• Salil Shukla


Arthritis is an inflammation of the joints. It can affect one joint or multiple joints. There are more than 100 different types of arthritis, with different causes and treatment methods. Two of the most common types are osteoarthritis (OA) and rheumatoid arthritis (RA).

The symptoms of arthritis usually develop over time, but they may also appear suddenly. Arthritis is most commonly seen in adults over the age of 65, but it can also develop in children, teens, and younger adults. Arthritis is more common in women than men and in those who are overweight.

Although the word "arthritis" means joint inflammation, the term is used to describe around 200 rheumatic diseases and conditions that affect joints, the tissues that surround the joint, and other connective tissue.

Types of arthritis

There are around 200 types of arthritis - or musculoskeletal conditions - which are split into seven main groups:

  • Inflammatory arthritis

  • Degenerative or mechanical arthritis

  • Soft tissue musculoskeletal pain

  • Back pain

  • Connective tissue disease

  • Infectious arthritis

  • Metabolic arthritis.

Risk factors for arthritis

Certain factors have been shown to be associated with a greater risk of arthritis. Some of these risk factors are modifiable while others are not.

Non-modifiable arthritis risk factors:

  • Age: the risk of developing most types of arthritis increases with age

  • Sex: most types of arthritis are more common in females; 60% of all people with arthritis are female. Gout is more common in males than females

  • Genetic: specific genes are associated with a higher risk of certain types of arthritis, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and ankylosing spondylitis.

Modifiable arthritis risk factors:

  • Overweight and obesity: excess weight can contribute to both the onset and progression of knee osteoarthritis

  • Joint injuries: damage to a joint can contribute to the development of osteoarthritis in that joint

  • Infection: many microbial agents can infect joints and trigger the development of various forms of arthritis

  • Occupation: certain occupations that involve repetitive knee bending and squatting are associated with osteoarthritis of the knee.

What Causes Arthritis?

Cartilage is a firm but flexible connective tissue in your joints. It protects the joints by absorbing the pressure and shock created when you move and put stress on them. A reduction in the normal amount of this cartilage tissue cause some forms of arthritis.

Normal wear and tear causes OA, one of the most common forms of arthritis. An infection or injury to the joints can exacerbate this natural breakdown of cartilage tissue. Your risk of developing OA may be higher if you have a family history of the disease.

Another common form of arthritis, RA, is an autoimmune disorder. It occurs when your body’s immune system attacks the tissues of the body. These attacks affect the synovium, a soft tissue in your joints that produces a fluid that nourishes the cartilage and lubricates the joints.

RA is a disease of the synovium that will invade and destroy a joint. It can eventually lead to the destruction of both bone and cartilage inside the joint.

The exact cause of the immune system’s attacks is unknown, but scientists have discovered genetic markers that increase your risk of developing RA tenfold.

Impact of arthritis

Arthritis has a significant impact on individuals, for example:

  • Almost 43.2% (22.7 million) of adults with arthritis report limitations in their usual activities

  • 40% report that it is "very difficult" or they "cannot do" at least 1 of 9 important daily functional activities

  • Almost 8 million adults who report an activity limitation due to arthritis also report severe limitation in their ability to stoop, bend, or kneel, and 6 million cannot walk 0.25 miles

  • 31% (8.3 million) of working age adults with arthritis report limitations in work.

Impairment in the ability of people with arthritis to perform essential daily tasks may interfere with their work, their sense of purpose in their community, or the care they can provide for their family.


Around 18% of total disabilities are caused by arthritis or rheumatism, making it the most common cause of disability in the US.

Emotional health

Arthritis has a strong association with major depression, with an attributable risk of 18.1% according to the CDC. This is thought to be most likely caused by the limitations arthritis can place on function and enjoyment of life. Around 6.6% of adults with arthritis report severe psychological distress.

What Are the Symptoms of Arthritis?

Joint pain, stiffness, and swelling are the most common symptoms of arthritis. Your range of motion may also decrease, and you may experience redness of the skin around the joint. Many people with arthritis notice their symptoms are worst in the morning.

In the case of RA, you may feel tired or experience a loss of appetite due to the inflammation that immune system activity causes. You may also become anemic — meaning your red blood cell count decreases — or have a slight fever. Severe RA can cause joint deformity if left untreated.


The CDC reports that 47% of US adults with arthritis also have at least one comorbid condition (the presence of more than one disease or condition in the same person at the same time).

Among people with arthritis the most common comorbidities are:

  • Heart disease - 24% (11.2 million)

  • Chronic respiratory conditions - 19% (9.0 million)

  • Diabetes - 16% (7.3 million)

  • Stroke - 6.8% (3.2 million).

Risk factors for other chronic conditions are common among US adults with arthritis, such as:

More than half (53%) of US adult with arthritis report high blood pressure. High blood pressure is associated with heart disease - the most common comorbidity among adults with arthritis.

Approximately 1 in 5 (19%) of US adults with arthritis are smokers. Smoking is associated with chronic respiratory conditions - the second most common comorbidity among adults with arthritis.

Smoking also adversely affects the synthesis of collagen, the key protein making up connective tissue and the scaffolding of bone, as well as increasing oxidative damage and decreasing circulation and the supply of nutrients to the joint tissues and bone. As such, smoking is detrimental to the health of joints and bone and contributes to arthritis development and progression.

Diagnosis of arthritis

Most cases of arthritis are diagnosed with a detailed medical history of current and past symptoms, physical examination and particular radiographic and laboratory studies. It is possible to have more than one form of arthritis at the same time, and only a few rheumatic diseases have a definitive diagnosis, such as gout

The tests ordered during the diagnostic process will depend on the type of arthritis suspected. Some tests that may be completed to make a diagnosis are:

In evaluating arthritis, the doctor uses X-rays to rule out injury or other diseases of the joint, to have a baseline for comparison while being treated for arthritis and to look at the structures of a particular joint or joints.

  • Rheumatoid factor

  • Anti-CCP antibody

  • Complete blood count (CBC)

  • C-reactive protein

  • Erythrocyte sedimentation rate (ESR)

  • Joint ultrasound or MRI

  • Joint X-ray

  • Bone scan

  • Synovial fluid analysis

  • Antinuclear antibody (ANA)

  • HLA antigens for HLA B27

  • Electrocardiogram (ECG)

  • Aspiration of joint fluid for cell count, examination of crystals under the microscope, gram stain and culture

  • Blood culture

  • Thyroid function tests

  • Synovial biopsy

  • Uric acid - urine

  • Uric acid - blood

  • Schirmer's test of tear production

  • Salivary gland biopsy

  • Tear test

  • Slit lamp examination of the eyes

  • Urinalysis.

With osteoarthritis, a physical exam can show:

  • Joint movement that causes a crackling (grating) sound, called crepitation

  • Joint swelling (bones around the joints may feel larger than normal)

  • Limited range of motion

  • Tenderness when the joint is pressed

  • Pain upon normal movement.

RA is diagnosed clinically, but classified according to the 2010 American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) classification criteria for rheumatoid arthritis.12

Diagnosis of SLE can be very difficult. The gold standard is a rheumatologist's diagnosis. The American College of Rheumatology (ACR) uses a standard classification scheme requiring 4 of 11 criteria for research definition, although this is recognized to miss early and mild cases.

How Is Arthritis Treated?

The main goal of treatment is to reduce the amount of pain you’re experiencing and prevent additional damage to the joints. Improving your joint function is also important. Your doctor may prescribe you a combination of treatment methods to achieve the best results.


A number of different types of medication treat arthritis. They include:

  • analgesics, e.g., hydrocodone (Vicodin) or acetaminophen (Tylenol): effective for pain management, but don’t help decrease inflammation

  • nonsteroidal anti-inflammatory drugs (NSAIDs), e.g., ibuprofen: help control pain and inflammation

  • menthol or capsaicin creams: block the transmission of pain signals from your joints

If you have RA, your doctor may put you on corticosteroids or disease-modifying antirheumatic drugs (DMARDs), which suppress your immune system.

Homeopathic treatment of arthritis

Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat arthritis but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several well-proved medicines are available for homeopathic treatment of arthritis that can be selected on the basis of cause, location, sensation, modalities and extension of the complaints. For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. Some important remedies are given below for the homeopathic treatment of arthritis:

  • Bryonia Alba. – Pain with inflammation which, is aggravated by movement and relieved by moderate pressure and rest.

  • Ledum pal. – Excellent remedy for gout and rheumatism which is of ascending nature, better by cold application.

  • Rhus Tox. – Pain aggravated by first movement, damp weather and better by continuous motion.

  • Colchicum – pain worse by motion touch or mental effort, better by warmth and rest.

  • Kalmia lot. – descending type of pain, pain with palpitation of heart and slow pulse

  • Guaiacum. – Gouty abscesses of joints, pain relieved by cold bath and cold application.

  • Calcaria Carb. – Arthritic swelling, knee pain especially in fleshy people which is worse by cold.

  • Benzoic acid – gouty concretions of joints, knee pain due to abnormal deposition of uric acid

  • Hypericum. – Remarkable remedy for rheumatoid arthritis has outstanding action over nerve pain.

What Is the Long-Term Outlook for People with Arthritis?

There is no cure for arthritis. However, the right treatment can greatly reduce your symptoms. In addition to the treatments your doctor recommends, you can make a number of lifestyle changes that may help you manage your arthritis.

Weight loss and maintaining a healthy weight reduce the risk of developing OA, and can reduce symptoms if you already have it. Eating a healthy diet is important for weight loss. Eating foods with lots of antioxidants can help reduce inflammation.

You’ll learn what works best for you in terms of controlling pain. Some people find heating pads and ice packs to be soothing. Others use mobility assistance devices, like canes or walkers, to help take pressure off sore joints.


In combination with medical treatment, self-management of arthritis symptoms is also important.

Key self-management activities include:

  • Developing arthritis management strategies

  • Staying physically active

  • Achieving and maintaining a healthy weight

  • Getting regular check-ups with the doctor

  • Protecting joints from unnecessary stress.

There are seven important self-management habits that can help you successfully manage your disease

  • Be organized: keep track of symptoms, pain levels, medications, and possible side effects for consultations with your doctor

  • Manage pain and fatigue: a medication regimen can be combined with non-medical pain management. Learning to manage fatigue is key to living comfortably with arthritis

  • Stay active: exercise is beneficial for managing arthritis and overall health

  • Balance activity with rest: in addition to remaining active, rest is equally important when your disease is active

  • Eat a healthy balanced diet: a healthy diet can help you achieve a healthy weight and control inflammation. Avoid refined, processed foods and pro-inflammatory animal-derived foods and choose whole plant foods that are high in antioxidants and that have anti-inflammatory properties

  • Improve sleep: poor sleep can aggravate arthritis pain and fatigue. Take steps to improve sleep hygiene so you find it easier to fall asleep and stay asleep - avoid caffeine and strenuous exercise in the evenings and restrict screen-time prior to bedtime

  • Joint care: tips for protecting joints include using your stronger, larger joints as levers when opening doors, using several joints to spread the weight of an object such as using a backpack and gripping as loosely as possible by using padded handles.

Do not sit in the same position for long periods; take regular breaks to keep mobile.

Physical therapies

Doctors will often recommend a course of physical therapy to help patients with arthritis overcome some of the challenges of arthritis and to reduce limitations on mobility. Forms of physical therapy that may be recommended include:

  • Warm water therapy - exercises in a warm-water pool. The water supports weight and puts less pressure on the muscles and joints

  • Physical therapy - specific exercises tailored to the condition and individual needs, sometimes combined with pain-relieving treatments such as ice or hot packs and massage

  • Occupational therapy - practical advice on managing everyday tasks, choosing specialized aids and equipment, protecting the joints from further damage and managing fatigue.

Physical activity

Research suggests that although individuals with arthritis may experience short-term increases in pain when first beginning exercise, continued physical activity can be an effective way to reduce symptoms long-term.

People with arthritis can participate in joint-friendly physical activity on their own or with friends. As many people with arthritis have a co-morbidity, such as heart disease, it is important to ensure that physical activity is appropriate for each condition. Some of the joint-friendly physical activities that are appropriate for adults with arthritis and heart disease include

  • Walking

  • Swimming

  • Riding a bike.

Living with arthritis is not easy and carrying out simple, everyday tasks can often be painful and difficult. However, there are many things you can do to relieve symptoms and it is important to discuss with your doctor ways to make sure you live a healthy lifestyle and have a better quality of life.

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