For those who have it, arthritis is the thing that makes everyday tasks much more challenging. Depending on which joints are affected, anything from tying shoelaces to opening a jar of pickles to walking can be extremely painful and maybe even impossible.
Arthritis is characterized by pain, stiffness and swelling in joints that occurs due to inflammation, according to the Cleveland Clinic.
The condition is quite common. Arthritis statistics show 22 percent of adults in the U.S. have been diagnosed, per the Centers for Disease Control and Prevention (CDC). And although the disease does become more common with age, according to the CDC, it does not solely affect the elderly.
"It's a misconception that arthritis is only seen in older adults," says Orrin Troum, MD, rheumatologist at Providence Saint John's Health Center in Santa Monica. Young adults and children can also get arthritis, he says.
Types of Arthritis
"There are over 100 different types of arthritis or rheumatic diseases, and they really can be quite different," Dr. Troum says.
Here's a look at some of the more common types, along with the strategies used to manage the pain, discomfort and mobility limitations associated with the condition.
This is the most common form of arthritis, per the U.S. National Library of Medicine (NLM). More than 32 million people in the United States have osteoarthritis (OA), per the CDC, which is also sometimes referred to as degenerative arthritis.
OA occurs as a result of wear and tear on your cartilage, which is the tissue lining the ends of bones, according to the National Institute on Aging (NIA).
"When cartilage is normal, and you have cartilage rubbing against cartilage lubricated by joint fluid, the amount of friction is extremely low," says John Tiberi, MD, an orthopedic surgeon specializing in joint replacement and joint preservation at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles.
But as this slippery substance wears down, you'll notice its absence — you may feel stiffness in your joints, or experience pain or tenderness, per the NIA. Osteoarthritis can affect any joint in your body, but it's most commonly found in the hands, knees, hips and low back, per the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).
As people age, their risk for osteoarthritis increases, per the CDC. "It can also happen in younger patients that have had repeated trauma [to a joint] or just one traumatic event, like a major skiing injury," Dr. Troum says.
2. Inflammatory Arthritis
There are many kinds of inflammatory arthritis, but rheumatoid arthritis (RA) is the most common, per the NLM. Unlike osteoarthritis, which results from wear and tear on a joint, RA is an autoimmune disease, which leads to an inflammatory result in the tissues, Dr. Tiberi says.
RA is two to three times more commonly diagnosed in women than men, per the CDC. This form of arthritis affects the joints but can affect other organs in the body as well.
Spondyloarthropathies are another category of inflammatory arthritis — this is an umbrella term for several autoimmune inflammatory rheumatic diseases that cause arthritis, per the American College of Rheumatology. These include:
- Ankylosing spondylitis (AS): This type of arthritis can cause the bones in your spine to fuse together, per the Mayo Clinic. "There's an HLA-BT7 gene that predisposes people to having this form of arthritis," says Dr. Troum.
- Axial spondyloarthritis (axSpA): Like AS, this form of arthritis primarily affects the spine, as well as pelvic joints, per the American College of Rheumatology.
- Peripheral spondyloarthritis (pSpA): Where AS affects the spine, pSpA affects mainly the arms and legs, according to the American College of Rheumatology.
- Reactive arthritis: This used to be known as Reiter's syndrome. Infections in the intestines, genitals or urinary tract can cause this arthritis, which typically affects the knees and ankles and feet, per the Mayo Clinic.
- Psoriatic arthritis (PsA): Thirty percent of people with psoriasis have this form of arthritis, according to the National Psoriasis Foundation. It affects the joints in the fingers and toes, as well as wrists, knees, ankles and lower back, per NIAMS.
- Enteropathic arthritis (EA): This type of spondyloarthritis affects the limbs and spine, and is associated with having inflammatory bowel disease (IBD), such as Crohn's disease or ulcerative colitis, according to the Spondylitis Association of America.
Other types of arthritis include:
- Gout: This form of arthritis is characterized by sudden and severe bouts of pain, very commonly in the big toe, according to the Mayo Clinic. The pain often strikes at nighttime, and this condition is far more common for men, per the Mayo Clinic. Gout occurs when there is excess uric acid in your body, which can develop as your body breaks down food that contains purines, such as red meat and certain types of seafood, per the CDC.
- Septic arthritis (aka infectious arthritis): An infection from a germ traveling through your bloodstream or directly in your joint can cause this type of arthritis, per the Mayo Clinic. It can occur in the knees, hips, shoulders and other joints and is quite painful. It's treated by draining the liquid in the joint along with antibiotics.
3. Childhood Arthritis
What Really Causes Arthritis?
For many types of arthritis, the exact causes are unknown.
"There's a large genetic component to the development of osteoarthritis, in addition to other factors like advanced age, use over time and that kind of thing," Dr. Tiberi says.
While OA is the result of cartilage wearing away, rheumatoid arthritis is an autoimmune disease — that means it occurs due to your immune system misfiring and attacking the lining of the joint capsule, per the Mayo Clinic.
Arthritis Risk Factors
Some risk factors for arthritis are outside of your control (think: your genes), but for some, you can modify your behavior, potentially leading to a reduced risk of getting arthritis, per the CDC. Risk factors include:
- Age: With age, the risk of osteoarthritis, rheumatoid arthritis and gout increases, per the Mayo Clinic.
- Sex: Aside from gout, which is more frequently diagnosed in men, risk for arthritis is higher for women, per the CDC.
- Injuries: According to the Mayo Clinic, a previous injury to a joint increases the likelihood of arthritis later in life.
- Weight: Additional weight can be hard on your joints, and people who are overweight or obese have a greater risk for OA, per the CDC.
- Work: Jobs that entail repetitive motions or heavy lifting are a potential factor in getting arthritis, according to the Cleveland Clinic.
- Genes: There is a genetic component when it comes to arthritis. Genes known as HLA (human leukocyte antigen) class II genotypes can make you more likely to have arthritis, and also make the condition worse, per the CDC.
"Pain within the joint would be a hallmark symptom of pretty much any kind of arthritis," Dr. Tiberi says. Stiffness and a restricted range of motion are also classic symptoms of the disease.
But where it hurts in the joint may be different depending on which type of arthritis you have, he notes. "People with an inflammatory form of arthritis are more likely to have multiple joints affected," Dr. Tiberi adds.
Common arthritis symptoms include:
- Stiffness and swelling around the joint
- Trouble moving and/or a decreased range of motion
It's also possible that you'll experience fatigue, fever or a rash, per the Cleveland Clinic.
How Is Arthritis Diagnosed?
Diagnosis usually begins with a history, Dr. Tiberi says. "Depending on the joint, there are certain classic things you hear."
For example, he notes that patients with arthritis in their hip joint will often share that it's hard to put on shoes and socks.
Doctors will also perform a physical exam, checking on the range of motion and looking for swelling, tenderness or warmth at the joint.
Your doctor may also request imaging tests. "Probably the most common diagnostic tool that we use would be an X-ray," Dr. Tiberi says. Through it, doctors can see if the space between bones is abnormal or reduced, indicating that the cartilage isn't its typical thickness or pattern, he says.
Along with X-rays, doctors may use MRIs and ultrasounds to gain perspective on your joints, as well as drawing blood, per the Mayo Clinic.
There are a multitude of treatment options for arthritis, and they're not all medicine, Dr. Troum says. Treatment strategies depend on the type of arthritis, along with the severity of symptoms.
The trio of treatment goals when it comes to arthritis are controlling the symptoms (such as pain), reducing joint damage and improving quality of life, per the CDC. Common treatment strategies include:
- Over-the-counter medications: Both over-the-counter painkillers such as Tylenol (which help with pain) and non-steroidal anti-inflammatory medications (NSAIDs, which help with both pain and inflammation), can help alleviate symptoms, Dr. Tibiri says.
- Other medications: Several prescription medications can also help treat arthritis, including disease-modifying antirheumatic drugs (DMARDs), biologic response modifiers and corticosteroids, per the Mayo Clinic.
- Surgery: There are several types of surgical treatment tactics, including joint replacement, joint repair and joint fusion, which involves fusing bones together in smaller joints such as fingers, per the Mayo Clinic. "The success of the procedures we have to offer has been very, very high," Dr. Tiberi says.
Treatment for arthritis has come a long way. In the 1980s, Dr. Troum ran a clinic in California where patients with RA would be injected with liquid gold weekly (yes, you read that right — gold). Needless to say, that's not a treatment strategy anymore.
"Although we don't know what causes them and we can't cure them, these conditions can now be completely controlled in a lot of cases," he says.
Lifestyle modifications can also play a role in treating arthritis, including:
- Weight loss: Maintaining a healthy weight can help cut down on pain, limit the progression of arthritis and also potentially improve mobility, per the CDC. "Less force on a bad joint should equal less pain," Dr. Tiberi says.
- Activity modifications: Both avoiding activities that cause pain and doing activities that lessen pain can be helpful, Dr. Tiberi says. A physical therapist, for example, can help you learn exercises that'll strengthen the muscles around the joint, per the Mayo Clinic. Or, occupational therapists can show you ways to do everyday tasks (like stepping into the tub) that'll reduce pain, according to the Cleveland Clinic.
- Using assistive devices: A brace, cane, crutch or other assistive devices can help take the stress off the joint, Dr. Tiberi says. Other devices — such as a grabber or bath stool — can make it easier to perform tasks that would otherwise be challenging, per the Cleveland Clinic.
- Exercise: While pain may make it feel like sitting is the best option, engaging in physical activity can help with pain and also improve the strength of muscles, per the NLM. Yoga and tai chi may help with flexibility, per the Mayo Clinic.
- Dietary changes: Include plenty of fruits and veggies in your diet, as well as omega-3 fatty acids (found in fish, flaxseed and walnuts), according to the NLM. These kinds of foods can help fight inflammation, per the Arthritis Foundation.