Arthritis is an inflammation of the joints. It is caused by many disorders that affect the joints and their surrounding tissues. Arthritis affects people of all ages, but is more common in people over the age of 65.
A body’s protective immune response to injury or infection. The accumulation of fluid, cells and proteins at the site of an infection or physical injury, resulting in swelling, heat, redness, pain and loss of function.
A connecting surface or tissue between two bones.
Causes of arthritis depend on the specific type of arthritis and are detailed under the heading 'Types'.
Some general risk factors for developing arthritis include:
A tough, flexible connective tissue found in various parts of the body including the joints and larynx.
A unit of inheritance (heredity) of a living organism. A segment of genetic material, typically DNA, that specifies the structure of a protein or related molecules. Genes are passed on to offspring so that traits are inherited, making you who you are and what you look like.
Related to genes, the body's units of inheritance or origin.
Entry into the body of microorganisms that can reproduce and cause disease.
A body’s protective immune response to injury or infection. The accumulation of fluid, cells and proteins at the site of an infection or physical injury, resulting in swelling, heat, redness, pain and loss of function.
A connecting surface or tissue between two bones.
The word ‘stress’ can have a variety of meanings, but generally describes the physical and mental responses of the body to a demand placed upon it. Often used to describe conditions where the demand is high or unable to be resolved and creates anxiety and tension.
There are many types of arthritis. Some of the more common ones are:
Rheumatoid arthritis (RA) is a chronic and generally progressive autoimmune disorder causing inflammation of the membranes lining the joints. It typically affects the smaller joints of the hand and feet.
Osteoarthritis (OA) is caused by the degeneration of cartilage, which loses its elasticity and becomes more easily damaged with age. It typically affects weight-bearing joints such as the hips and knees.
The progression of osteoarthritis.
Juvenile arthritis is any type of arthritis occurring under the age of 16 years. As young people have not suffered from the same mechanical damage caused by ageing, most cases of arthritis in young people are likely due to autoimmune disorders, although the causes of many cases are unknown.
Infectious arthritis is a joint infection due to bacteria, viruses or fungi. Usually the infection is established elsewhere in the body and reaches the joints by the bloodstream, or by getting directly into the joint through an open injury.
Polymyalgia rheumatica is a type of arthritis that causes inflammation in the larger joints and their surrounding tissues, such as the hips and shoulder joints. It causes muscle pain and stiffness in these areas. It is a common form of arthritis and mainly affects the elderly, but it is treatable. It is not to be confused with fibromyalgia, a different condition in which muscle pain and stiffness can occur anywhere in the body, not just the joints. Fibromyalgia does not cause inflammation. Rather, it is likely the result of overactive pain signals.
Psoriatic arthritis is an autoimmune disorder of the joints that can develop if you have psoriasis. While the exact cause is unknown, psoriatic arthritis is associated with HLA-B27, a protein on the surface of white blood cells that is linked to certain autoimmune disorders. If you have psoriatic arthritis, you should take note of what seems to trigger flare-ups, avoid those triggers and ensure you receive ongoing treatment as recommended by your doctor. In about 5% of cases, people develop a more severe form that results in bone deformities.
Gout is a type of arthritis caused by a build-up of uric acid (urate crystals) in the joints. Men are more likely to get gout, although the risk for women increases after menopause. Gout is one of the few causes of arthritis that can be effectively treated to prevent future damage.
Gout.
SLE, more commonly just referred to as lupus, is an autoimmune disorder. Its exact cause is unknown, but could be due to any or a combination of genetics, viruses, stress, or sunlight, among others. Flare-ups, which can vary in duration and severity, are periods when symptoms get worse. Most people with lupus can live a full life, if they stick to their treatment program. In some cases, however, complications can occur that can be life-threatening.
Bursitis is the inflammation of the bursa, which are small fluid-filled sacs between adjoining structures of joints, such as bones, muscles, and tendons. Technically bursitis is not a type of arthritis, because the bursa are outside the joints. It can be caused by injury or underlying conditions, such as rheumatoid arthritis.
Polymyositis is a disorder of connective tissue that causes inflammation, the cause of which is unknown. It affects women more than men and tends to occur between the ages of 50-70 years, but can affect people of all ages.
A medical condition in which the body's immune system abnormally targets substances that are normally found within the body.
A tough, flexible connective tissue found in various parts of the body including the joints and larynx.
Related to genes, the body's units of inheritance or origin.
A body’s protective immune response to injury or infection. The accumulation of fluid, cells and proteins at the site of an infection or physical injury, resulting in swelling, heat, redness, pain and loss of function.
A connecting surface or tissue between two bones.
A rare condition in which excess collagen fibers are produced by the body, affecting the skin and internal organs.
The word ‘stress’ can have a variety of meanings, but generally describes the physical and mental responses of the body to a demand placed upon it. Often used to describe conditions where the demand is high or unable to be resolved and creates anxiety and tension.
A thin layer of tissue that lines the surfaces of organs or cells.
An autoimmune condition marked by painful and swollen joints, pain during urination and eye redness.
Symptoms vary according to the cause of arthritis. Common symptoms include:
A feeling of tension, nervousness and dread about future events. It can trigger physical symptoms such as a rapid pulse or breathing difficulties.
A state of exhaustion and weakness.
A connecting surface or tissue between two bones.
Methods used to diagnose arthritis are:
Your doctor will likely look for signs of:
ESR is a test used to indicate inflammation, but it does not diagnose a specific disorder. For this test a blood sample is taken and the rate at which red blood cells accumulate at the bottom of a test tube is measured. The higher the rate, the greater the degree of inflammation. Normal values will vary between laboratories according to different methods used. Your doctor will tell you what your results mean.
Measuring CRP levels in the blood provides an indication of the degree of inflammation in the body. CRP is a general test that indicates that there is inflammation somewhere in the body, but does not localize the inflammation or identify its underlying cause. Your doctor may order this test to check if anti-inflammatory medicine is working, or during any flare-up periods of the inflammatory diseases.
Anti-CCP antibodies are auto-antibodies, which means they are mistakenly directed against a person's healthy tissues instead of microorganisms. This test is used to confirm a diagnosis of rheumatoid arthritis.
RF is an auto-antibody directed against one of the body's antibodies, called immunoglobulin G (IgG). RF binds to IgG, forming immune complexes. When these complexes are deposited in the joints, they produce a reaction that causes inflammation. Up to 70% of people with rheumatoid arthritis have RF in their blood, but some people without rheumatoid arthritis can have it too.
Normally the immune system produces antibodies to fight infection. ANAs attack your body's own cells. A positive result for ANAs does not necessarily mean you have an autoimmune disorder, because it can be caused by other conditions or certain medications. Some healthy people also have ANAs and this increases with age.
HLAs are found on the surface of white blood cells. A particular type, HLA-B27, is associated with certain autoimmune disorders that may cause arthritis. In a healthy person, HLA-B27 will generally be absent, but its presence in your blood does not necessarily mean you have an autoimmune condition.
A protein molecule produced by the immune system. Antibodies bind specifically to foreign substances to neutralize them or target them for destruction.
A medical condition in which the body's immune system abnormally targets substances that are normally found within the body.
A chemical waste product of protein metabolism that is filtered from the blood by the kidneys.
A scan that uses X-rays to create a 3D image of the body. This can detect abnormalities more effectively than a simple X-ray can.
A type of antigen associated with particular inflammatory diseases.
Entry into the body of microorganisms that can reproduce and cause disease.
A body’s protective immune response to injury or infection. The accumulation of fluid, cells and proteins at the site of an infection or physical injury, resulting in swelling, heat, redness, pain and loss of function.
A connecting surface or tissue between two bones.
A type of imaging that uses a magnetic field and low-energy radio waves, instead of X-rays, to obtain images of organs.
Cells in the blood that transport oxygen from the lungs throughout the body and carbon dioxide from the body to the lungs.
A chemical that is a by-product of the digestion of proteins. It is filtered from the blood and excreted from the body as part of the urine.
A scan that uses ionizing radiation beams to create an image of the body’s internal structures.
A type of antibody produced by the body in response to an infection by bacteria, viruses or fungi, to protect the body in the future from the same infection.
An infection caused by Borrelia bacteria that is spread through a tick bite. It may cause a characteristic rash and/or non-specific symptoms that mimic other conditions.
Refers to the immunological properties in the clear component of the blood (i.e. serum), once all the blood cells and clotting factors are removed.
Treatment options your doctor will consider include:
These medications reduce pain and some are available without a prescription, such as acetaminophen and low-dose codeine. Some that require a prescription include oxycodone, propoxyphene and higher-dose codeine.
NSAIDs are a group of medications that reduce inflammation, pain and fever. As such, they are used to ease these symptoms in a wide range of conditions. Examples are ibuprofen and naproxen.
DMARDs are a range of drugs that act on the immune system in different ways to prevent inflammation. They include drugs such as methotrexate, sulfasalazine and hydroxychloroquine. Their effects are not immediate and can take weeks to months to be noticed. Unlike NSAIDs, early intervention with DMARDs can slow down disease progression.
Biological therapies can work faster than DMARDs. They are drugs that act on the immune system and are sometimes used in conjunction with other medication if you have rheumatoid arthritis.
These are powerful anti-inflammatories that block the inflammatory pathway of the immune response. They can be taken orally or injected. Injection is usually only required in extreme cases of inflammation that only affect one or two joints.
Physiotherapy can help by improving mobility, flexibility and strength in arthritic joints.
When non-surgical methods fail, an orthopedic surgeon may perform surgery to:
Regular exercise can help improve flexibility, improve supporting-muscle strength and reduce fatigue.
Assistive devices, such as walkers, canes and raised toilet seats, are available to help protect the joints and improve your ability to perform daily tasks.
Applying icepacks or heating pads may help reduce pain. However, speak to your doctor first, as this can make some types of arthritis worse.
Unproven therapies for arthritis include oral glucosamine and chondroitin, and acupuncture.
A form of complementary therapy that involves fine sterilized needles being inserted into the skin at specific points to treat medical conditions.
A state of exhaustion and weakness.
A naturally-occurring substance found in connective tissues such as cartilage.
A body’s protective immune response to injury or infection. The accumulation of fluid, cells and proteins at the site of an infection or physical injury, resulting in swelling, heat, redness, pain and loss of function.
A connecting surface or tissue between two bones.
A healthcare profession that treats bodily weaknesses or defects with physical remedies, such as massage or exercise.
Side effects associated with long-term use of NSAIDs can be gastritis and ulcers in the digestive system. NSAIDs can also interact with other drugs. If you are taking NSAIDs for arthritis, your doctor or pharmacist will tell you what drugs you should not mix with them.
DMARDs can have a wide range of side effects depending on the agent used. Methotrexate can weaken the immune system, resulting in increased susceptibility to infection. It can also cause damage to the lungs and liver. Side effects and potential complications will be closely monitored by your treating doctor.
Biological therapies can result in the formation of anti-drug antibodies (ADAs), which can reduce the effectiveness of a treatment. Further research is needed to identify the optimal dosage required to reduce the problem of ADA formation. Biological therapies can also weaken the immune system, making it harder for the body to fight infections.
Side effects of long-term oral or intravenous corticosteroids, include osteoporosis, a weakened immune system, weight gain, glaucoma, muscle weakness and elevated blood pressure.
A protein molecule produced by the immune system. Antibodies bind specifically to foreign substances to neutralize them or target them for destruction.
The pressure the blood places on the walls of the arteries, largely mirroring the contraction of the heart, and consisting of two readings. The higher reading is systolic blood pressure, when the heart contracts, and the lower is diastolic blood pressure, when the heart is relaxed.
A condition in which there is increased pressure in the eyeball, gradually resulting in loss of sight.
Entry into the body of microorganisms that can reproduce and cause disease.
A condition in which bone loses mass and density and becomes weak, brittle and prone to fracture. Osteoporosis is often the result of a deficiency of calcium or vitamin D, or hormonal changes.
An open sore in the skin or mucous membranes such as those of the stomach lining, intestine or mouth.
The outlook for arthritis varies, according to the underlying cause and response to treatment. Most forms of arthritis are chronic, with only a few able to be cured with treatment. Early diagnosis generally results in better treatment outcomes.
Ways you can help prevent the development of arthritis include: