What is arthritis?
Arthritis and other rheumatic diseases are common conditions that cause pain, swelling, and limited movement. They affect joints and connective tissues around the body. Millions of people in the U.S. have some form of arthritis.
Arthritis means redness and swelling (inflammation) of a joint. A joint is where 2 or more bones meet. There are more than 100 different arthritis diseases. Rheumatic diseases include any condition that causes pain, stiffness, and swelling in joints, muscles, tendons, ligaments, or bones. Arthritis is usually ongoing (chronic).
Arthritis and other rheumatic diseases are more common in women than men. They are also often linked with old age. But they affect people of all ages.
The 2 most common forms of arthritis are:
- Osteoarthritis. This is the most common type of arthritis. It is a chronic disease of the joints, especially the weight-bearing joints of the knee, hip, and spine. It destroys the padding on the ends of bones (cartilage) and narrows the joint space. It can also cause bone overgrowth, bone spurs, and reduced function. It occurs in most people as they age. It may also occur in young people from an injury or overuse.
- Rheumatoid arthritis. This is an inflammatory disease of the joint linings. The inflammation may affect all of the joints. It can also affect organs such as the heart or lungs.
Other forms of arthritis or related disorders include:
- Gout. This condition causes uric acid crystals to build up in small joints, such as the big toe. It causes pain and inflammation.
- Lupus. This is a chronic autoimmune disorder. It causes periods of inflammation and damage in joints, tendons, and organs.
- Scleroderma. This autoimmune disease causes thickening and hardening of the skin and other connective tissue in the body.
- Ankylosing spondylitis. This disease causes the bones of the spine to grow together. It can also cause inflammation in other parts of the body. It can affect the shoulders, hips, ribs, and the small joints of the hands and feet.
- Juvenile idiopathic arthritis (JIA) or juvenile rheumatoid arthritis (JRA). This is a form of arthritis in children that causes inflammation and joint stiffness. Children often outgrow JRA. But it can affect bone development in a growing child.
What are the symptoms of arthritis?
Each person’s symptoms may vary. The most common symptoms include:
- Pain in 1 or more joints that doesn’t go away, or comes back
- Warmth and redness in 1 or more joints
- Swelling in 1 or more joints
- Stiffness in 1 or more joints
- Trouble moving 1 or more joints in a normal way
These symptoms can look like other health conditions. Always see your healthcare provider for a diagnosis.
How is arthritis diagnosed?
Your healthcare provider will take your medical history and give you a physical exam. Tests may also be done. These include blood tests such as:
- Antinuclear antibody (ANA) test. This checks antibody levels in the blood.
- Complete blood count (CBC). This checks if your white blood cell, red blood cell, and platelet levels are normal.
- Creatinine. This test checks for kidney disease.
- Sedimentation rate. This test can find inflammation.
- Hematocrit. This test measures the number of red blood cells.
- RF (rheumatoid factor) and CCP (cyclic citrullinated peptide) antibody tests. These can help diagnose rheumatoid arthritis.
- White blood cell count. This checks the level of white blood cells in your blood.
- Uric acid. This helps diagnose gout.
Other tests may be done, such as:
- Joint aspiration (arthrocentesis). A small sample of synovial fluid is taken from a joint. It's tested to see if crystals, bacteria, or viruses are present.
- X-rays or other imaging tests. These can tell how damaged a joint is.
- Urine test. This checks for protein and different kinds of blood cells.
- HLA tissue typing. This looks for genetic markers of ankylosing spondylitis.
- Skin biopsy. Tiny tissue samples are removed and checked under a microscope. This test helps to diagnose a type of arthritis that involves the skin, such as lupus or psoriatic arthritis.
- Muscle biopsy. Tiny tissue samples are removed and checked under a microscope. This test helps to diagnose conditions that affect muscles.
How is arthritis treated?
Treatment will depend on your symptoms, your age, and your general health. It will also depend on how what type of arthritis you have, and how severe the condition is. A treatment plan is tailored to each person with his or her health care provider.
There is no cure for arthritis. The goal of treatment is often to limit pain and inflammation, and help ensure joint function. Treatment plans often use both short-term and long-term methods.
Short-term treatments include:
- Medicines. Short-term relief for pain and inflammation may include pain relievers such as acetaminophen, aspirin, ibuprofen, or other nonsteroidal anti-inflammatory medicines (NSAIDs).
- Heat and cold. Pain may be eased by using moist heat (warm bath or shower) or dry heat (heating pad) on the joint. Pain and swelling may be eased with cold (ice pack wrapped in a thin towel) on the joint.
- Joint immobilization. Using a splint or brace can help a joint rest and protect it from more injury.
- Massage. Lightly massaging painful muscles may increase blood flow and bring warmth to the muscle.
- Transcutaneous electrical nerve stimulation (TENS). Pain may be eased with a TENS device. The device sends mild, electrical pulses to nerve endings in the painful area. This blocks pain signals to the brain and changes how you feel pain.
- Acupuncture. Thin needles are inserted at certain points in the body. It may help the release of natural pain-relieving chemicals made by the nervous system. The procedure is done by a licensed healthcare provider.
Long-term treatments include:
- Disease-modifying antirheumatic drugs (DMARDs). These prescription medicines may slow down the disease and treat any immune system problems linked to the disease. Examples of these medicines include methotrexate, hydroxychloroquine, sulfasalazine, and chlorambucil.
- Corticosteroids. Corticosteroids reduce inflammation and swelling. These medicines, such as prednisone, can be taken by mouth (orally) or as a shot.
- Hyaluronic acid therapy. This is a joint fluid that appears to break down in people with osteoarthritis. It can be injected into a joint such as the knee to help ease symptoms.
- Surgery. There are many types of surgery, depending on which joints are affected. Surgery may include arthroscopy, fusion, or joint replacement. Full recovery after surgery takes up to 6 months. A rehabilitation program after surgery is an important part of the treatment.
Arthritis treatment can include a team of healthcare providers, such as:
- Orthopedist/orthopedic surgeon
- Primary care doctor (family medicine or internal medicine)
- Rehabilitation nurse
- Physical therapist
- Occupational therapist
- Social worker
- Psychologist or psychiatrist
- Recreational therapist
- Vocational therapist