Common types of arthritis

Created date

February 27th, 2020
An older man rubs his hand, as if it's sore.

The word arthritis is a general term for conditions affecting the joints or surrounding tissue. There are more than 100 types of arthritis.

The Centers for Disease Control and Prevention (CDC) estimates that over 54 million people in the U.S. have been told by a doctor that they have some form of arthritis.

The word arthritis is a general term for conditions affecting the joints or surrounding tissue. There are more than 100 types of arthritis, but in the U.S., osteoarthritis (OA) is the most common form. The other main types affecting adults are rheumatoid arthritis (RA) and gout.  

There are some similarities in symptoms, but treatment for each type of arthritis may be different.

Osteoarthritis

OA is related to aging or may develop due to an injury. About 30 million Americans have this form. The most common sites for OA are the lower back, knees, hips, and hands, according to the CDC.

“OA is a degenerative disorder,” says Dan Kim, D.P.T., a physical therapist at the Rubin Institute for Advanced Orthopedics at Sinai Hospital in Baltimore, Md. “The cartilage in-between the joints has worn down over time, and joint surfaces eventually rub together.”

Symptoms of OA include pain, achiness, stiffness. decreased flexibility, and swelling. 

Factors associated with a higher risk of developing OA include increasing age, joint overuse, obesity, and genetics. Women are more likely than men to develop OA, and Asians are less likely to develop OA compared to other races.

Some seniors think that OA is inevitable, so there is no reason to do much about it. Research shows, however, that a combination of medications and joint-friendly activity can go a long way toward a better quality of life, especially if OA prevents you from getting around or functioning.

“With regard to medications, acetaminophen is often the first line of choice for mild to moderate pain, and it has few side effects,” says Jain Ruchi, M.D., attending physician in the department of rheumatology at Montefiore Health System in Bronx, N.Y. 

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, and aspirin, usually work well, but the American Geriatrics Society lists NSAIDs as a risky medication for seniors. “A high risk of adverse gastrointestinal, cardiovascular, and kidney effects in older people may limit the use of NSAIDs,” Ruchi says. “In certain situations, topical NSAIDs can be used so people may experience pain relief in a specific area with less likelihood of systemic side effects.”

A physical therapist can help you learn joint-friendly exercises. “It is most useful for people to learn exercises that will help them from a functional standpoint,” Kim says. “Physical therapists can teach seniors techniques that can make it easier to get around and perform daily living activities.”

Rheumatoid arthritis

Rheumatoid arthritis (RA) is a form of arthritis that causes pain, swelling, redness. stiffness, and sometimes a loss of function in your joints. It is most common in the wrist and fingers, and more women get RA than men.

“RA is not a degenerative process,” Kim says. “It begins when your body’s immune system attacks the joints and causes inflammation and pain.” 

Causes are not known, but scientists think genes, environment, and hormones might all play a part.

Treatments must be very individualized and may include medication and gentle exercise. Medications can range from over-the-counter pain relievers to steroids, immunosuppressants, and anti-rheumatic medications. In more advanced cases, injections or joint replacement may be needed.

Gout

Gout is a type of especially painful arthritis that is caused by too much uric acid in the body. Uric acid forms when compounds called purines are broken down. Purines occur naturally in the body’s tissues, and high amounts are found in foods such as dried beans, peas, liver, gravy, and anchovies. 

Usually, uric acid dissolves in the bloodstream and is eliminated through the kidneys. In people with gout, however, uric acid forms needle-like crystals that build up in the joints, causing the severe pain. Gout strikes most often in the joint of the big toe, but can affect other joints, including ankles, heels, knees, wrists, fingers, and elbows. 

Treatment for gout can vary from person to person. Medication can help manage pain and swelling of gout attacks, and there are also medications that can lower uric acid levels. People with gout should also avoid alcoholic beverages and foods high in purines. 

Regular exercise has been shown to help reduce the number of acute gout attacks, or flares. 

The common thread: exercise (ouch!)

Exercise is almost always part of treatment, but one of the biggest obstacles to being active for people with arthritis is pain. 

“Our first consideration as physical therapists is to make sure people with any type of arthritis pain can tolerate exercises well,” Kim says. “We can start out with very light activities that cause little pain, and build up as you get stronger.”

“If exercises that have been prescribed to you are causing pain, let your doctor or therapist know,” Kim says. “We don’t want our patients to avoid activity because of pain.”

Your doctor may be able to prescribe short-term medication that will help, and your PT can find different exercises that may be easier. “For many people, aquatic exercises are best,” Kim says. “In the water, you can strengthen muscles without putting pressure on joints.”

Arthritis experts believe that you should stay as active as you can, and don’t be afraid to modify your activity level depending on your symptoms. After all, some physical activity is better than none.


The S.M.A.R.T. way to stay active

Experts have found an easy-to-remember acronym to help you exercise:

Start low, go slow.

Modify activity when arthritis symptoms increase; try to stay active.

Activities should be “joint friendly.”

Recognize safe places and ways to be active.

Talk to a health professional or certified exercise specialist.

Source: Centers for Disease Control and Prevention


Did you know?

A condition called pseudogout has symptoms similar to gout, but it is caused by calcium phosphate, not uric acid.

Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases

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