Arthritis is a common condition affecting 1 in 4 people in the United States and more than 350 million people globally. Symptoms of arthritis include pain, aching, stiffness, and swelling of the joints.

What is Arthritis?

Arthritis is a general term for a large group of conditions that involve joint inflammation. There are over 100 different types of arthritis that share symptoms of pain, stiffness, and swelling in joints. The most common form of arthritis is osteoarthritis which is a wear and tear condition isolated to the joints. In some other forms of arthritis, other tissues in the body may be affected which leads to systemic symptoms of fatigue, fever, weakness, and weight loss. Symptoms may vary in intensity from mild to severe. Anyone can live with arthritis independent of age, race, and sex though it is more common among women. Arthritis is also often linked with older age, though it can affect people of all ages including children.

Causes

There are many different causes of arthritis depending on the type of arthritis that you have. Osteoarthritis is caused by the wear and tear of the joints over time. Many forms of arthritis are caused by the body’s immune system attacking the joints and other tissues such as rheumatoid arthritis, psoriatic arthritis, juvenile arthritis, ankylosing spondylitis, and lupus. These are known as inflammatory arthritis and are also considered autoimmune conditions. Gout is caused by a buildup of uric acid crystals in the joints due to abnormal metabolism (1). Many types of arthritis are linked to a combination of factors and in some cases, the cause may not be known.

Summary: The cause of arthritis depends on the type of arthritis you have. Inflammatory types of arthritis are caused by your body’s immune system attacking your joints. Many types of arthritis are caused by a combination of factors.

Risk Factors

Some behaviors and characteristics increase your chance of developing arthritis. These are known as risk factors. Some risk factors are controllable and some can not be avoided, though you can decrease your risk of developing arthritis by changing the risk factors you can control.

Age: the risk of developing arthritis increases with age.
Gender: women are more likely to develop arthritis than men.
Genetics: some types of arthritis are linked to certain genes meaning you are more likely to develop arthritis if a close family member has been diagnosed.
Weight: the risk of developing arthritis increases with higher body weight.
Injury: a joint that has sustained an injury is more likely to develop arthritis in the future.
Infection: some types of arthritis can develop after certain infections.
Occupation: occupations that require repetitive knee bending and squatting are associated with arthritis in the knee (2).
Smoking: cigarette smoke increases the risk of developing rheumatoid arthritis and can make the disease progression worse (3).

Summary: There are many different risk factors for arthritis. Some risk factors can be changed to reduce the risk of developing arthritis such as body weight, occupation, and smoking.

Symptoms

The symptoms of arthritis appear differently in everyone. Symptoms may develop gradually or suddenly and may be mild or very severe. Arthritis is typically a progressive and chronic disease, though symptoms may either come and go or may persist over time.

The key symptoms of most forms of arthritis include:

Pain: pain occurs in the joints and muscles of the body. It may be constant or come and go. The pain may be in only one joint, or may be felt in many areas of the body.
Swelling: in some types of arthritis the skin over the affected joints becomes red, swollen, and warm to the touch.
Stiffness: stiffness in the joints occurs upon waking up in the morning or after a prolonged period of inactivity. Typically it takes about 30 minutes of light activity to warm up the joints (4). Though in some cases, stiffness may be persistent.
Impaired movement: symptoms of pain, swelling, and stiffness in the joints makes it difficult to move around and perform daily activities.

Some types of arthritis may involve their own unique symptoms such as fever, weight loss, fatigue, eye irritation, and rashes. These symptoms are more common in inflammatory types of arthritis.

Summary: Symptoms of arthritis include pain, swelling, and stiffness which affect the joints in the body. Some forms of arthritis may affect other tissues in the body as well as the joints.

Most Common Forms of Arthritis

Osteoarthritis, rheumatoid arthritis, and gout are the most common types of arthritis, but there are many other forms.

Osteoarthritis

Osteoarthritis is the most common type of arthritis. It affects the weight-bearing joints of the knee, hip, and spine most often but can develop in any joint in the body. Osteoarthritis damages the cartilage which coats the end of the bones and leads to a narrow joint space with less cushion. It can also cause an overgrowth of bone at the joint, bone spurs, and loss of function and mobility. Osteoarthritis typically affects people as they age due to the wear and tear nature of the condition, though it can also occur in younger people after an injury to the joint or overuse (5. Symptoms of osteoarthritis include joint pain, swelling, and reduced range of motion.

Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune condition that damages the lining of joints causing inflammation. The joints most often affected by rheumatoid arthritis are the hands, wrists, and knees, though it can affect any joint. Symptoms occur in a symmetrical pattern so that the same joint on both sides of the body is involved. Signs and symptoms in the joint include pain, stiffness, tenderness, and swelling. Rheumatoid arthritis can also affect other body systems and tissues and lead to symptoms of weight loss, fever, fatigue, and weakness.

Gout

Gout is a common form of inflammatory arthritis that typically involves significant pain at the joint of the big toe. Gout flares usually start suddenly and can last for several days or weeks. The flares are followed by long periods of remission without symptoms before another flare starts. Gout usually occurs in only one joint at a time and may also occur at the lesser toe joints, the ankle, and the knee. Symptoms include intense pain, swelling, redness, and heat.

Psoriatic Arthritis

Psoriatic arthritis is a type of arthritis linked with psoriasis, which is a chronic skin condition. Psoriasis causes red, scaly rashes on the skin and about 1 in 4 people who have psoriasis will eventually develop psoriatic arthritis (6). This type of arthritis is an autoimmune condition that targets the joints resulting in pain, stiffness, and swelling. The most common joints involved are the fingers, wrists, ankles, and knees. Psoriatic arthritis can also involve symptoms in the nails including cracking and pitting and in the eyes including redness and pain. Inflammation in the tendons and ligaments of the body is also a common symptom.

Juvenile Idiopathic Arthritis

Juvenile Idiopathic arthritis is an autoimmune disease that develops in children under the age of 16 and causes joint inflammation, swelling, pain, and tenderness. Some types of juvenile arthritis have few or no joint symptoms and only affect other body tissues such as the skin and internal organs, though this is less common. Symptoms of juvenile arthritis make it difficult to move around and complete everyday tasks.

Ankylosing Spondylitis

Ankylosing spondylitis is a type of arthritis that primarily affects the spine, though other joints may become involved. It causes inflammation in the spinal joints that can lead to severe pain and in more advanced cases, the inflammation can lead to ankylosis, or sections of the spine fusing together. Other joints that may be affected include the shoulders, hips, ribs, heels, and small joints of the hands and feet.

Reactive Arthritis

Reactive arthritis develops after an infection by certain bacteria, most commonly after infections of the genitals or the bowel (7). The bacteria cause arthritis by affecting the body’s immune system as it is fighting off the infection. Common symptoms include pain and swelling in the joints and persistent low back pain which tends to be worse at night or in the morning. The joints most often affected are the knees, ankles, heels, toes, and fingers. Other signs may include burning with urination and a rash on the palms or soles of the feet.

Septic Arthritis

Septic arthritis is an infection of the joint fluid and joint tissues which occurs more often in children than adults. The joints may become infected due to an injection, surgery, or injury and the infection usually reaches the joints through the bloodstream. The most common type of bacteria that causes septic arthritis is Staphylococcus aureus which can enter the body through an open fracture, an infection of the skin or genitals, an infected wound, a foreign object that goes through the skin, or any other injury that breaks the skin (8). Symptoms include fever, joint pain, and joint swelling which most often affects the knee, hip, shoulder, wrist, and finger. Usually, only one joint is affected.

Lupus

Lupus is an autoimmune condition that causes inflammation that affects multiple organs in the body. In addition to causing joint symptoms, it can affect the skin, kidneys, lungs, heart, and brain. A hallmark symptom of lupus is a butterfly-shaped rash that occurs across the nose and the cheeks, though rashes may develop on any part of the body that is exposed to the sun. Other symptoms aside from muscle and joint pain include hair loss, fever, kidney problems, mouth sores, blood clotting, and fatigue.

Summary: There are over 100 different forms of arthritis that have their own set of unique symptoms. The joints and other tissues affected depend on the type of arthritis you have.

Diagnosis

Diagnosing arthritis typically involves a combination of medical history, physical exam, lab tests, and imaging. Your doctor will start by getting your medical history including your family history and ask you about your symptoms. During the physical exam, the doctor will check your joints for swelling, redness, warmth, and range of motion. Lab tests may include blood work, urine, and joint fluid tests. Imaging may also be recommended which may include x-rays, CTs, MRIs, or ultrasounds.

Treatment Options

Treatment is different depending on the type of arthritis and the cause, but the goal is always to relieve pain and inflammation and maximize function. A range of medications and lifestyle changes can help to reduce symptoms and protect joints from further damage. The exact treatment is different for every person based on personal factors and the type of arthritis involved.

Medication

There are several different classes of drugs that are used to treat arthritis. The medication will depend on the type of arthritis but common drugs include:

Analgesics: this class of medication works to reduce pain, but does not have any effect on inflammation or disease progression. Analgesics may be purchased over the counter such as Tylenol or you may need a prescription.
Nonsteroidal anti-inflammatory drugs (NSAIDs); these drugs work to control both pain and inflammation. Common over the counter NSAIDs include Tylenol and Aleve, though others may need a prescription. NSAIDs are often prescribed in pill form but may be found in creams, gels, or patches which are applied to the affected joints.
Disease-modifying antirheumatic drugs (DMARDs): this class of drug is used to treat autoimmune forms of arthritis and work to slow or stop the progression of the disease by targeting the immune system. These are usually taken in pill form and examples include Methotrexate and Plaquenil.
Biologics: biologics are a class of DMARDs that are genetically engineered to target various protein molecules involved in the immune response. These are usually taken by injection and include Enbrel and Remicade.
Corticosteroids: these drugs are powerful anti-inflammatory medications that work to reduce inflammation and suppress the immune system. They can be taken in either pill form or injection inside the joint. An example includes Prednisone.

Diet

Eating a nutritious diet and avoiding inflammatory foods can help to manage the symptoms of arthritis. There is no known diet that can cure arthritis, but following a well-balanced and anti-inflammatory diet is recommended (9). An anti-inflammatory diet includes lots of fruits and vegetables, foods containing omega-3 fatty acids such as fish and nuts, lean protein, whole grains, and healthy fats such as avocado and olive oil. Avoiding inflammatory foods such as processed food, red meat, and alcohol is also encouraged.

Physical Therapy and Exercise

Regular exercise can reduce pain and improve physical function, muscle strength, endurance, and quality of life for people with arthritis. The stronger the muscles surrounding the joints, the less stress will be placed on the joints during movement. Exercise also helps to reduce body weight which is a risk factor for developing arthritis.

It can be difficult to get started with exercise when dealing with the symptoms of arthritis. Physical therapists are experts in helping people with arthritis maximize their joint function and find healthy and pain-free ways to stay active. If joint pain is affecting your ability to exercise or move for your daily routine, getting started with a physical therapist can be helpful.

Surgery

In some cases, if medication and lifestyle modifications are not controlling symptoms, surgery may be recommended. The most common surgery for arthritis is a joint replacement which can remove the damaged part of the knee and the hip joint and replace it with an artificial one. Other surgical options include joint fusion which is typically used for smaller joints such as the wrist, ankle, finger, and toes and involves fusing the joints together.

Summary: Treatment options for arthritis vary depending on the type of arthritis you have. Usually treatment consists of a combination of medication, diet, and exercsie. Surgery may be recommended in some cases.

Conclusion

Arthritis is a common condition affecting 1 in 4 people in the United States. There are over 100 types of arthritis and the causes, symptoms, and treatments vary depending on the type of arthritis you have. Hallmark symptoms of arthritis include joint pain, swelling, and stiffness, though some forms of arthritis affect other tissues in the body. Treatment options include medication, diet, exercise, and surgery. If you have joint pain and inflammation, consult your healthcare provider to learn about your options today.

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