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Bending your knees to climb the stairs. Moving your fingers to button a shirt. Swaying your hips to a favorite song. Most of us don’t give much thought to these simple movements, unless they start to become painful or difficult. That can happen when a person has arthritis.
What is arthritis?
Arthritis is a progressive condition marked by pain or stiffness in the joints—parts of the body where two or more bones meet (like the elbow, wrist, or knee). It can be caused by simple wear and tear or by an overactive immune system, depending on the type of arthritis. But in both cases, the condition can make it harder to carry out everyday activities and have a major impact on a person’s quality of life.
Roughly 58.5 million US adults have been diagnosed with arthritis, and that number is expected to jump to 78 million by 2040, according to the Centers for Disease Control and Prevention. It’s the leading cause of work disability, and may increase a person’s risk for problems like excess body fat and depression.
“With arthritis, even the simplest tasks can become monumental. Whether it’s knitting, hiking, cycling, or just playing with a beloved pet, the pain, stiffness and limitations that come with arthritis can render these activities difficult,” says Elizabeth Ortiz, M.D., a Dallas-based rheumatologist in private practice and medical director of Motto Health.
The condition doesn’t have to sideline you, though. With the right care plan, you can keep your arthritis symptoms in check and find ways to do more of the things you love with less pain.
Types of arthritis
You might be surprised to hear that there are more than 100 types of arthritis. While each kind has its own specific symptoms, most can be lumped into one of two big categories.
Osteoarthritis or OA is the most common type of arthritis. It’s sometimes called degenerative arthritis, since it happens when wear and tear (from repeatedly using a joint or injuring it) causes damage to a joint’s cartilage. Cartilage is the smooth, flexible tissue that cushions the ends of your bones, allowing your joints to move without friction. Once it becomes damaged or roughened, the joint bones begin to grind directly on each other, causing pain and stiffness that typically gets worse with activity or as the day goes on.
OA can happen in any joint, but it most often involves weight-bearing joints like the knees or the hips and typically affects them asymmetrically. “Experts don’t fully know why, but each joint is an independent variable with OA. One could easily have mild OA in the left knee, severe OA in the right hip, and no OA at all in other joints”, says Benjamin Bengs, M.D., an orthopedic surgeon at Providence Saint John’s Health Center in Santa Monica, CA.
Simply getting older is a major risk factor, since age alone can cause joint cartilage to wear down. You’re even more prone if you’ve regularly engaged in high-impact sports (like running, dancing, or basketball), have a job that requires a lot of bending or squatting, or if you’ve sustained a joint injury (from playing sports or from a car accident, for instance). Women are also significantly more likely to develop OA than men, though experts don’t fully understand why.
While osteoarthritis develops from wear and tear, inflammatory arthritis is an autoimmune condition where the immune system mistakenly attacks healthy joint tissue. This, too, can cause pain, stiffness, swelling, and inflammation that tends to get worse with activity and ease up when a person rests. The pain and stiffness can also be intense first thing in the morning.
The most common type of inflammatory arthritis is rheumatoid arthritis or RA. Joints on both sides of the body are typically affected, especially those in the hands, wrists, fingers, knees, ankles, and feet. But RA’s problems can also be more far-reaching—especially when the condition isn’t well-managed—increasing the risk for fatigue, dry mouth, digestive trouble, hives, or slow-to-heal wounds, as well as lung scarring and heart disease. Its immune system ties also mean that RA also makes people more prone to complications from illnesses like the flu or COVID-19, research shows.
Unlike osteoarthritis, aging isn’t a risk factor for RA. In fact, it most often develops in a person’s 30s, 40s, or 50s, and can even develop in kids and teens. It tends to run in families, and again, is significantly more common in women than in men.
There are other types of inflammatory arthritis too, including:
Psoriatic arthritis, arthritis that occurs in people who have the skin condition psoriasis
Ankylosing spondylitis, arthritis that affects the spine
Gout, arthritis caused by the buildup of crystals in the joints, most often affecting the big toe
Reactive arthritis, pain or swelling caused by an infection
Different types and the potential to affect different joints means that arthritis symptoms tend to be pretty individualized. One person with osteoarthritis in their knee might hear cracking or popping when they bend down to grab something or feel like the knee might buckle when they try to stand back up. Another with rheumatoid arthritis in their fingers might find it difficult to write a check or a grocery list and struggle with chronic fatigue or brain fog, for instance.
But some arthritis symptoms tend to show up across the board. Though the severity isn’t always the same, most people will experience:
Decreased range of motion
Feeling of joint weakness or instability
Arthritis can affect your mood too. In fact, up to 1 in 5 people with the condition have symptoms of depression or anxiety. “When faced with chronic joint pain and an inability to do the activities we once loved, it is only natural for our mood to be impacted,” Dr. Ortiz says. Problem is, these feelings can end up zapping a person’s motivation to manage their arthritis, which can lead to a cycle of worsening symptoms and worsening mood.
Osteoarthritis and inflammatory arthritis stem from different causes. OA happens when cartilage surrounding the joint starts to break down, leading the bones surrounding the joint to grind against each other. It’s often the result of age-related wear and tear, but can be exacerbated by joint injuries or years of performing high-impact activities.
Inflammatory forms of arthritis like RA occur when the immune system mistakenly attacks the lining of the joints, causing the joints to become swollen and inflamed. Experts don’t fully understand what triggers this immune response, but it likely has to do with genes (you’re more likely to get RA if close family members have it) and environmental factors like exposure to certain viral infections.
Women are at higher risk for developing both OA and RA. Being overweight or obese can also make a person more prone to arthritis. Excess weight puts more pressure on joints, but there may be more to it. Fat cells can give off inflammatory signals, and simply having more of them may increase inflammation throughout the body, including inflammation around the joints, explains Micah Yu, M.D., an integrative rheumatologist in private practice in Newport Beach, CA.
The goal of arthritis care is to limit a person’s pain and improve their function so they can do more of their everyday activities. For RA, it’s also about controlling inflammation and slowing the disease’s progression. That usually involves a combo of medication, therapy, and lifestyle changes, and in some cases, surgery.
Both oral and topical meds can help manage osteoarthritis pain. Some people rely on OTC pain relievers like acetaminophen or NSAIDs ibuprofen, but when that’s not enough, prescription NSAIDs or chronic pain meds like duloxetine can offer more relief.
OTC or prescription pain relievers such as NSAIDs can also be helpful for rheumatoid arthritis. But disease-modifying drugs (DMARDs) and biologics such as hydroxychloroquine, methotrexate, adalimumab, or rituximab also play an important role, since they can help prevent or delay the onset of worsening symptoms and permanent joint damage.
Injectable meds may be another option when oral or topical treatments aren’t doing enough. Your doctor might recommend a corticosteroid injection to temporarily relieve intense pain or inject a lubricant like hyaluronic acid to provide extra cushioning around a painful joint.
During sessions with a physical or occupational therapist, you’ll learn stretching and strengthening exercises that can go a long way towards reducing your joint pain and making movement easier and more comfortable. In fact, one study found that adults with knee osteoarthritis who participated in regular physical therapy experienced less pain and disability after one year compared to those who received steroid injections.
Healthy habits won’t make arthritis go away. But when adopted as part of a comprehensive treatment plan, you’ll likely notice that you have less joint discomfort and more energy, so you feel better overall. Some behaviors to consider:
Manage your weight. Being overweight or obese can exacerbate pain by putting extra pressure on your joints, especially the hips and the knees.
Be active. It might seem counterintuitive, but the more you move, the better you’ll feel. “Regular exercise can help lubricate joint cartilage and reduce stiffness and pain,” Dr. Yu says. The key is picking activities that are gentle on your joints (and getting the green light from your doctor before starting): Opt for low-impact workouts like walking, swimming, cycling, tai chi, or yoga over high-impact ones that involve running, jumping, or pounding.
Get enough sleep. Quality sleep can be harder to come by when you’re in pain. At the same time, sleep deprivation can make your arthritis symptoms feel worse, studies show. Make it a point to practice good sleep hygiene, and if that’s not enough, see your doctor to be evaluated for a possible sleep disorder.
Eat a healthy diet. A dietary plan rich in anti-inflammatory foods (fruits and vegetables, fatty fish, whole grains, legumes, and healthy fats) can significantly reduce pain for people with RA. Choosing nutritious foods can also make it easier to maintain a healthy weight, regardless of arthritis type.
Consider supplements, but be skeptical. Options like fish oil have been shown to reduce pain for people with RA as well as OA. But not every supplement is as effective as it might claim, and some could have negative side effects, Dr. Bengs says. If you’re thinking about trying a vitamin or herbal remedy, check with your doctor first.
Practice self-care. Dealing with joint pain can be discouraging. Carving out time for stress-reducing activities like yoga, journaling, or even listening to music can lift your mood. Talking with a therapist can also be helpful.
You and your doctor might decide to consider surgery to repair or restore damaged joints when other treatment options haven’t delivered the relief you’re looking for. Depending on your symptoms, the procedure might involve removing inflamed joint linings, repairing tendons, fusing or realigning joints, or replacing joints that are badly damaged.
When to see a doctor
Aches or pains that last a day or two generally aren’t cause for concern. But you should let your doctor know if you’re experiencing persistent joint pain, stiffness, or swelling, or if you’re experiencing joint symptoms that are getting in the way of your everyday activities. Rheumatoid arthritis needs to be treated early in order to stave off permanent joint damage. And regardless of your arthritis type, getting care sooner can help you feel better.
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