  • Counterirritants, such as capsaicin or menthol, which can be applied topically to disrupt pain signals
  • Glucosamine and chondroitin, which can help strengthen damaged joint cartilage
  • Heat and cold therapies
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) and aspirin
  • Occupational therapy to help maximize function
  • Physical therapy, including range-of-motion exercises that can help strengthen joints and delay the loss of joint function

Osteoarthritis treatment

Medications and treatments used to treat osteoarthritis may include:

  • Cortisone injections
  • Injection of a synovial fluid substitute to help lubricate joints and ease stiffness and movement
  • Surgery to help improve joint pain, correct deformities, and increase function in seriously affected joints. Surgery may include a synovectomy, the removal of the joint lining. Total joint replacements may also be performed in severe cases. In these cases, a diseased joint in the knee or hip is replaced with a new, synthetic joint (prosthesis).

Rheumatoid arthritis treatment

Medications and treatments for rheumatoid arthritis may include:

  • Anakinra (Kineret), which reduces inflammation
  • Biologic response modifiers (biologics), medications that are genetically engineered to alter the body’s immune response
  • Corticosteroid medications, which reduce inflammation
  • Disease-modifying antirheumatic drugs (DMARDs), which may reduce inflammation and slow the destruction of joints
  • Surgery to help improve joint pain, correct deformities, and increase function in seriously affected joints. Surgery may include a synovectomy, the removal of the joint lining. Total joint replacements may also be performed in severe cases. In these cases, a diseased joint in the knee or hip is replaced with a new, synthetic joint (prosthesis).
  • Tumor necrosis factor (TNF) inhibitors, which reduce inflammation

Septic arthritis treatment

Medications and treatments for septic arthritis may include:

  • Antibiotics if caused by a bacterial infection
  • Surgically opening the affected joint to drain infected synovial fluid and clean the area

Home therapies for arthritis

In addition to your prescribed treatment plan, you can take steps at home to minimize the frequency and severity of your arthritis symptoms.

At-home therapies and lifestyle changes for arthritis include:

  • Assistive devices, including home modifications, such as shower bars or raised toilet seats, and personal devices like canes, shoe inserts, or walkers
  • Exercising regularly with low-impact activities, such as walking, swimming or an elliptical machine, that avoid stress on the joints
  • Getting adequate, high-quality sleep
  • Heating pads or ice packs, particularly after exercise or other activity, to help reduce swelling and pain
  • Losing weight, which helps take pressure off your joints and improves mobility

Alternative treatments for arthritis

While alternative medicine does not cure arthritis, and has not been scientifically proven as a treatment, many people find these therapies can ease symptoms and help manage stress.

Talk to your doctor about your individual symptoms and whether alternative treatments could help, including:

  • Acupuncture, which is reported to help reduce pain
  • Massage, making sure to notify your massage therapist about your affected joints
  • Supplements, such as glucosamine, chondroitin, or fish oil, to help reduce inflammation and promote healthy cartilage
  • Tai chi and yoga, which can help improve flexibility and mobility

Again, these treatments are not proven to be effective for arthritis, but in most cases, have not been shown to cause harm, either. Always talk to your doctor before adding any supplement or new therapy to your treatment regimen.

How does arthritis affect quality of life?

Experts evaluate a variety of factors to determine the impact of a condition on a person’s daily life, known as health-related quality of life (HRQL). Research has shown that arthritis has a significant, sometimes debilitating, effect on quality of life.

In one study, people with arthritis were three times more likely to report being in fair to poor health, compared to people without arthritis. They also reported a markedly higher number of days when their daily activities were limited by arthritis symptoms, which in turn had a negative impact on physical and mental health.

Areas in which arthritis can affect quality of life include:

  • Ability to participate in hobbies or activities you enjoy, which may be reduced due to pain or limited mobility

  • Activities of daily living, including personal hygiene, dressing, food preparation, and home maintenance, which can become more difficult as the disease progresses

  • Financial security, as your symptoms may limit your ability to work and cover your medical costs

  • Mental and emotional health, which may suffer due to living with chronic pain and the loss of independence or activities you previously enjoyed

  • Personal relationships, which may change as you rely on loved ones for caregiving or become less able to socialize with friends due to your symptoms

Along with following your treatment plan, it is essential to ask friends and family for support, and to communicate your needs effectively. Work with loved ones to determine the best ways to express how you are feeling and specific steps they can take to provide the help you need.

Steps you can take to manage and cope with the impact of arthritis include:

  • Avoiding flare triggers when possible and maintaining a healthy lifestyle, including diet and low-impact exercise, to help slow the progression of your arthritis

  • Keeping your home organized, with items easily reachable, to make daily tasks more manageable

  • Making modifications to your home, such as removing loose rugs, eliminating clutter, and adding support devices where needed to reduce your risk of falls or injury

  • Observing the factors that affect your symptoms, such as what time of day you have the most energy and feel the least pain, then plan your tasks accordingly

  • Plan meals in advance and prep ingredients during times when you feel strongest. Use electric appliances when possible to minimize stress on your joints from tasks like opening cans, chopping, or mixing.

  • Using personal assistive devices when needed, including canes, grabbers or walkers

While an arthritis diagnosis is challenging, many people live healthy, active lives with arthritis. By working with your doctor, care team, and loved ones, you can develop a treatment and support plan that maintains as high a quality of life as possible.

What are the potential complications of arthritis?

In some cases, arthritis can lead to serious, even life-threatening complications, especially when left untreated. Complications of arthritis include:

  • Bleeding gastric ulcer

  • Chronic pain

  • Immobility and disability

  • Joint deformity and destruction

  • Nerve problems that cause pain, numbness or tingling

  • Rheumatoid vasculitis, a type of inflammation of the blood vessels, which can lead to atherosclerosis, stroke, heart attack, and other cardiac conditions

  • Skin ulcerations

It is important to seek medical care if you have symptoms of arthritis. Early diagnosis and treatment can minimize discomfort and reduce your risk of these serious complications.

Does arthritis shorten life expectancy?

Autoimmune forms of arthritis, particularly rheumatoid arthritis, are more likely to affect a person’s overall life expectancy, as they have a systemic impact on the body and affect areas beyond the joints.

Rheumatoid arthritis itself does not reduce a person’s lifespan, but the complications it causes, such as cardiovascular disease, increase a person’s risk of dying earlier than someone without RA. It is impossible to determine a person’s specific prognosis, but in general, patients with RA have a lifespan 10 to 15 years shorter than people without the condition.

People with psoriatic arthritis (PsA) have a 60% higher risk of a lifespan that is three years shorter than that of the general population. This is often due to other conditions that are more likely in people with PsA, such as heart disease, obesity, diabetes, and liver disease, rather than arthritis itself.

The good news is the prognosis for people with arthritis continues to improve as researchers develop new and more effective treatments. Early diagnosis also allows for prompt treatment, helping slow the progression of the disease and reducing the risk of serious complications.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jul 18
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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