Also known as joint pain, joint stiffness

Overview

Arthritis is a common condition that affects joints and bones (especially the knees, elbows, wrists, and ankle). The symptoms of arthritis usually appear gradually or sometimes may appear suddenly. The signs and symptoms include joint pain and stiffness, swelling of the joints, decrease in range of motion of joints, or redness of the skin around the joint. 

There are different causes depending on the type of arthritis. The most common types are osteoarthritis and rheumatoid arthritis. Risk factors for arthritis include family history, old age, previous joint injury, obesity, smoking etc.

The main goal of treatment is to reduce pain, prevent any additional damage to the joints and improve joint mobility. Management includes the use of medications, surgery, weight management and exercises.

Key Facts

Usually seen in

  • Individuals older than 65 years of age.

Gender affected

  • Both men and women

Body part(s) involved

  • Hands and Wrists
  • Elbow joint
  • Shoulders joint
  • Hip joint 
  • Knee joint
  • Ankles and feet

Prevalence

Mimicking Conditions

  • Lupus 
  • Lyme Disease
  • Gout 
  • Vasculitis
  • Osteoarthritis 
  • Fibromyalgia

Necessary health tests/imaging

  • Physical examination
  • Laboratory tests
  • MRI
  • CT
  • Arthroscopy

Treatment

Causes Of Arthritis

There are different causes depending on the type of arthritis. The most common types are:

1. Osteoarthritis

Osteoarthritis is the most common form of arthritis, affecting millions of people worldwide. The most common symptoms are joint pain and stiffness and results in the breakdown of joint cartilage and underlying bone. 

2. Rheumatoid arthritis

Rheumatoid arthritis, or RA, is an autoimmune and inflammatory disease. It typically results in warm, swollen, and painful joints. 

3. Gout

Gout is a type of arthritis that causes pain and swelling in your joints. It is characterized by recurrent attacks of a red, tender, hot, and swollen joint. Gout is due to persistently elevated levels of uric acid in the blood. 

4. Juvenile idiopathic arthritis

Juvenile idiopathic arthritis, formerly known as juvenile rheumatoid arthritis, is the most common type of arthritis in children under the age of 16. This type of arthritis can cause serious complications, such as growth problems, joint damage and eye inflammation.

5. Ankylosing spondylitis

Ankylosing spondylitis is a type of chronic arthritis that causes inflammation in certain parts of the spine.This causes pain and stiffness in the lower back and hips, especially in the morning and after periods of inactivity. 

6. Psoriatic arthritis

Psoriatic arthritis  is a chronic, autoimmune form of arthritis that causes joint inflammation and occurs with the skin condition psoriasis. Psoriasis causes red, scaly rashes and thick, pitted fingernails.
 

7. Reactive arthritis

Reactive arthritis is pain or swelling in a joint that is caused by an infection in your body. It causes extremely painful, swollen joints and the person feels very tired. 

8. Septic arthritis

Septic arthritis is also known as infectious arthritis, and is usually caused by bacteria. It can also be caused by a virus or fungus. This type of arthritis typically causes extreme discomfort and difficulty in  the affected joint. The joint could be swollen, red and warm, and you might have a fever. 

Symptoms Of Arthritis

While it is difficult to know for sure if your joint pain is due to arthritis or not, based on the symptoms, there are certain signs that usually indicate you should consult a doctor. The four key signs include:

  • Pain: Pain from arthritis can be constant or it may come and go. It may occur when at rest or while moving. Pain may be in one part of the body or in many different parts.
  • Swelling: Some types of arthritis cause the skin over the affected joint to become red and swollen, feeling warm to the touch. Swelling that lasts for three days or longer or occurs more than three times a month should prompt a visit to the doctor.
  • Stiffness: This is a classic arthritis symptom, especially when waking up in the morning or after sitting at a desk or riding in a car for a long time. Morning stiffness that lasts longer than an hour is a good reason to suspect arthritis.
  • Difficulty in mobility: If you find it hard or painful to get up from your favorite chair, or after sitting in a single position for a long time, then it could be a warning sign of arthritis.

Risk Factors For Arthritis

Risk factors associated with Arthritis include:

  • Being overweight/obese exerts more stress on joints, particularly weight-bearing joints like the hips and knees
  • Trauma or injuries to joints
  • Habits of repetitive knee bending and squatting 
  • Smoking puts you at more risk of developing rheumatoid arthritis
  • Bacterial and viral infections can infect joints and cause the development of some types of arthritis
  • Gender – Women are more likely than men to develop rheumatoid arthritis, while most of the people who have gout, another type of arthritis, are men.
  • Genetic and hereditary factor

Diagnosis Of Arthritis

The doctor diagnoses arthritis on the basis of:

  • Physical examination: Based on the symptoms, your doctor will do a thorough examination of the joints for pain and swelling of the affected areas.
  • Laboratory tests: Fluids commonly analyzed include blood, urine, and joint fluid.
  • Imaging tests: Imaging scans such as X-ray, MRI, and CT scans are commonly used to assess the extent of damage to joints.
  • Arthroscopy: This procedure involves inserting a small, flexible tube called an arthroscope through an incision near the joint. The arthroscope transmits images from inside the joint to a video screen.

Prevention Of Arthritis

Some of the common ways to prevent arthritis include:

  • Strengthen joints with easy exercises.
  • Warm-up before any physical activity.
  • Consume calcium every day.
  • Maintain a healthy weight.
  • Add exercise in your life to increase strength and muscle tone.
  • Do some moderate activity at least 5 times a week. 

Specialist To Visit

If you experience any symptoms of arthritis:

  1. Do consult your doctor at the earliest for proper diagnosis of the condition
  2. Before visiting the doctor, keep track of your symptoms (for a few weeks) such as
    1. Which part of the joint/body is swollen and stiff,
    2. When and for how long the symptoms appear
    3. Which helped to ease the symptoms. 
  3. Also, make a note of other symptoms such as fatigue or rash.
  4. If you have a fever along with these symptoms, seek immediate medical care.


Sometimes arthritis is difficult to be diagnosed by a general physician and might need to see a specialist. In such cases, your doctor might advise you to consult:

  • Orthopedician
  • Rheumatologist

Treatment Of Arthritis

1. Medications

  • NSAIDs (nonsteroidal anti-inflammatory drugs) are used to treat pain and inflammation and decrease joint damage.Some examples of drugs are: ibuprofen, aspirin, and naproxen.
  • Steroids are given to manage symptoms of arthritis, mainly pain and inflammation. These drugs also help in improving the range of motion by managing the symptoms.Steroids like prednisolone, betamethasone, and dexamethasone are used in inflammation. 
  • DMARDs (disease-modifying anti-rheumatic drugs) are used to reduce pain, swelling, and inflammation, especially in people suffering from rheumatoid arthritis. Commonly used conventional DMARDs include methotrexate, leflunomide, hydroxychloroquine, and sulfasalazine. 

2. Surgery

  • Synovectomy, i.e., removal of the damaged joint lining, is also recommended in case of severe inflammation of the synovial fluid that causes arthritis. 
  • Joint replacement therapy is a surgical procedure in which parts of an arthritic or damaged joint are removed and replaced with a metal, plastic, or ceramic device called a prosthesis.

3. Physiotherapy

Physiotherapy is recommended to keep joints supple and flexible. Exercise can help in strengthening the muscles around the affected joint and prevent further damage. Options include stretching exercises, exercises that provide a range of motion, low-impact aerobic exercises such as walking, cycling.

Home Care For Arthritis

Using hot-water bags

Hot water bags or electric heating bags can be used to give temporary relief from joint pain and swelling on a daily basis.

Losing weight

Being overweight can increase complications of arthritis and contribute to arthritis pain. Make gradual and permanent lifestyle changes like eating healthy, portion control, avoiding deep-fried foods, and following an exercise regimen.

Exercising

It might sound contradictory to suggest exercise with arthritis pain when even getting up can be painful. Research has shown that exercise helps to warm up the fluid present in our joints and prevents it from thickening.


There are 3 types of exercises that are essential for healthy joints as well as for people with arthritis. These include flexibility exercises, aerobic exercises, and strengthening exercises. Each one plays a role in maintaining and improving your ability to move and function.


1. Flexibility exercises

  • These exercises are aimed at improving the range of motion. This means that they improve the ability to move your joints through the full motion that your joints were designed to achieve.
  • Flexibility exercises include gentle stretching and movements that take joints through their full span.
  • Doing these exercises regularly, ideally, every day, can help maintain and even improve the flexibility in your joints.

2. Aerobic exercises

These exercises strengthen your heart and make your lungs more efficient. They improve your stamina, reduce fatigue, and help in keeping your weight in check.

  • Brisk walking: This is one of the best bone-strengthening aerobic activities. While it is recommended to take a 30-minute brisk-walking session at least 5 days a week, you can start with three 10 minutes walking sessions anytime throughout the day.
  • Swimming: If you don’t know how to swim yet, get enrolled in a local swimming club and befriend water as swimming strengthens the hips, knees, shoulders, and chest while having minimum impact on the joints. A 30-minute swimming session, 5 days a week is very beneficial.
  • Cycling: Cycling takes the hips and knees through their range of motion. It strengthens the thigh and calf muscles thereby providing support to essential joints of the hips and legs. A 30-minute ride 5 or more days every week is recommended.

3. Strength Training Exercises

Strengthening exercises help maintain and improve your muscle strength. Strong muscles can support and protect joints thereby preventing as well as improving arthritis.

1. Chair sit

  • Sit on a chair that does not revolve or have wheels fitted. 
  • Slowly rise up using the legs and the hip. 
  • Use the elbow rests for support if required. 
  • Stand up straight and again sit back down. 
  • Perform 20 reps anytime throughout the day.
  • This movement strengthens the hips, knees, and feet.

2. Leg raises

  • Lie down on your back and keep your hands on your sides, palms down. 
  • Slowly raise the right leg using the abdominal muscles while keeping both legs straight. 
  • Repeat on both sides 10 times each. 
  • This exercise strengthens the core muscles that support the spine.

3. Knee rolls

  • Lie down on your back, hands on the side and bend your legs at the knees so that the feet touch the ground. 
  • Inhale and slowly lower both knees towards the ground on the right side. 
  • Hold for 5 seconds and come back to the starting position. 
  • Repeat 20 times on both sides. 
  • This exercise relieves stiffness of the hips and the abdominal muscles.

Massaging

Experts suggest that regular massage can help reduce pain caused due to arthritis. You can consult a massage therapist for learning massages that you can administer yourself or see a masseuse regularly. Massage with extra virgin olive oil is especially beneficial for relieving joint pain.

Other Daily tips

Here are some essential tips on how to care for your joints on a daily basis:


1. When using a chair

  • Avoid using your wrists or knuckles when getting up from your chair. Instead, use your forearms to push or get up from a chair. This helps in distributing the weight more evenly and prevents any undue stress on joints.
  • When getting out of the chair, one way is to lean forward with your hands around your knees and push up/stand up by using your leg muscles.
  • Another way of getting up from the chair is to distribute the weight between your forearms and the legs. This avoids straining the knuckles or the shoulders.

2. When carrying a bag

  • Avoid carrying too much weight. You may strain your shoulders and fingers if you carry your bag by holding the strap.
  • Carry your bag on your shoulder if it is not too heavy.

3. When reading a book

  • Avoid resting your face on your elbows and knuckles when reading a book.
  • Avoid resting your face on your wrists when reading a book.
  • Avoid holding the book too tightly. It can strain your wrist. You can use a book rest. It avoids any strain on your elbows, knuckles, wrists, and neck.

4. When opening a jar

  • Avoid holding the lid with your fingers and thumb to open the jar. It can strain your thumb.
  • Instead, use both hands to increase your grip on the jar. Use the palm of the hand to increase the grip and always screw open towards the thumb.
  • Both hands can be used to hold the lid after opening the jar on a non-slip mat or damp cloth.

5. When holding a cup

  • Avoid holding the cup with just one hand. 
  • Use both hands to hold a lightweight cup or a mug.
  • Use cups with larger handles.

6. When carrying the dishes

  • Avoid carrying dishes in one hand. It causes strain on the thumb and wrist. Use both hands instead.
  • Also avoid carrying dishes on a tray as it causes strain on your neck, shoulders, and elbows.
  • It is best to use a trolley to carry dishes.

7. When lifting heavy objects

  • Avoid bending forward to lift an object. 
  • Instead, bend your knees, rest the weight equally on both feet, hold the heavy object close to your body, and then lift.

Tips to keep in mind

  • For those suffering from arthritis or joint pain of any kind, high impact exercises are best avoided
  • Wear proper clothing and footwear when you go out for exercise.
  • Rest is as important as the exercise itself, not getting enough may cause injury.
  • An expert’s supervision is recommended while working out with heavy equipment.
  • Patients with heart conditions and other chronic health conditions should always consult a doctor before taking up an exercise regimen.

Complications Of Arthritis

Arthritis can lead to several severe health complications that may affect other parts and organs of your body. Arthritis is a complex disorder, it’s sometimes hard to treat effectively. Some of the complications you may encounter with arthritis include:

  • Trouble sleeping: Stiff and painful joints, makes it hard for you to sleep. 
  • Mobility issues: Arthritis can hamper the mobility of the person, moving out of bed and working causes a lot of pain.
  • Weight gain: Arthritis affects your ability to get around. Being less active can lead to weight gain. 
  • Anxiety and depression: it can lead to a toll on your mental health.When you’re unable to walk around properly and remain in pain all the time. This can lead to both anxiety and depression. 

Alternative Therapies Of Arthritis

Home Remedies 

1. Turmeric (Haldi): Turmeric contains curcumin that has anti-inflammatory properties and can help reduce arthritis pain especially rheumatoid arthritis.It also acts as an antioxidant. 

Tip: You can mix ½ teaspoon of turmeric powder to warm milk and drink it. 

2. Ginger (Adrak): Ginger has anti-inflammatory properties that help relieve pain. You can take ginger either in powder form or in raw form. 

Tip: Prepare a mixture of raw, crushed ginger, black pepper powder, and honey and take one
teaspoon of it daily.

3. Epsom salt (Sendha namak): Epsom salt consists of magnesium sulfate which has been used to relieve pain since historical times. 

Tip: You can either soak yourself in bath water mixed with Epsom salt or take it orally by mixing Epsom salt with equal amounts of lemon juice in warm water and taking 2 teaspoons of it daily.


4. Cinnamon (Dalchini): Cinnamon has anti-inflammatory properties which can help relieve arthritis pain.

Tip: You can add more cinnamon to food or try having crushed cinnamon powder mixed with honey and warm water.


5. Magnesium rich foods: Magnesium is an essential nutrient that is needed by the body to maintain healthy muscles, bones, heart and for relieving stress and pain. It is important for arthritis patients to get enough magnesium from food. Some examples of magnesium-rich foods are dark green, leafy vegetables like spinach, legumes/beans, and nuts. 

Tip: You can consider taking magnesium supplements and rubbing magnesium oil on the joints.

Living With Arthritis

Arthritis can be a constant source of agony for the patient. Being in chronic pain can affect the quality of life. Efforts to make some lifestyle changes can decrease the risk of getting arthritis or making arthritis worse. Losing weight, quitting smoking, avoiding underuse or overuse of joints etc can help in managing the disease. The aim of arthritis treatment is to reduce pain, minimize joint damage and enhance or support function. Along with treatment, being physically active can also reduce aches and pains, improve function and overall health of arthritis patients. It can also help in reducing the risk of developing or managing other diseases like heart disease and diabetes. Staying active and changing the activity levels accordingly with the severity of symptoms can go a long way in helping the patients.