Arthritis

  • Medical Author:
    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Symptoms of Rheumatoid Arthritis

Arthritis facts

  • Arthritis is inflammation of one or more joints.
  • Symptoms of arthritis include pain and limited function of joints.
  • Arthritis sufferers include men and women, children and adults.
  • A rheumatologist is a medical arthritis expert.
  • Earlier and accurate diagnosis can help to prevent irreversible damage and disability.

What is arthritis?

Arthritis is a joint disorder featuring inflammation. A joint is an area of the body where two different bones meet. A joint functions to move the body parts connected by its bones. Arthritis literally means inflammation of one or more joints.

Arthritis is frequently accompanied by joint pain. Joint pain is referred to as arthralgia. When four or more joints are involved, the arthritis is referred to as polyarthritis. When two or three joints are involved, it is referred to as oligoarthritis. When only a single joint is involved, it is referred to as monoarthritis.

How many types of arthritis exist?

There are many types of arthritis (over 100 identified, and the number is growing). The types of arthritis range from those related to wear and tear of cartilage (such as osteoarthritis) to those associated with inflammation resulting from an overactive immune system (such as rheumatoid arthritis). Together, the many types of arthritis make up the most common chronic illness in the United States.

What causes arthritis?

The causes of arthritis depend on the form of arthritis. Causes include injury (leading to osteoarthritis), metabolic abnormalities (such as gout and pseudogout), hereditary factors, the direct and indirect effect of infections (bacterial and viral), and a misdirected immune system with autoimmunity (such as in rheumatoid arthritis and systemic lupus erythematosus).

Arthritis is classified as one of the rheumatic diseases. These are conditions that are different individual illnesses, with differing features, treatments, complications, and prognoses. They are similar in that they have a tendency to affect the joints, muscles, ligaments, cartilage, and tendons, and many have the potential to affect other internal body areas.

What are risk factors for arthritis?

The major risk factors for most forms of arthritis are genes that are inherited from ancestors. Trauma-related arthritis is related to the risk of injury from specific activities.

Quick GuideRheumatoid Arthritis (RA) Symptoms & Treatment

Rheumatoid Arthritis (RA) Symptoms & Treatment
Joint pain is a common symptom of arthritis.

Arthritis Symptoms

Joint pain can be caused by injury affecting any of the ligaments, bursae, or tendons surrounding the joint. Injury can also affect the ligaments, cartilage, and bones within the joint. Pain is also a feature of joint inflammation (arthritis, such as rheumatoid arthritis and osteoarthritis) and infection, and extremely rarely it can be a cause of cancer of the joint.

Symptoms and signs associated with joint pain can include

  • joint redness,
  • joint swelling,
  • joint tenderness,
  • joint warmth,
  • limping,
  • locking of the joint,
  • loss of range of motion of the joint,
  • stiffness,
  • weakness.

What are arthritis symptoms and signs?

Symptoms of arthritis include pain and limited function of joints. Joint inflammation from arthritis is characterized by joint stiffness, swelling, redness, pain, and warmth. Tenderness of the inflamed joint can be present with or without pain. When large joints are involved, such as the knee, there can be loss of cartilage with limitation of motion from the joint damage. When arthritis affects the small joints in fingers, there can be bone growth and loss of hand grip and grip strength of the hand.

Many of the forms of arthritis, because they are rheumatic diseases, can cause symptoms affecting various organs of the body that do not directly involve the joints. Therefore, symptoms in some patients with certain forms of arthritis can also include fever, gland swelling (swollen lymph nodes), weight loss, fatigue, feeling unwell, and even symptoms from abnormalities of organs such as the lungs, heart, or kidneys.

Who is affected by arthritis?

Arthritis sufferers include men and women, children and adults.

How do health-care professionals diagnose arthritis? Why is a diagnosis important?

The first step in the diagnosis of arthritis is a meeting between the doctor and the patient. The doctor will review the history of symptoms, examine the joints for inflammation and deformity, as well as ask questions about or examine other parts of the body for inflammation or signs of diseases that can affect other body areas. Furthermore, certain blood, urine, joint fluid, and/or X-ray tests might be ordered. The diagnosis will be based on the pattern of symptoms, the distribution of the inflamed joints, and any blood and X-ray findings. Several visits may be necessary before the doctor can be certain of the diagnosis. A doctor with special training in arthritis and related diseases is called a rheumatologist (see below).

Many forms of arthritis are more of an annoyance than serious. However, millions of people suffer daily with pain and disability from arthritis or its complications.

Earlier and accurate diagnosis can help to prevent irreversible damage and disability. Properly guided programs of exercise and rest, medications, physical therapy, and surgery options can idealize long-term outcomes for those with arthritis. Exercise and exercise routines can be helpful in providing joint stability by strengthening the musculoskeletal system while improving balance. Physical therapists can provide the care needed for properly guided exercise regimens.

It should be noted that both before and especially after the diagnosis of arthritis, communication with the treating doctor is essential for optimal health. This is important from the standpoint of the doctor, so that he/she can be aware of the vagaries of the patient's symptoms as well as their tolerance of and acceptance of treatments. It is important from the standpoint of patients, so that they can be assured that they have an understanding of the diagnosis and how the condition does and might affect them. It is also crucial for the safe use of medications.

Is there an arthritis diet?

For most forms of arthritis, diets play little or no role in precipitating or exacerbating the condition. However, in general, oils of fish have been shown to have anti-inflammatory properties. Some osteoarthritis suffers benefit from omega-3 fatty acid supplements. Some people with osteoarthritis feel they benefit from the curcumin that is present in curry foods.

Gout is a particular type of metabolic arthritis that is clearly diet-related. Foods that are high in purines, especially red meats and shellfish, can worsen the condition. Moreover, certain foods elevate the levels of uric acid, including alcohol (especially beer) and those foods containing high amounts of fructose (such as the corn syrup found in soft drinks). For people with celiac disease, gluten-containing foods (wheat, barley, rye) can worsen joint pains.

Are there foods to avoid when you have arthritis?

With the exception of the unique metabolic form of arthritis in gout and celiac disease, there are no universally accepted foods that must be avoided by people with arthritis. Gout can be promoted and precipitated by dehydration as well as fructose-containing foods (corn syrup, etc.), high-purine foods (seafood, shellfish, organ meats), and alcoholic beverages (particularly beer). People with gout should avoid these foods. The arthritis of celiac disease can be worsened by intake of gluten-containing foods (wheat, barley, rye).

Quick GuideRheumatoid Arthritis (RA) Symptoms & Treatment

Rheumatoid Arthritis (RA) Symptoms & Treatment

What is the treatment for arthritis?

The treatment of arthritis is very dependent on the precise type of arthritis present. An accurate diagnosis increases the chances for successful treatment. Treatments available include physical therapy, home remedies, splinting, cold-pack application, paraffin wax dips, anti-inflammatory drugs, pain medications (ranging from acetaminophen [Tylenol] and ibuprofen [Motrin, Advil] to narcotics), immune-altering medications, biologic medications, and surgical operations. Pain from osteoarthritis of the knee can be relieved by hyaluronic acid injections. Rheumatoid arthritis can require medications that suppress the immune system. Low back arthritis that is irritating nerves of the spine can require surgical repair. For more on treatments of particular forms of arthritis, see the corresponding articles for the form of arthritis of interest.

What are the prognosis (outlook) for arthritis, and what are arthritis complications?

The outlook for patients with arthritis depends on its severity, complications, and whether or not there are non-joint manifestations of the disease. For example, rheumatoid arthritis can affect the lungs, kidneys, eyes, etc. Chronic joint inflammation can lead to permanent damage to the joint and loss of joint function, making movement difficult or impossible.

Is it possible to prevent arthritis?

Since most forms of arthritis are inherited to some degree, there is no real way to prevent them. Arthritis that follows joint injury could be prevented by adhering to safety regulations and trying to avoid becoming injured. Arthritis related to infection (for examples, septic arthritis, reactive arthritis, Whipple's disease) could be prevented by not becoming infected with the causative organism. The extent to which this is possible varies depending upon the individual condition.

What is a rheumatologist, and what specialties of doctors treat arthritis?

A rheumatologist is a medical doctor who specializes in the nonsurgical treatment of rheumatic illnesses, especially arthritis.

Rheumatologists have special interests in unexplained rash, fever, arthritis, anemia, weakness, weight loss, fatigue, joint or muscle pain, autoimmune disease, and anorexia. They often serve as consultants, acting like medical detectives at the request of other doctors.

Rheumatologists have particular skills in the evaluation of the over 100 forms of arthritis and have special interests in inflammatory arthritis such as rheumatoid arthritis, seronegative arthritis, spondylitis, psoriatic arthritis, systemic lupus erythematosus, antiphospholipid syndrome, Still's disease, dermatomyositis, Sjögren's syndrome, vasculitis, scleroderma, mixed connective tissue disease, sarcoidosis, Lyme disease, osteomyelitis, osteoarthritis, back pain, gout, pseudogout, relapsing polychondritis, Henoch-Schönlein purpura, serum sickness, reactive arthritis, Kawasaki disease, fibromyalgia, erythromelalgia, Raynaud's disease, growing pains, iritis, osteoporosis, reflex sympathetic dystrophy, and others.

Classical adult rheumatology training includes four years of medical school, one year of internship in internal medicine, two years of internal-medicine residency, and two years of rheumatology fellowship. There is a subspecialty board for rheumatology certification, offered by the American Board of Internal Medicine, which can provide board certification to approved rheumatologists.

Pediatric rheumatologists are physicians who specialize in providing comprehensive care to children (as well as their families) with rheumatic diseases, especially arthritis.

Pediatric rheumatologists are pediatricians who have completed an additional two to three years of specialized training in pediatric rheumatology and are usually board-certified in pediatric rheumatology.

Other doctors who treat arthritis include pediatricians, internists, general-medicine doctors, family medicine doctors, and orthopedic surgeons.

Quick GuideRheumatoid Arthritis (RA) Symptoms & Treatment

Rheumatoid Arthritis (RA) Symptoms & Treatment

What is the Arthritis Foundation?

The Arthritis Foundation is the only national voluntary health organization whose purpose is directed solely to all forms of arthritis. The Arthritis Foundation has national and international programs involving support for scientific research, public information and education for affected patients and their families, training of specialists, public awareness, and local community assistance.

Local branch chapters of the Arthritis Foundation serve to disseminate information about arthritis and rheumatic diseases, as well as function as referral centers. Moreover, many of the various forms of arthritis have their own foundations that serve as information and referral health resources for local communities.

Summary

It is the ultimate goal of scientific arthritis research that optimal treatment programs are designed for each of the many form of arthritis. This field will continue to evolve as improvements develop in the diagnosis and treatment of arthritis and related conditions.

REFERENCES:

"Arthritis Prevalence: A Nation in Pain." Arthritis Foundation. <http://www.arthritis.org>.

Firestein, Gary S., et al. Kelley's Textbook of Rheumatology, 9th Edition. Philadelphia, PA: Saunders, 2013.

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Reviewed on 1/20/2017
References
REFERENCES:

"Arthritis Prevalence: A Nation in Pain." Arthritis Foundation. <http://www.arthritis.org>.

Firestein, Gary S., et al. Kelley's Textbook of Rheumatology, 9th Edition. Philadelphia, PA: Saunders, 2013.

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