Arthritis

Overview

Arthritis is a broad term referring to joint inflammation and related conditions. Joints are places where two bones meet, such as your elbow or knee. Arthritis often refers to any disorder that affects the joints. In contrast, rheumatic disorders usually affect joints, tendons, ligaments, bones, and muscles.

Types of Arthritis

There are many different types of arthritis, each with different causes and treatments. These include:

• Ankylosing spondylitis causes inflammation in the joints and ligaments of the spine.
• Gout occurs as sudden, intense flares, typically in the big toe or a lower limb. 
• Juvenile idiopathic arthritis (JIA) is the most common type of chronic arthritis in children.
• Osteoarthritis (OA) is the most common type of arthritis. It generally affects older adults and leads to joint pain, stiffness, and swelling as cartilage breaks down over time.
• Polymyalgia rheumatica (PMR) is an inflammatory condition that causes pain and stiffness in the shoulders, upper arms, hip area, and neck. It mainly affects adults over 50.
• Psoriatic arthritis can occur in people who have psoriasis (scaly red and white skin patches). It affects the skin, joints, and areas where tissues attach to bone.
• Reactive arthritis is caused by an infection in your body; symptoms often clear up on their own within a few weeks or months.
• Rheumatoid arthritis is a chronic autoimmune disease that mostly affects the joints. 

Signs and Symptoms

Common symptoms of arthritis include pain, redness, heat, and swelling in the joints. Symptoms vary by condition:

• Ankylosing spondylitis produces redness, heat, swelling, and pain in the spine where it joins the pelvis. A distinguishing pattern of ankylosing spondylitis is that the pain often improves with movement and worsens with rest, sometimes waking people up at night.
• Gout causes sudden, sever joint pain, along with swelling, redness, and warmth, usually starting overnight with little warning.
• Juvenile idiopathic arthritis (JIA) leads to persistent joint pain, swelling, warmth, and stiffness that are typically worse in the morning and after a nap or prolonged sitting. Other symptoms may include eye inflammation (uveitis), skin changes, fever, and growth problems.
• Osteoarthritis causes pain, swelling, and loss of motion as bones rub together.
• Psoriatic arthritis can cause scaly, inflamed patches of skin often on the scalp, elbows, or knees.
• Reactive arthritis results in joint pain and swelling and may cause red, swollen eyes and a swollen urinary tract.
• Rheumatoid arthritis causes pain, swelling, and stiffness. Tiredness and fever may also be present.

Related Health Effects

In some types of arthritis, inflammation can also affect other organs, such as the eyes, heart, or skin, can also be affected. In severe forms of systemic JIA, this inflammation can develop in and around organs such as the spleen, lymph nodes, liver, and linings of the heart and lungs.

Causes and Risk Factors

Anyone can get arthritis. But certain groups of people may be more likely to develop different types of arthritis.

Juvenile Idiopathic Arthritis

In JIA, the body’s immune system mistakenly attacks some of its own healthy cells and tissues, resulting in inflammation. Scientists do not know why the immune system attacks healthy tissues in children with JIA, but they believe that a complex mix of genes and environmental factors is involved. JIA begins in children and adolescents before the 16th birthday.

Psoriatic Arthritis

Psoriatic arthritis is an immune-mediated disease in which the immune system overreacts and causes problems. Factors that may trigger the immune system include genes (many people who get psoriatic arthritis have a family history of the disease) and environmental factors such as obesity, infection, injury, or stress. Most people who get this disease already have psoriasis. On average, psoriatic arthritis develops about 7 to 10 years after the beginning of skin symptoms.

Prevention Guidance

There are ways to lower your risk of developing osteoarthritis specifically, such as staying physically active and keeping a healthy weight.

Other types of arthritis, like rheumatoid or psoriatic arthritis, are driven mainly by genetic and immune factors and can't be prevented the same way.

Strategies to help keep joints healthy include:

• Avoid joint injuries:
  • Stretch and warm up before playing sports or working out
  • Wear the right protective equipment and shoes to support and protect your joints
  • Cool down and stretch after physical activity
  • Give your body time to rest and recover after intense activity
• Exercise: Being physically active is one of the most important things you can do to keep your joints healthy; regular activity helps keep the muscles around your joints strong and working the way they should.
• Eat a balanced and healthy diet and maintain a healthy weight: Being healthy puts less stress on your joints and reduces wear and tear.
• Go to the doctor regularly for check-ups: Ask your doctor any questions you have about your joints.

Arthritis can affect old or young people. Keeping your joints healthy as a young person may help reduce your risk of getting osteoarthritis later in life.

Diagnosis

Symptoms vary by arthritis type but usually include joint pain and stiffness.

Healthcare providers can diagnose arthritis by:

• Reviewing your health and family history
• Doing a physical exam
• Taking X-rays
• Doing lab tests (as needed)

Once you know the type of arthritis you have, you can work with your provider to decide on the best ways to manage and treat it.

Treatment and Management

There is no cure for arthritis, many types can be treated and managed. Treatments depend on type of arthritis.

Osteoarthritis Treatment

Since there is no cure for osteoarthritis, doctors focus on treatments to ease pain, help you move better, and stop the disease from getting worse.

Rheumatoid Arthritis Treatment

Treatment of rheumatoid arthritis has improved significantly in recent years, helping many people relieve symptoms and maintain a good quality of life.

Gout Treatment

The goals for treating gout include reducing pain during flares, preventing future flares, preventing damage to joints, and managing related health complications.

Juvenile Idiopathic Arthritis Treatment

The goals of treatment for juvenile idiopathic arthritis are to control inflammation, reduce pain and stiffness, prevent joint and organ damage, preserve and improve joint function, and achieve remission. Most children with JIA need a combination of medicines and a healthy lifestyle, including a balanced diet and exercise, to reach these goals. Medicines may include anti-inflammatory and pain medicines, disease-modifying anti-rheumatic drugs, biologic response modifiers, and corticosteroids.

Find Clinical Trials

Clinical trials uncover better ways to prevent, diagnose, treat, and understand diseases and conditions. To ensure results apply to everyone, volunteers of all ages, sexes, and backgrounds, including both healthy individuals and those with specific medical conditions, are needed. Find clinical trials on arthritis.

Find Treatment

Treating arthritis can require a team effort involving you and several types of healthcare professionals, which may include:

• Rheumatologists, who specialize in arthritis and other chronic diseases affecting the bones, joints, muscles, and connective tissue
• Primary care doctors (such as a family physician or internal medicine specialist) who coordinates care between your different health providers
• Orthopaedic surgeons, who specialize in treatment and surgery for bone and joint diseases
• Physical therapists, who help improve joint function
• Occupational therapists, who teach ways to protect joints, minimize pain, perform activities of daily living, and conserve energy
• Dietitians, who teach about nutrition and maintaining a healthy weight
• Nurse educators, who help you understand your condition and start a treatment plans
• Physiatrists (physical medicine and rehabilitation specialists), who supervise exercise programs
• Psychologists or social workers, who help with psychosocial challenges of managing a medical condition.
• Chiropractors, who focus treatment on the relationship between the body’s structure, mainly the spine, and its function.

Research Information

The National Institutes of Health (NIH) is the largest public funder of biomedical research in the world. NIH invests most of its budget in medical research seeking to enhance life and to reduce illness and disability. NIH-funded research has led to breakthroughs and new treatments helping people live longer, healthier lives, and building the research foundation that drives discovery.  

Researchers supported by the NIH continue to study the cause of pain in people who have different types of of arthritis, as well as research to improve treatment options.

Find NIH-funded research projects using NIH RePORTER, a searchable database of current and past research projects supported by NIH and other federal agencies.