Arthritis is the inflammation of the joints.
The inflammation causes pain, stiffness of the joints.1

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What is Arthritis?

A joint is where two or more bones come together, such as your knee or wrist2.

There are many types of arthritis and related conditions3. And it’s not just an elderly person’s condition – it can affect people of all ages, even children4. The good news is that with current available treatments, people living with arthritis can still lead full, active lives3.

Types of Arthritis

While there are many different types of arthritis and related conditions, there are two that are the most common2:

Osteoarthritis

This is the kind that results from wear and tear (degenerative) and it’s the most common5. People in their mid-40s or older and women are more likely to develop osteoarthritis 4. It will often occur in the hands, spine, hips and knees4. The ends of your bones are lined with a smooth, but strong layer of tissue called cartilage, which allows the bones to glide over each other safely1. When the cartilage wears away, the exposed bones start rubbing against each other, which causes pain, swelling and stiffness in the joint1. As time goes on, the affected joints can become stiff and the pain may become chronic2.

Rheumatoid arthritis

In rheumatoid arthritis and other types of inflammatory arthritis, the immune system mistakenly starts attacking your body’s own healthy tissue with inflammation, causing damage to the joints. The joint becomes painful and difficult to move. These effects will worsen over time if the rheumatoid arthritis is not treated. Any joint can be affected, but it’s most prevalent in the fingers, wrists and knees1.

Gout

Is caused by uric crystals deposits in the joint. It usually affects the big toe, but any joint can be affected3.

Ankylosing spondylitis

Is a type of arthritis that affects the joints of the spine, causing pain and swelling3.

Juvenile arthritis

When inflammatory arthritis is diagnosed in a person under 16 years old1.

Know the Signs

Osteoarthritis

Does not usually have symptoms outside of the affected joints, but the joints will usually appear red and feel4:

  • Painful
  • Swollen
  • Stiff
  • Tender
  • Warm

Rheumatoid arthritis

Is not only a disease of the joints – symptoms may include fatigue, anemia, weight loss, eye inflammation, lung inflammation, bumps under the skin and fever2. Another early sign could be prolonged stiffness in the joints in the morning – meaning the joint does not move properly6.

Other symptoms of rheumatoid arthritis include:

  • Pain or aching in more than one joint6
  • Stiffness in more than one joint6
  • Tenderness and swelling in the affected joints6
  • Sensitivity to light6
  • Gut inflammation 6
  • Inflammation of the eye6
  • Symptoms on both sides of the body, for example, both knees6
  • Fever1
  • Fatigue1
  • Deformities in the joints in the long term1
  • Symptoms get worse for a while (flare-ups) and then better for a time (remission) 1

Arthritis Triggers

Often the cause of arthritis is unknown, although it’s likely a combination of genes (runs in families), events in a person’s life, such as injuries, and lifestyle factors, such as weight and smoking3,5.

Risk factors for osteoarthritis

Repeat injuries and repetitive use1.
Age – risk increases as you get older5.
Gender – women are more susceptible than men4.
Obesity – carrying extra bodyweight puts extra strain on the joints5.

Risk factors for rheumatoid arthritis

It’s believed that a combination of genetics and environmental factors is what triggers autoimmune disorders like rheumatoid arthritis – as in, if your genes give you a higher predisposition for developing it, then being exposed to particular environmental triggers could set it off7.

Get Diagnosed

The earlier you get diagnosed and start treatment for arthritis, the better.

So, if you have unexplained swelling or stiffness in your joints that does not go away, make an appointment with your medical practitioner as soon as possible8.

You will probably be asked for a detailed medical history and have a physical exam6. Other tests may include:

  • X-rays3,6
  • Ultrasound6
  • MRI6
  • Blood tests5,6.

Treating Arthritis

There’s no cure for arthritis, but there are ways you can relieve the effects and slow its progress3,4. These include lifestyle interventions, medication, applying hot or cold therapies, and physiotherapy4. In the case of osteoarthritis, surgery may also be an option4. Low-impact exercise can keep joints mobile and increase strength2.

Physiotherapy

Will focus on increasing the range of motion of your joints, stretching and strengthening the muscles around the joints and posture2.

Exercise

Can strengthen your muscles to support your joints, help you move better, reduce stiffness in your joints and help you lose weight. Low-impact activities, such as walking, swimming and cycling are your best bet as they’re kinder to your joints2,3.

Weight loss

Takes pressure off the joints – especially weight-bearing joints, such as your hips and knees5.

Heat and cold therapies

Can provide relief from pain and swelling3.

Medication

Painkillers – Reduce pain but don’t do anything for inflammation. Include: acetaminophen, tramadol, and oxycodone.
Non-steroidal anti-inflammatory drugs (NSAIDs) – Reduce both pain and inflammation, but taken orally, can irritate the stomach or increase risk of heart attack or stroke1.
Disease-modifying anti-rheumatic drugs (DMARDs A) – Treat rheumatoid arthritis by stopping your immune system from attacking your joints. Over time you’ll start experiencing less pain, swelling and stiffness8.
Corticosteroids – Work very well to reduce inflammation but have side-effects after prolonged use, so a low dosage is advised1.

Surgery

In the case of severe osteoarthritis, joint replacement surgery, for example, knee- or hip-replacement surgery, may be considered if nothing else is working for you1,3.

Keep your weight at a healthy level to avoid straining your joints unnecessarily. Fat tissue also promotes inflammatory cells that damage cartilage6.
Stay active to control your weight, lower blood sugar, strengthen supportive muscles and improve joint mobility3.
Protect your joints by practising good, healthy movement patterns to limit strain on your joints2.
Maintain a generally healthy lifestyle, which will lower your risk as you age or in the event that you have a genetic disposition – obesity and metabolic disease are major risk factors for osteoarthritis5.

A number of clever gizmos exist specifically to help people living with arthritis to perform everyday tasks. These include10:

  • Reacher: Helps you reach things without getting up or stretching.
  • Walker or cane: Helps negotiate uneven terrain.
  • Grab rails and bath bench: Prevent bathroom falls.
  • Jar openers: Make it easier to open jars on your own.
  • Grooming and dressing aids: Allow you to get ready on your own.

What to eat if you have arthritis:

Avoid

Gluten – found in wheat, barley and rye
Milk products
High calories
High salt
High glycaemic index
Refined sugar
Coffee processing substances
Trans fats
Omega-6 fatty acids
Alcohol – problematic, as it weakens the liver
Saturated fats – found in animal products

Eat more11

Fibre-rich foods
Low-GI foods
Antioxidant-rich foods
Omega-3 fatty acids
Vitamin D

What it feels like to have a a double-knee replacement

I had years of pain. Fifteen years ago I had an arthroscope where they cleaned out my knee joints and at that stage they didn’t mention the knee replacement. But it got more painful. At its worst it felt like a nagging toothache – and it’s constant. Nothing you take takes it away and it never goes away. If you sit and then stand it’s even worse.

Just over two years ago I went to a rheumatologist. She tested me and said I have 50% fibromyalgia and 50% osteoarthritis, but the osteoarthritis in my knees was very bad. When they X-rayed, they said it was bone on bone in both knees so they suggested knee replacements immediately. On my left knee, the bone was already wearing away.

My first op went so well that two-and-a-half months later I had the second knee done. I was in hospital for three days. The first day after the op the physiotherapist had me stand and the second day I started walking. Two days later I stopped taking the pain medication because I didn’t need it.

The second op was a bit more painful. I think it’s because I knew what was going to happen. But even though it was painful after the op, by the second day I could walk and climb stairs.

Back at home after the first op, I walked with crutches for two or three days and then one crutch for a week after the op. With the second op, within a week I was walking without crutches. For two or three weeks I also had to do some physio exercises at home. It took a year for my knees to heal completely. I could do a lot even in that time, though. I could nearly go onto my haunches even, but sometimes, like if you’re walking on uneven ground, your knee just makes you aware of it.

My knee replacement is the best thing I did. My knees feel fine now. There’s no throbbing, no aching, nothing. Just now and again my left knee tells me cold weather is coming. My scars are beautiful – very light and no keloid. And I can do things I wouldn’t do before. That nagging pain was very tiring and I would rather not go for a long walk because the pain afterwards wasn’t worth it. Now the only thing I don’t do is go down on my knees – it’s not sore, but it feels… weird. I would recommend a knee replacement. I was stupid to last so long without seeking medical advice.

Medical professionals in your corner

Speak to your GP about your symptoms first.

Rheumatologist: Specialises in arthritis and other diseases that involve the bones, joints and muscles – your GP may refer you to a rheumatologist if necessary3.

Physiotherapist: Can teach you to move better and help you strengthen the muscles around your joints – both of which will help take pressure off your joints4.

Occupational therapist: Advises you on how to adapt your home and workplace and recommends adaptive devices that will make day-to-day living easier10.

References

  1. Sokoloff, Leon. Joint disease. Encyclopedia Britannica. (2020) Available here: https://www.britannica.com/science/joint-disease
  2. NIH staff. Osteoporosis and Arthritis: Two Common but Different Conditions. (2018) Available here: https://www.bones.nih.gov/health-info/bone/osteoporosis/conditions-behaviors/osteoporosis-arthritis
  3. NIAMS Staff. Arthritis. Available here: https://www.niams.nih.gov/health-topics/arthritis
  4. NHS Staff: Overview: Arthritis. Available here: https://www.nhs.uk/conditions/arthritis/
  5. Mobasheri A, Henrotin Y. Biomarkers of (osteo)arthritis. Biomarkers. 20, 8. 513-8. (2015)
  6. Pujalte, George & Albano-Aluquin, Shirley. Differential Diagnosis of Polyarticular Arthritis. Am Fam Physician. 92, 1. 35-41. (2015)
  7. Okada Y, et al. Genetics of rheumatoid arthritis: 2018 status. Ann Rheum Dis. 78. 446-453. (2019)
  8. Demoruelle MK & Deane KD. Treatment strategies in early rheumatoid arthritis and prevention of rheumatoid arthritis. Curr Rheumatol Rep. 14, 5. 472-80. (2012)
  9. Mann, William, et al. Assistive Devices Used by Home-Based Elderly Persons with Arthritis. Am. J. Occup. Ther. 49, 810-820. (1995)
  10. Gioia C, et al. Dietary Habits and Nutrition in Rheumatoid Arthritis: Can Diet Influence Disease Development and Clinical Manifestations? Nutrients. 12, 5. 1456. (2020)

Learn more about other areas of pain.

Learn more about other areas of pain.