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Arthritis

Americans of all ages—up to 70 million of them—suffer from arthritis. One-in-three adults has arthritis. Children can be affected by arthritis too.

With arthritis, your affected joint is swollen and most likely, quite tender. The cartilage in your joint is probably wearing down and no longer doing its job of protecting the joint.

Arthritis and other rheumatic diseases are more common in women than men. While they are often linked with aging, they affect people of all ages.

More than 100 forms of arthritis exist in joints including the knee, foot and ankle, hand and wrist, hip, and shoulder. The spine can be affected as well.
Some of the more common types of arthritis include:

  • Osteoarthritis (OA). This is the most common type of arthritis, most often affecting the knee, hip, and spine. It wears out and depletes cartilage and narrows the joint space. Often, the bones of the joint will develop spurs and the joint will lose function. OA impacts many aging people, in addition to arising in younger people due to injuries or overuse.
  • Reactive arthritis. This form of arthritis results from an infection in the body, is painful, and is more common in men and in people aged 20 to 50. It develops most often between the ages of 20 and 50.
  • Rheumatoid arthritis (RA). Not only does this form of inflammatory arthritis affect joint linings; it can also infiltrate organs like the lungs and the heart.
  • Juvenile idiopathic arthritis (JA). Children who have JA suffer from pain and stiffness due to inflammation in the joints; it is commonly outgrown but can affect bone development.

Other forms of arthritis or related disorders include:

  • Inflammatory arthritis diseases include psoriatic arthritis, ankylosing spondylitis, and systemic lupus erythematosus (lupus), all of which entail inflammation in the joints among other symptoms
  • Gout occurs when uric acid crystals accumulate in small joints, causing pain and swelling
  • Scleroderma is an autoimmune condition causing hardening of the skin and other connective tissues

What Are Arthritis Symptoms?

Often, pain and other symptoms of arthritis aren’t debilitating until the disease is quite advanced. The earlier you recognize the signs of arthritis, the earlier you can start treatment, some of which could slow the progression of the arthritis.

Symptoms include:

  • Pain in a joint
  • Stiffness, particularly when rising after being seated or being in a prone position for a prolonged period
  • Joint swelling
  • The sound/sensation of crunching or of bone rubbing against bone when you move the affected joint

How is Arthritis Diagnosed?

Your healthcare provider will take your medical history and perform a range of tests to confirm a suspected arthritis diagnosis, including:

  • Physical exam will evaluate your range of motion and pain.
  • Laboratory tests can help identify certain forms of arthritis and may include:
    • Antinuclear antibody (ANA) test to check antibody levels
    • Complete blood count (CBC) to test kidney function, red and white blood cell function, and more
    • RF (rheumatoid factor) and CCP (cyclic citrullinated peptide) antibody tests to identify rheumatoid arthritis
    • Sedimentation rate to detect inflammation
    • Uric acid to diagnose gout
    • Urine test to assess protein levels and blood cell function
  • Imaging tests allow doctors to see inside your joints to identify bone spurs and soft tissue erosion indicative of certain forms of arthritis. These tests can include X-rays, CT scans, MRIs, and ultrasounds.

Other tests that may be ordered to confirm an arthritis diagnosis include:

  • Joint aspiration (arthrocentesis) to test synovial fluid for crystals, bacteria, or the presence of a virus
  • HLA tissue typing to identify any ankylosing spondylitis genetic markers
  • Skin or muscle biopsy to look for lupus, psoriatic arthritis, or other arthritis-related conditions that affect skin and muscle

Who is at Risk for Arthritis?

Arthritis can be caused by a number of natural factors that are out of our control. These include increasing age, female gender, and genetics. However, we can make life modifications to avoid arthritis or slow its progression, including:

  • Watch your weight to lighten the load on your knee joints
  • Practice safe sports and lifting techniques to avoid damaging your joints
  • Avoid infection by following good wound-care practices and carefully follow post-op instructions after any surgery

Treatment

The goal of arthritis treatment is to relieve symptoms like pain, swelling, and stiffness—and to improve joint function. The type of arthritis and the response to therapy, your age, and your general health will help guide the course of your treatment.

Available treatments include:

  • Medications like non-steroidal anti-inflammatory drugs (NSAIDs)
  • Injections of corticosteroids (which reduce inflammation and suppress the immune system) or hyaluronic acid (which helps to lubricate the joint and acts as a shock absorber within the joint)
  • Heat and cold including moist heat (warm bath or shower) or dry heat (heating pad) and cold (ice pack)
  • Joint immobilization with a splint or brace to protect and relax the affected joint
  • Massage to increase blood flow and help soothe muscles protecting the joint
  • Transcutaneous electrical nerve stimulation (TENS) to relax pain pathways from the brain to the joint
  • Acupuncture (by a licensed acupuncturist) to release tight muscles and stimulate the release of endorphins that fight pain
  • Disease-modifying antirheumatic drugs (DMARDs like methotrexate, hydroxychloroquine, sulfasalazine, and chlorambucil) to slow disease progression and treat any immune system issues
  • Physical therapy to strengthen muscles that support the joint and to improve range of motion
  • Surgery (for advanced disease and when conservative measures have been exhausted) including arthroscopic joint repair, fusion, or joint replacement