Arthritis means inflammation of the joints. It is not one disease but a group of more than 100 conditions that cause joint pain, swelling and stiffness. Arthritis is a leading cause of disability worldwide, but with the right diagnosis and treatment most people can reduce pain and stay active.
Key facts
- Osteoarthritis is the most common type and mostly affects the knees, hips and hands.
- Rheumatoid arthritis is an autoimmune disease that needs early specialist treatment to prevent joint damage.
- Gout causes sudden, very painful attacks, often in the big toe.
- Regular exercise is one of the most effective treatments for most types.
- Weight loss reduces pain and slows damage in knee osteoarthritis.
Common types of arthritis
Osteoarthritis
The smooth cartilage that cushions the ends of bones gradually wears and the joint changes shape. It usually develops after age 45 and commonly affects knees, hips, hands and the spine. Risk factors include age, obesity, previous joint injury, and repetitive heavy work.
Rheumatoid arthritis
The immune system attacks the lining of the joints, causing painful, swollen joints, usually the small joints of the hands and feet on both sides of the body. It often starts between 30 and 50 and is more common in women. Without treatment it can destroy joints and affect the heart, lungs and eyes.
Gout
Crystals of uric acid form in a joint, causing sudden severe pain, redness and swelling, often in the big toe at night. Risk factors include being overweight, alcohol (especially beer), sugary drinks, eating a lot of red meat and organ meat, kidney disease and some water tablets.
Other types
- Psoriatic arthritis in people with psoriasis
- Septic arthritis, a joint infection that is an emergency
- Reactive arthritis after some infections
- Joint pain after viral infections such as chikungunya
Symptoms
- Joint pain, often worse with movement (osteoarthritis) or after rest (rheumatoid arthritis)
- Stiffness, especially in the morning. Stiffness lasting more than 30 minutes suggests inflammatory arthritis.
- Swelling, warmth or redness
- Reduced movement or a grinding feeling
- Tiredness and feeling generally unwell in inflammatory types
Diagnosis
A doctor will ask about your symptoms and examine your joints. Tests may include:
- Blood tests for inflammation, rheumatoid factor and anti-CCP antibodies, and uric acid
- X-rays or ultrasound of affected joints
- Removing a small amount of fluid from a swollen joint to look for crystals or infection
Treatment
For most types
- Exercise: strengthening, stretching and low-impact activities such as walking, cycling and swimming reduce pain and improve function.
- Weight management: every kilogram lost reduces load on the knees.
- Pain relief: paracetamol, and anti-inflammatory gels or tablets such as ibuprofen for short periods if suitable. Ask a doctor first if you have stomach ulcers, kidney disease, heart disease or high blood pressure.
- Physiotherapy and aids such as walking sticks, supportive shoes or knee braces
- Heat or cold packs for comfort
Osteoarthritis
Steroid injections can help flares. Joint replacement surgery is an option for severe hip or knee damage.
Rheumatoid arthritis
Disease-modifying antirheumatic drugs (DMARDs) such as methotrexate should start early to control the immune system and protect joints. Biological medicines are used when these are not enough.
Gout
Attacks are treated with anti-inflammatory medicines, colchicine or steroids. Long-term medicine such as allopurinol lowers uric acid to prevent attacks. Drinking water and reducing alcohol and sugary drinks help.
Living well with arthritis
- Keep moving. Rest during flares, but avoid long periods of inactivity.
- Pace activities and use joint-friendly techniques.
- Be cautious with herbal remedies and unregistered “joint pain” tablets, some of which contain hidden steroids.
- Look after your mood. Chronic pain can affect sleep and mental health.
When to see a doctor
See a doctor if joint pain, swelling or stiffness lasts more than a few weeks, or morning stiffness lasts more than 30 minutes. Seek urgent care for a single hot, red, very painful joint with fever, which may be infection, or after a joint injury with severe swelling or inability to bear weight.
Frequently asked questions
Does cracking your knuckles cause arthritis?
Studies have not found that knuckle cracking causes arthritis.
Can young people get arthritis?
Yes. Rheumatoid arthritis and other types can start in young adults, and some forms affect children.
