Arthritis

Arthritis is a common condition that causes pain and inflammation (swelling) of the joints and bones.

The main symptoms of  arthritis include:

• pain
• stiffness
• restricted movements of the joints
• inflammation and swelling
• warmth and redness of the skin over the joint

Types of arthritis

There are over 200 different types of rheumatic diseases (diseases that cause aches and pains in a person’s bones, joints, and muscles).

Some of the most common types of arthritis include:

• ankylosing spondylitis - a chronic (long-term) type of arthritis that affects the bones, muscles and ligaments of the spine
• cervical spondylitis - also known as degenerative osteoarthritis, cervical spondylitis affects the joints and bones in the neck
• fibromyalgia - a condition that causes pain in the muscles, ligaments, and tendons, as well as all over the body
• systemic lupus erythematosis (lupus) - a chronic (long-term) condition that causes inflammation in the body's tissues
• gout - a type of arthritis that usually affects the big toe, but can develop in any joint in the body
• psoriatic arthritis- joint inflammation that affects people with the skin condition psoriasis
• reactive arthritis - also known as Reiter’s syndrome, reactive arthritis can cause inflammation of the joints, eyes, and urethra (the tube that runs from the bladder through the penis or the vulva, through which urine is passed)
• secondary arthritis- a type of arthritis that can develop after a joint injury, and sometimes occurs many years after the injury
• polymyalgia rheumatica - a condition where the immune system attacks healthy tissue, causing muscle pain, stiffness, and joint inflammation

How common is arthritis?

Arthritis is a very common condition in the UK, affecting over nine million people. Two of the most common forms of arthritis are:

• osteoarthritis
• rheumatoid arthritis

The characteristics of these two conditions are described below.

Osteoarthritis

Osteoarthritis is the most common form of arthritis in the UK, affecting an estimated 8.5 million people.

In osteoarthritis, the cartilage (connective tissue) between the bones gradually wastes away (degenerates), leading to painful rubbing of bone on bone in the joints. It may also cause joints to fall out of their natural positions (misalignment). The most frequently affected joints are in the hands, spine, knees, and hips.

Osteoarthritis often develops in people who are over 50 years of age. However, the condition can develop at any age as a result of an injury or another joint condition.

Osteoarthritis begins slowly, causing pain, stiffness, and restricted movement in the affected joints. Some people only experience slight stiffness, whereas others go on to have cracking, or creaking, joints (crepitation), knobbly bone growths (particularly on the hands), and joints that move out of alignment. The pain and loss of movement tends to get worse throughout the day, as the joints are used more.

The cause of osteoarthritis is not fully known. One theory is that some people are genetically predisposed to developing the disease, but this has not yet been proven. Factors that may contribute to the development of osteoarthritis include:

• obesity, which puts added strain on joints
• jobs, or activities, that involve repetitive movements of a particular joint
• previous damage to the joint, such as from a sports injury

See the Health A-Z topic about Osteoarthritis for more information about the condition.

Rheumatoid arthritis

Rheumatoid arthritis is a more severe, but less common, form of arthritis than osteoarthritis. In this condition, the body's immune system attacks and destroys the joint, causing pain and swelling to occur. This can lead to a reduction in movement, and the breakdown of bone and cartilage.
 
Rheumatoid arthritis affects 350,000 in the UK and often starts between 40 and 50 years of age. Women are three times more likely to be affected by rheumatoid arthritis than men.

Like osteoarthritis, rheumatoid arthritis begins gradually, with the first symptoms often being felt in small joints, such as in the fingers or toes. The condition can then progress to cause pain, swelling, and stiffness in other joints, and a lack of mobility.

The symptoms of rheumatoid arthritis are often worse in the morning, with cold and damp weather sometimes aggravating the condition. However, the symptoms may improve during the day as you start to use and flex your joints. Rheumatoid arthritis can also sometimes leave you feeling generally unwell and tired.

Rheumatoid arthritis is caused by a faulty immune system (the body’s natural defence against infection) that makes the body attack its own tissues. The fault may be inherited genetically (passed on from a family member).

See the Health A-Z topic about Rheumatoid Arthritis for more information about the condition.

Arthritis and children

Arthritis is often associated with older people, but sometimes it can also affect children, known as juvenile idiopathic arthritis (JIA). However, JIA is uncommon, affecting about one in 1,000 children.

The main types of JIA are outlined below.

Oligo-articular JIA

Oligo-articular JIA is the most common type of JIA. It affects four or fewer joints in the body, most commonly in the knees, ankles, and wrists.

Oligo-articular JIA has good recovery rates, and long-term effects are rare. However, there is a risk of developing eye problems, is associated with the, so children with condition should have regular eye checks with an eye specialist (ophthalmologist).

Polyarticular JIA (or polyarthritis)

Polyarticular JIA (or polyarthritis) is type of JIA that affects five or more joints, and can develop at any age during childhood.

The symptoms of polyarticular JIA are very similar to those of adult rheumatoid arthritis, and can quickly spread from one joint to another. The condition is often accompanied by a rash and a high temperature (fever) of 38C (100.4F) or above.

Systemic onset JIA

Systemic onset JIA begins with symptoms, such as a fever, rash, lethargy (a lack of energy), and enlarged glands. Later on, joints can become swollen and inflamed. Like polyarticular JIA, systemic onset JIA can also affect children of any age.

Enthesitis-related arthritis

Enthesitis-related arthritis is a type of juvenile arthritis that affects older boys or teenagers. The condition can cause pain in the soles of the feet and around the knee and hip joints where the ligaments attach to the bone.
 
More information about arthritis in children can be found on the Arthritis Care website.

Outlook

There is no cure for arthritis, but there are a number of treatments that can be used to slow down the progress of the condition. For example, medication can help to relieve the symptoms of arthritis and, in the most severe cases, surgery may be used.

Osteoarthritis

For osteoarthritis, analgesics (painkillers), non-steroidal anti-inflammatory drugs (NSAIDs), and corticosteroids may be prescribed.

NSAIDs help to relieve pain and reduce inflammation and joint swelling. Corticosteroids can also help reduce inflammation by suppressing the immune system.

Surgery may be recommended in very severe cases of osteoarthritis. Some of the different types of surgery that are used to treat osteoarthritis are briefly outlined below.

• Arthroplasty - a procedure that is also known as joint replacement therapy and is most commonly carried out to replace knee and hip joints.
• Arthrodesis - a type of surgery that fuses your joint in a permanent position. It will not relieve swelling and stiffness, but your joint will be much stronger and less painful.
• Osteotomy - where a surgeon adds or removes a small section of bone either above or below your knee joint.

Arthroplasty and osteotomy are also sometimes used to treat the most severe cases of rheumatoid arthritis.
 
See the Health A-Z topic about Osteoarthritis - treatment for more information about the various treatments that are available for the condition.

Rheumatoid arthritis

Treatments for rheumatoid arthritis aim to slow down the condition’s progress, and minimise the amount of joint damage.

Treatments that may be recommended for rheumatoid arthritis include analgesics (painkillers), disease modifying anti-rheumatic drugs (DMARDs), physiotherapy, and regular exercise.

DMARDs relieve pain and help to slow down the activity in the immune system (immunosuppressants), reducing the amount of damage it does to the body.

See the Health A-Z topic about Rheumatoid arthritis - treatment for more information about the various treatments that are available for the condition.

Support groups

There are several support groups, such as Arthritis Research UK and Arthritis Care that offer advice and support for people with arthritis and their families.