Joints are the places in your body where two bones meet (think: elbows and knees). Diseases of the joints are known as arthritis. The term is derived from the Greek word that means exactly that: diseases of the joints.
More than 58.5 million American adults (1 in 4) have arthritis, according to the Centers for Disease Control and Prevention. Arthritis is more common among adults 65 and older, and more women than men develop it. Children may develop arthritis, too.
What is arthritis?
There are many types of arthritis—more than 100. Some types of arthritis—such as rheumatoid arthritis (RA)—not only affect the joints, but also your immune system and some internal organs, such as the eyes or skin.
Symptoms of arthritis may include:
What causes arthritis?
Experts believe that factors such as genetics, lifestyle and environment all play a role in who develops arthritis. However, no one can say for sure what causes many forms of arthritis.
Some types have known causes. For example, gout is caused by having too much uric acid in the body. Injuries to joints and overuse also contribute to osteoarthritis.
Here are some risk factors that you may control that may increase the likelihood of developing arthritis:
Obesity or overweight: Excess pounds put extra stress on your joints, especially those that are weight-bearing, such as your hips and knees. People who carry extra weight are more likely to develop osteoarthritis than those who don’t.
Infections: Microbial agents such as bacteria and viruses may cause infections in the joints, which may lead to some types of arthritis. Joints swollen, warm or red? It could be an infection. Seek medical attention right away.
Injury or overuse: Constantly bending or placing ongoing stress on joints with repetitive motions may damage them and lead to the development of osteoarthritis in those joints. If your work requires you to constantly bend and squat, you may be at risk of developing osteoarthritis.
Smoking: Cigarette smoking may increase your risk for developing rheumatoid arthritis, and if you have RA, smoking may make your disease worse. When you smoke, it may be harder to stay physically active, and physical activity is an important part of managing diseases such as RA.
Here are risk factors for arthritis that you have no control over:
Age: The older you are, the more wear and tear on your joints, and the more susceptible you become to arthritis.
Gender: Women are at greater risk for osteoarthritis, rheumatoid arthritis and fibromyalgia. Men are at greater risk of developing gout.
Genes: Experts believe there is a link between specific genes and the likelihood of developing some types of arthritis such as RA, systemic lupus erythematosus (SLE) and ankylosing spondylitis. No one knows why certain genes put those who have them at higher risk or why these genes may make some people’s arthritis worse.
You might have heard from a parent or friend that cracking your knuckles could cause you to develop arthritis in your hands. Not so, according to Harvard Health. Cracked knuckles may be annoying to those who overhear the pop, but, if you develop arthritis in your hands, that won’t be the reason.
While there are more than 100 types of arthritis, some are more common than others. The top four types include the following.
Osteoarthritis
This type of arthritis is also known as degenerative joint disease. Thanks to age or overuse, the cartilage that cushions your joints and prevents bone rubbing on bone wears thin or out. Symptoms of osteoarthritis include stiffness, pain and limited movement. Osteoarthritis typically affects weight-bearing joints, such as the hips, spine and knees.
Gout
This can be one of the more disabling forms of arthritis. A chronic disease, gout is caused by the buildup of uric acid in the body. Symptoms include painful swelling in single joints, often the big toe. Episodes are often repeated.
Fibromyalgia
The hallmark of this type of arthritis is chronic widespread pain. Most people with fibromyalgia are also extremely fatigued, have trouble sleeping, are sensitive to touch, light and sound, and have cognitive difficulties. Physical trauma, surgery, infection or psychological stress may trigger symptoms.
RA is an autoimmune disease, which means your body turns on itself. RA most likely affects the joints in the hands, feet, wrists, elbows, knees and ankles. In some cases, RA may also affect the skin, eyes, lungs, heart, blood and nerves. When you have RA, you likely experience flares, but you may also go into remission. As the disease progresses, your joints (fingers, toes, knees, wrists) may become deformed.
Other more common types of arthritis include:
People who have psoriasis, a skin disease that causes itchy, red, thick patches of skin with silvery scales, may also develop psoriatic arthritis. Not everyone with psoriasis develops psoriatic arthritis, but those who do may experience pain, stiffness and swelling of their joints. Psoriatic arthritis may be mild and affect a few joints, or it may be more severe and affect many joints. Psoriatic arthritis may also damage joints over time.
Less common forms of arthritis include:
Gonococcal arthritis is caused by the same bacteria that causes gonorrhea, a sexually transmitted infection. It’s more commonly diagnosed in otherwise young, healthy individuals. Left untreated, gonococcal arthritis may cause permanent joint pain.
Most types of arthritis cause pain and stiffness in and around a single joint or many joints. Symptoms may come on suddenly, or they may build up gradually over time. Symptoms may be constant, or they may periodically disappear for some time.
Some symptoms are specific to the type of arthritis you have. Here are some of the more common types of arthritis and their specific symptoms.
Osteoarthritis
Gout
Sudden and intense attacks of joint pain, often in the big toe and at night
Pain may also be in other toes, ankles, knees or finger joints
Pain may be recurrent and become increasingly severe
Fibromyalgia
Pain and stiffness all over
Exhaustion and fatigue
Anxiety and depression
Difficulty sleeping
Problems with memory and concentration
Headaches, possibly migraines
Tingling in hands and feet
Face or jaw pain known as TMJ (temporomandibular joint syndrome)
Abdominal pain, bloating, constipation or irritable bowel syndrome (IBS)
Rheumatoid arthritis
Aches and pain in more than one joint
Stiffness in multiple joints
Tenderness and swelling in joints
Weight loss
Fever
Fatigue/tiredness
Feeling weak
Symptoms are known to flare and also to go into remission. RA symptoms tend to be the same on both sides of the body.
Psoriatic arthritis
Joint inflammation (may be in large and small joints)
Swollen fingers and toes
Pitted nails or nails that separate from their beds
Foot or heel pain
Red, flaky patches of skin (psoriasis)
Ankylosing spondylitis
Pain, stiffness and inflammation in joints, including ribs, shoulders, knees and feet
Difficulty breathing deeply when rib joints are affected
Vision changes, eye pain due to inflammation of the eyes
Fatigue, weariness
Loss of appetite and weight
Skin rashes, such as psoriasis
Stomach pain and loose bowels
Gonococcal arthritis
Fever
Joint pain
Pain in a single joint
Tendon inflammation that causes pain in the hands or wrists
Pain or burning urinating
Skin rash that looks like sores. The rash may be pink to red and contain pus.
What does arthritis feel like?
If you have arthritis, you likely have pain and stiffness in your joints. Pain may be local or widespread.
If you have osteoarthritis, your joints tend to be sore and stiff in the morning or if you haven’t used them for a while. The pain usually lasts about a half-hour and improves with movement. You may feel as though your joints are loose or unstable. If you have pain in your hips, it may radiate to your knees. When walking or moving, your knees may buckle.
Rheumatoid arthritis affects everyone differently. You may have joint pain at rest or when you are moving. You may feel low in energy and could have a low-grade fever. Your joints may feel tender or warm to the touch. Your symptoms are likely to be the same on both sides of your body.
The goal in treating arthritis is to control pain, minimize joint damage and improve, or at least maintain, quality of life. Treatments for arthritis include medications, physical therapy, patient education and surgery in some cases.
A number of different medications are available to provide relief from arthritis symptoms:
Analgesics
Analgesics, or general pain relievers such as acetaminophen (Tylenol), are available over the counter and may help reduce inflammation and pain from joints that are hot and swollen. Analgesics are gentler on the stomach and heart than nonsteroidal anti-inflammatory drugs (NSAIDs), but if you take too much for too long, they may harm your liver. You can ask your healthcare provider for a prescription-strength analgesic if necessary. Be aware of all of the medicines you are taking, and keep in mind that some cold, allergy or sleep medicines also contain analgesics.
Non-steroidal anti-inflammatory drugs (NSAIDs)
Like analgesics, NSAIDs may relieve the pain from arthritis. They work by blocking hormone-like substances called prostaglandins. NSAIDs are sold over the counter, but they may also be prescribed, too. NSAIDs include:
Naproxen (Aleve)
Ibuprofen (Motrin, Advil)
Celecoxib (Celebrex, prescription only)
NSAIDs may up your risk of heart problems (heart attack and stroke) and lead to stomach bleeding.
Corticosteroids
Corticosteroids, also called steroids, act like your body’s natural hormone, cortisol, to reduce inflammation. Corticosteroids are quick-acting and may provide short-term relief. Long-term use of corticosteroids may cause weight gain, cataracts and high blood pressure.
Corticosteroids are available as pills, but they may also be given as injections.
Disease-modifying antirheumatic drugs (DMARDs)
DMARDs are another medication designed to slow or stop the inflammation that causes arthritic pain. DMARDs are often used to treat RA and inflammatory types of arthritis, such as ankylosing spondylitis, psoriatic arthritis and lupus. It may be weeks or months until you see the results of DMARDs. Methotrexate is a common DMARD prescribed for arthritis.
DMARDs may weaken your body’s ability to fight infections.
Biologics
Biologics are a subset of DMARDs. Biologics are designed to block specific parts of the immune system, particularly proteins that promote inflammation. They are given as an intravenous (IV) infusion.
Long-term use of man-made biologics may worsen existing conditions, such as heart failure or multiple sclerosis.
When other treatments don’t work or stop working, your healthcare team may recommend surgery. Surgery may also be recommended if your arthritis is severe. There are different surgeries available for different types of arthritis.
Arthroscopy
This is a less-invasive procedure where the surgeon uses specialized surgical instruments and a camera to repair joints. The surgeons operate with specialized instruments through small incisions and make decisions on how to move the surgical instruments based on what they see on the camera. Arthroscopy may be used to repair tears in soft tissue and damaged cartilage and ligaments, and remove broken cartilage that is floating freely.
Total joint replacement
Total joint replacement (TJR) is a surgical procedure where the surgeon removes the joint and replaces it with an implant that mimics the original. Implants may be made of metal, plastic or ceramic. TJR is not for people who have weak bones or who are extremely overweight.
Minimally invasive TJR may be an option for people who are active, normal weight and younger than 50, but it still involves cutting bone and realigning soft tissue that supports the joint.
A surgery that replaces only part of a joint is called joint resurfacing.
Fusion
Fusion is for people with osteoarthritis or inflammatory arthritis whose joints are severely damaged from their disease. During this procedure, the surgeon places pins, plates, rods or other hardware to fuse the joint and lock two or more bones in place. Fusion may be used for ankles, wrists, thumbs, fingers or the spine (not the lower back). Fusion limits range of motion and flexibility, but it may provide relief.
Joint revision
A surgeon removes an implant that has failed, is infected or worn-out and replaces it with a new one. Patients with implants that are 15 to 20 years old or older may need revisions. Patients are at higher risk for fracture after revision surgery. They may also be at risk for dislocation or uneven leg lengths.
Synovectomy
This procedure removes synovium—the fluid lining of the joints—from the knee, elbow, wrist, fingers or hips, which may become inflamed or grow too much, causing damage to surrounding cartilage and joints. Open surgery or arthroscopic methods are used.
The procedure may only temporarily relieve pain, and serious complications are possible with open synovectomy versus arthroscopic methods. It may also limit range of motion.
Osteotomy
With osteotomy, surgeons cut away bone or add bone to support a damaged joint, usually in the knee or hip. It may help delay the need for a joint replacement for 10 to 15 years, according to the Arthritis Foundation, but this is a very complex surgery that requires a specialized surgeon.
Physical therapy
Physical therapy sessions with physical therapists (PTs), who are licensed professionals, may help you cope with your arthritis by:
Showing you exercises that strengthen joints
Recommending assistive devices that may help, such as walkers and canes
Suggesting modifications to make your home and workplace safe and supportive, such as ergonomic chairs and cushioned mats in your kitchen
Arthritis pain relief tips
Arthritis pain may make it difficult to perform tasks of daily living. Here are some tips to help make your pain more manageable:
Take medications as directed. It’s best to follow directions on the pill bottle or from your healthcare provider. If you’re hesitant because you have side effects, talk to your provider about other medications or solutions.
Watch your weight. The more weight you carry, the more pressure on your knees and other weight-bearing joints. Lose weight if you need to, and then maintain your weight. A balanced diet with an emphasis on fruits and vegetables, whole grains and lean protein is key to getting weight in control. Avoid processed foods, red meat and sugary drinks.
Be active. Walking, swimming, yoga and the like may help reduce joint pain and improve your flexibility, strength and balance. Cardiovascular exercises such as bicycling may also help you keep your heart in shape. Talk to your healthcare provider before starting an exercise program.
Manage injuries and workplace hazards. Practice exercises that may strengthen any troublesome areas or joints that you must use repetitively for work or other activities. Make sure your workplace is free of fall hazards and that you’re using tools and equipment that are appropriate for your abilities and physical limitations. Look into ergonomically designed workspaces.
Stay positive. Try not to give in to pain. Find ways to think about things other than the pain. Spend time with loved ones. Do activities you enjoy. Talk to your provider about hypnosis, meditation and breathing techniques that may help ease your pain.
Go hot and cold. Applying heat to joints increases blood flow, which may help reduce pain. Applying cold may numb and reduce swelling, which also helps to reduce pain.
Electrical stimulation. Some people find relief from home treatments that deliver electrical stimulation to the affected area. For example, a TENS unit, or transcutaneous electrical nerve stimulation device, uses sticky probes placed on the joint and a gentle pulsing electric current. According to the Arthritis Foundation, it may relieve osteoarthritis, and up to 50% of people with arthritis who try it get a 50% reduction in pain.
Complementary therapies. Therapies such as massage or acupuncture may also help with pain relief. Talk to your healthcare provider about trying these therapies, as caution is needed if you are having a flare, or have severely damaged or brittle joints.
Quit smoking. Smoking may make your symptoms worse. If you smoke, quit.
Living with arthritis
When you have a chronic condition such as arthritis, it’s important to learn as much as you can from reliable sources. You might find it helpful to join a support group or take an exercise class designed for those with arthritis.
Work with your healthcare team to manage your condition and find the treatment or therapies that work for you. Arthritis can’t be cured, but you may manage it.
References
U.S. National Library of Medicine MedlinePlus: Arthritis.
StatPearls: Arthritis.
Centers for Disease Control and Prevention (CDC): FAQs about Arthritis.
South Carolina Department of Health and Environmental Control: Arthritis.
CDC: Risk Factors.
CDC: How to quit smoking.
Harvard Health: Does cracking knuckles cause arthritis?
U.S. National Library of Medicine MedlinePlus: Psoriatic Arthritis.
U.S. National Library of Medicine MedlinePlus: Gonococcal arthritis.
National Fibromyalgia Association: All about fibromyalgia.
Arthritis Foundation: Gout.
CDC: Fibromyalgia.
CDC: Rheumatoid arthritis.
Arthritis Foundation: Psoriatic arthritis.
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS): Osteoarthritis.
NIAMS: Rheumatoid Arthritis.
Arthritis Foundation: Medications for Arthritis.
Arthritis Foundation: Biologics are powerful drugs.
Arthritis foundation: Understand your joint surgery options.
Arthritis Foundation: Physical therapy for arthritis.
Arthritis Foundation: 4 tips for managing chronic pain.
Arthritis Foundation: Electrical Nerve Stimulation for Arthritis Pain.
Arthritis Foundation: Benefits of massage.
National Center for Complementary and Integrative Health: Glucosamine and Chondroitin for Osteoarthritis.
NIAMS: Living with Arthritis.
American Association of Retired Persons: 8 early signs of arthritis you should never ignore.
