The joint is lined by the synovium. The synovium’s lining produces a slippery fluid — called synovial fluid — that nourishes the joint and helps limit friction within.
Outside it is a strong fibrous casing called the joint capsule. Strong bands of tissue, called ligaments, connect the bones and help keep the joint stable. Muscles and tendons also support your joints and allow you to move.
Types of Arthritis
Rheumatoid arthritis: This long-lasting disease can affect joints in any part of the body but most often involves the hands, wrists, and knees. With rheumatoid arthritis, the immune system — the body’s defense system against disease — mistakenly attacks the joints and causes the joint lining to swell. The inflammation spreads to the nearby tissues and can damage cartilage and bone. In more severe cases, rheumatoid arthritis can affect other areas of the body, such as the skin, eyes, and nerves.
Gout: This is a painful condition that happens when the body can’t get rid of a natural substance called uric acid. The excess uric acid forms needle-like crystals in the joints that cause marked inflammation with swelling and severe pain. Gout most often affects the big toe, knee, and wrist joints.
What Causes Arthritis?
- Age: Over time, your joints tend to get worn down. That’s why the risk of developing arthritis, especially osteoarthritis, goes up with age.
- Sex: Most types of arthritis are more common among women, except for gout.
- Genes: Certain types of arthritis run in families. Conditions like rheumatoid arthritis, lupus, and ankylosing spondylitis, for example, are linked to certain genes.
- Excess weight: Being overweight puts extra stress on weight-bearing joints, increasing wear and tear and the risk of arthritis, especially osteoarthritis.
- Injuries: They can cause joint damage that can bring on some types of the condition.
- Infection: Bacteria, viruses, or fungi can infect joints and trigger inflammation.
- Work: Some jobs that use repetitive movements or heavy lifting can stress the joints or cause an injury, which can lead to arthritis, particularly osteoarthritis. For example, if you need to do a lot of knee bends and squats at work, you might be more likely to get osteoarthritis.
- Joint deformity
How is Arthritis Diagnosed?
Use imaging tests like X-rays: These can often tell what kind of arthritis you have. X-rays are used to diagnose osteoarthritis, often showing a loss of cartilage, bone spurs, and in severe cases, bone rubbing against bone.
Test your joint fluid: Sometimes, joint aspiration (using a needle to draw a small sample of fluid from the joint for testing) and blood tests are used to tell osteoarthritis from other types.
If your doctor suspects infectious arthritis as a complication of some other disease, testing a sample of fluid from the affected joint will usually confirm the diagnosis and determine how it will be treated.
Test your blood or urine: These tests can help tell your doctor what type of arthritis you have or rule out other diseases as the cause of your symptoms.
Blood tests for rheumatoid arthritis include one for antibodies called rheumatoid factors (RF), which most people with rheumatoid arthritis have in their blood, though RF may also be present in other disorders.
A newer test for rheumatoid arthritis that measures levels of antibodies in the blood (called the anti-CCP test) is more specific and tends to be higher only in people who have or who are about to get rheumatoid arthritis. The presence of anti-CCP antibodies can also be used to predict which people will get more severe rheumatoid arthritis.
How is Arthritis Treated?
Arthritis Treatment: Occupational Therapy
- Avoid positions that strain your joints
- Use your strongest joints and muscles while sparing weaker ones
- Provide braces or supports to protect certain joints
- Use grab bars in the bath
- Use modified doorknobs, canes, or walkers
- Use devices to help you with tasks such as opening jars or pulling up socks and zippers
Arthritis Treatment: Medicine
- Which pain medication is best for me right now?
- Is it safe to take this drug every day?
- How long will I need to take this medication? Is it a short-term or long-term treatment?
- When can I expect to see improvement in my arthritis pain?
- Will this pain medicine interact with other medications I’m taking?
- What potential side effects should I know about with this drug?
- What can I do to decrease the risk of side effects?
- What should I do if I have flare-ups of pain while taking this medication?
- Is there anything else I can do to relieve my pain?
In addition to painkillers, your doctor may recommend corticosteroid joint injections to ease the pain and stiffness of affected joints. Results range from temporary to long-lasting relief. Additional drugs that may help preserve joint function in people with rheumatoid arthritis include:
- abatacept (Orencia)
- adalimumab (Humira)
- adalimumab-atto (Amjevita), a biosimilar to Humira
- anakinra (Kineret)
- azathioprine (Imuran)
- certolizumab (Cimzia)
- etanercept (Enbrel)
- etanercept-szzs (Erelzi), a biosimilar to Enbrel
- golimumab (Simponi, Simponi Aria)
- hydroxychloroquine (Plaquenil)
- infliximab (Remicade)
- infliximab-dyyb (Inflectra), a biosimilar to Remicade
- leflunomide (Arava)
- rituximab (Rituxan)
- sulfasalazine (Azulfidine)
- tocilizumab (Actemra)
- tofacitinib (Xeljanz)
In general, these medications work by suppressing the overactive immune system.
Treatment of infectious arthritis typically involves large intravenous doses of antibiotics, as well as drainage of excess infected fluid from the joints.
Arthritis Treatment: Surgery
Non-Medical Management of Arthritis Pain
Alternative Medicine for Arthritis
The NIH considers acupuncture an acceptable alternative treatment for osteoarthritis, especially if it affects the knee. Studies have shown that acupuncture helps reduce pain, may significantly lessen the need for painkillers, and can help increase range of motion in affected knee joints.
Fish oil has been shown to reduce inflammation, lessen the need for painkillers, and possibly decrease joint stiffness. A diet low in animal and dairy fats may have similar effects. Excellent sources of fish oil include EPA/DHA capsules and oily fish such as salmon and mackerel.
At least a dozen herbs have been used to ease the symptoms of both osteoarthritis and rheumatoid arthritis. Ask your doctor about using any herbs, since they can interact with each other or with medication you are taking. Herbs that have been used are powdered ginger, borage seed oil, and devil’s claw to reduce pain and swelling. Stinging nettles and turmeric have also been used.
Ayurvedic medicine uses herbal compounds internally and externally for arthritis symptom relief. Topical curcumin may help relieve the inflammation of rheumatoid arthritis; if taken in capsule form, it can reduce morning stiffness and boost endurance.
In one study, a combination of Withania somnifera, Boswellia serrata, andCucurma longa caused a significant drop in pain and disability for people with osteoarthritis.
Home Remedies for Arthritis
Although arthritis may not be preventable, disability is — with a well-designed treatment program, including medications, exercise, and physical therapy when needed.
- Educate yourself. Take a self-management course to learn specifics on day-to-day arthritis care.
- Get active. Exercise can help you move better, lessen pain, and put off disability.
- Use joint-protecting devices and techniques at work. Proper lifting and posture can help protect your muscles and joints.
- Eat a healthy diet. A well-balanced, nutritious diet can help strengthen your bones and muscles.
- Don’t put off treatment. The sooner you’re treated, the more likely you are to avoid permanent joint damage.