If you have achy knees, hips, fingers, ankles, shoulders, or other joints, you are in good company. Many people have joint pain, and arthritis is a common cause. The disease affects more than 54 million adults—approximately one in five—in the United States.

Types of Arthritis

1. Osteoarthritis (OA)

• Pathophysiology: OA involves the gradual degeneration of cartilage, which serves as a cushion between bones. This breakdown leads to bone-on-bone contact, causing pain, inflammation, and loss of joint function. The condition is associated with aging but can also result from joint injury or excessive stress.
• Risk Factors: Age, obesity, joint injuries, repetitive stress on joints, genetics.
• Diagnosis: Based on symptoms, physical examination, and imaging tests such as X-rays or MRI to observe cartilage loss and bone changes.

2. Rheumatoid Arthritis (RA)

• Pathophysiology: RA is characterized by chronic inflammation of the synovial membrane, which lines the joints. This inflammation leads to joint damage and deformity over time. It can also affect other organs due to systemic inflammation.
• Risk Factors: Gender (more common in women), family history, age (typically starts between 30 and 60 years), smoking, and specific genetic markers.
• Diagnosis: Based on symptoms, blood tests (such as rheumatoid factor and anti-CCP antibodies), and imaging studies to assess joint damage.

3. Gout

• Pathophysiology: Gout is caused by hyperuricemia, or elevated uric acid levels in the blood, which leads to the formation of uric acid crystals in the joints. This results in intense inflammatory reactions and severe pain.
• Risk Factors: Diet (high purine foods), obesity, certain medications, genetic predisposition, chronic kidney disease.
• Diagnosis: Based on symptoms, blood tests for uric acid levels, and joint fluid analysis to identify uric acid crystals.

4. Reactive Arthritis

• Pathophysiology: Reactive arthritis occurs as a reaction to an infection elsewhere in the body, leading to joint inflammation. It often follows genitourinary or gastrointestinal infections.
• Risk Factors: Recent infection (especially sexually transmitted infections), genetic predisposition (HLA-B27 positive individuals).
• Diagnosis: Based on recent history of infection, symptoms, and exclusion of other types of arthritis. Blood tests and joint fluid analysis may be used.

5. Psoriatic Arthritis

• Pathophysiology: This type of arthritis occurs in people with psoriasis and involves both skin and joint inflammation. It can lead to joint damage and changes in skin and nail appearance.
• Risk Factors: Having psoriasis, family history of psoriasis or psoriatic arthritis, genetic factors.
• Diagnosis: Based on the presence of psoriasis, joint symptoms, and sometimes imaging studies. Blood tests may help rule out other types of arthritis.

Symptoms of Arthritis

• Osteoarthritis (OA): Pain is often described as a deep ache centered in the joint, typically aggravated by activity and relieved by rest. Morning stiffness is common but usually improves with movement. Other symptoms include joint swelling and a grinding sensation.
• Rheumatoid Arthritis (RA): Pain is often described as a dull ache, and stiffness is usually most severe in the morning. RA can cause joint deformities and other systemic symptoms like fatigue and low-grade fever.
• Gout: Pain is sudden and severe, often starting at night. Joints may be red, swollen, and extremely tender. The pain is usually intense during a gout attack and may be accompanied by fever.
• Reactive Arthritis: Symptoms may include joint pain, swelling, and redness, often following an infection. It may also affect other areas like the eyes or urinary tract.
• Psoriatic Arthritis: Symptoms include joint pain and stiffness, and the presence of psoriasis patches. The type of arthritis can vary, affecting different numbers of joints and areas.

Joints Most Commonly Affected

• Osteoarthritis (OA): Commonly affects weight-bearing joints like the knees, hips, and spine. It can also impact the hands, especially the distal interphalangeal joints.
• Rheumatoid Arthritis (RA): Typically affects joints in a symmetrical pattern, including the hands, wrists, knees, and feet.
• Gout: Most commonly affects the big toe, but can also involve other joints like the knee or ankle.
• Psoriatic Arthritis: Can affect any joint, including the spine and pelvis, with varying patterns of involvement.

Self-Care Strategies for Arthritis

• Heat and Cold Therapy: Heat can help relax muscles and alleviate joint stiffness, while cold can reduce inflammation and numb pain. It’s important to use these therapies appropriately and follow any guidance provided by a healthcare professional.
• Massage: Can help with pain relief by improving blood circulation and reducing muscle tension. It’s beneficial to work with a therapist experienced in arthritis care.
• Exercise: Regular physical activity strengthens the muscles around the joints, improves flexibility, and can help with weight management. Low-impact exercises like swimming and cycling are generally recommended.
• Diet: For gout, reducing purine intake (found in red meat, certain fish, and alcohol) can help manage symptoms. A balanced diet rich in omega-3 fatty acids, fruits, vegetables, and whole grains is beneficial for overall joint health.
• Physical Therapy: Occupational therapists can suggest modifications to daily activities and provide assistive devices. Physical therapists can design specific exercises to improve joint function and reduce pain.

Treatment Options for Arthritis

• Medication:
  • Over-the-Counter: Pain relievers like acetaminophen and NSAIDs help manage symptoms.
  • Prescription: DMARDs (for RA), JAK inhibitors, and other medications like corticosteroids or biologics may be prescribed for more severe cases.
• Injections: Corticosteroids can reduce inflammation, while hyaluronic acid can provide lubrication to the joint. Biologics are advanced medications used for severe cases of RA and psoriatic arthritis.
• Surgery: Options include arthroscopy (to remove inflamed tissue), joint replacement (for severely damaged joints), or tendon repair (for RA-related damage).