Arthritis is the term used to describe pain and stiffness in a joint. There are over 100 different types of arthritis, though the two most common are osteoarthritis and rheumatoid arthritis. You may also hear the word rheumatism, which is a general term to describe any aches or pains in and around your joints.

Arthritis is very common, affecting around 10 million people in the UK, mainly over the age of 65. However, it can affect children, teenagers and young adults too eg ankylosing spondylitis usually develops in teenagers and young adults, causing pain and stiffness in the back and other joints.

Symptoms often develop gradually but can also appear suddenly.

Degenerative arthritis

Degenerative arthritis is known as osteoarthritis. Normally the surfaces of the bones in your joints are surrounded by a tissue called cartilage, which prevents them from rubbing against each other. In osteoarthritis, your cartilage becomes damaged through gradual wear and tear, causing pain and stiffness in the affected joints.

As your cartilage wears out, your ligaments and tendons are forced to work harder, causing swelling. This also causes bony growths to develop called osteophytes.

Severe cartilage loss causes bones in your joints to rub against each other. This wears the bones down and can force them out of their normal position, causing joint deformities.

Osteoarthritis affects around nine million people in the UK and is more common in women. In some cases, it is associated with other types of arthritis, such as gout and rheumatoid arthritis.

Factors that increase your risk of developing osteoarthritis include:

A family history of osteoarthritis
Being aged 40 or over
Joint injury
Obesity
Lyme disease

It's most common to have this type of arthritis in your hands, hips, knees or spine.

Inflammatory arthritis

Inflammation is a healthy immune response by your body to fight infections and help heal damaged tissue. Sometimes, your immune system can also mistakenly attack healthy tissues — this is called an autoimmune condition. Many forms of inflammatory arthritis are autoimmune conditions that affect your joints, making them painful, stiff and swollen. It isn’t yet known what causes these autoimmune conditions.

The most common type is rheumatoid arthritis. Studies have found genetic risk factors for this condition, which increase your risk by five times, although the overall genetic risk still remains low. It affects around 400,000 people in the UK and can develop at any age, but usually in your 40s or 50s. It affects many joints, causing the joint linings to become inflamed. It then spreads across the whole joint, causing swelling and joint deformities. This can lead to the bones and cartilage in the joints breaking down.

In 40% of people with rheumatoid arthritis, it also causes inflammation elsewhere in the body, which affects structures outside the joints, including:

Bone marrow
Blood vessels
Major organs — this includes:

Eyes
Heart
Kidneys
Lungs
Skin

Nerve tissue
Salivary glands

Other symptoms of rheumatoid arthritis include:

Anaemia
Depression
Fatigue
Flu-like symptoms
Irritability
Loss of appetite due to inflammation

Infectious arthritis

This is caused by bacteria, viruses or fungi infecting your joint and causing inflammation. This includes infection with:

Chlamydia and gonorrhoea — sexually transmitted infections (STIs)
Hepatitis C — blood-to-blood infection; this can occur when sharing needles
Salmonella and shigella — due to food poisoning or contamination

Usually, the joint infection can be cleared through prompt treatment with antibiotics. However, your arthritis may persist even after the infection has cleared.

Metabolic arthritis

Metabolic arthritis is known as gout. It is caused by high levels of uric acid in your blood. Uric acid is formed when your body breaks down a substance called purine, which is found in your cells and in food. You can develop high levels of uric acid if you naturally make more than you need or your body can't get rid of it fast enough.

In some people, high uric acid levels cause uric acid crystals to build up in the joints. This causes sudden attacks of joint pain. Gout can come and go or, if your uric acid levels remain high, it can become a long-term (chronic) condition. Chronic gout causes ongoing pain and can lead to disability.

Other types of arthritis and related conditions

Other types of arthritis include:

Enteropathic arthritis
Psoriatic arthritis
Reactive arthritis
Secondary arthritis

Conditions related to arthritis include:

Ankylosing spondylitis
Lupus
Polymyalgia rheumatica

Arthritis in children

Around 15,000 children and young people in the UK have arthritis; most have juvenile idiopathic arthritis (JIA). It causes inflammation and pain in one or more joints. Symptoms usually improve as the child gets older.

There are four main types of JIA:

Enthesitis-related JIA

This usually affects joints in the legs and spine and is linked to acute uveitis (a painful eye condition). Symptoms include inflammation where tendons attach to the bone and in teenagers, stiffness in the lower back.

Oligo-articular JIA

This is the most common type of JIA and affects up to four joints, usually including the ankles, knees and wrists. In most cases, the condition goes away without permanently damaging the joints. However, there is a risk of developing eye problems so children affected by the condition must have regular eye tests with a doctor specialising in eye health (an ophthalmologist).

Polyarticular (polyarthritis) JIA

This is the second most common type of JIA and affects up to five or more joints. It affects children of all ages and can occur suddenly or develop gradually. Symptoms are similar to adult rheumatoid arthritis; children affected may feel unwell and occasionally have a fever.

Systemic onset JIA

This can affect children of all ages. Symptoms begin with a fever, a lack of energy, a rash and/or enlarged glands.Symptoms then develop, causing inflamed, swollen joints.

What are the symptoms of arthritis?

Symptoms of arthritis vary from person to person and depend on the type of arthritis you have. They can also come and go at different times of the day, and improve or worsen as time goes on. The most common arthritis symptoms are:

Crepitus
Muscle wasting and weakness
Pain — this includes:

Restricted movement
Swelling and inflammation around your joint
Warm, red skin around your joint

If you have severe arthritis, you may find it difficult to do everyday tasks such as walking or climbing the stairs.

Diagnosis and tests for arthritis

Your GP will discuss your symptoms with you and carry out a physical examination to make a diagnosis. During your physical examination, they will check for:

Fluid around the joints
Reduced range of movement of your joints
Warm or red joints

They may refer you to a rheumatologist (a consultant who specialises in diagnosing and treating arthritis and joint problems) if they think your arthritis may be inflammatory. If you have severe symptoms, you can schedule an appointment with a rheumatologist directly to speed up diagnosis and treatment.

Your rheumatologist may recommend having a blood test to check for signs of rheumatoid arthritis and/or determine what type of arthritis you have. Blood tests can measure markers of inflammation in your blood as well as markers for autoimmune responses; these include:

Anti-nuclear antibodies (ANA)
anti-cyclic citrullinated peptide (anti-CCP) antibodies
Rheumatoid factor

They may also conduct the following investigations to assess joint damage, rule out other causes of joint pain (eg bone spurs) and monitor disease progression:

Common treatments for arthritis

Although there is no cure, there are many treatments available to help you live with arthritis. Over-the-counter painkillers will be recommended to ease discomfort.

Your doctor may prescribe:

Analgesics to relieve pain eg acetaminophen or hydrocodone — these do not reduce inflammation
Immunosuppressants to reduce inflammation eg cortisone or prednisone
Menthol or capsaicin creams — these block pain signals from your joints
Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation eg ibuprofen
Salicylates to relieve pain eg aspirin — these can thin your blood; if you are taking blood thinners eg warfarin, you should speak to your doctor about whether you should take these and if so, what dosage
Steroid joint injections

If you have osteoarthritis, your doctor may recommend treatment including lifestyle changes, medications and/or surgery (eg joint replacement).

If you have rheumatoid arthritis, your doctor may recommend:

Disease-modifying anti-rheumatic drugs (DMARDs) to slow down disease progression
Other medications
Physiotherapy
Surgery

Treatment can help prevent joint damage and reduce joint inflammation.

Surgery

In severe cases, your doctor may recommend joint replacement surgery; your affected joint will be replaced with a prosthetic one. This is usually recommended to replace hips and knees.

If you have severe arthritis in your fingers or wrists, your doctor may recommend a joint fusion to lock together the ends of your bones so they fuse together.

Physiotherapy

A physiotherapist can recommend exercises to strengthen the muscles around your affected joints. This will help with your movement and pain.

Occupational therapy

An occupational therapist can provide you with advice and training to help you protect your joints at home and work. They can also recommend self-help equipment.

Depending on the severity of your arthritis, your GP can refer you to an occupational therapist. In some cases, you will need to access occupational therapy through your local council.

Living with arthritis

Arthritis can make everyday tasks challenging due to discomfort and pain. However, you can still live a full, healthy life and there are benefits and services to help you do this.

Working with arthritis

Having arthritis doesn't always mean you have to stop working. Early and improved diagnosis and treatment means many people with arthritis continue working. Your employer should help with support and training.

However, if you can’t work because of your arthritis, you can apply to the government for financial support, specifically a Personal Independence Payment (PIP).

Healthy eating

Eating a healthy balanced diet and maintaining a healthy weight is important. Excess weight puts more pressure on your joints and can make your arthritis worse.

A healthy balanced diet should include a variety of foods from all five food groups:

Dairy foods and milk
Foods containing fat and sugar
Fruits and vegetables
Meat, fish, eggs and beans
Starchy foods eg bread, pasta, potatoes and rice

Exercises for arthritis

It is important to stay active, even though your arthritis is causing you pain. Being active and exercising regularly can:

Boost your energy levels
Improve your joint mobility and range of movement
Increase your muscle strength
Prevent or reduce your pain
Reduce joint stiffness

It is important to engage in the right kinds of exercise that won't worsen your symptoms. Swimming is a good exercise as it doesn't put too much pressure on your joints. Exercises you can do at home include:

Head tilts, neck rotations and other exercises focused on relieving neck pain
Finger and thumb bends to relieve hand pain
Leg raises, hamstring stretches and other exercises for knee arthritis

Joint care

It is important to look after your joints and reduce the strain you put on them. Make sure you:

Use several joints to spread the weight of objects eg if carrying your shopping, hug it close to you using both hands or carry it in a rucksack
Use your larger, stronger joints as levers eg if opening a heavy door, let your shoulder take the strain instead of your hand
Don't grip too tightly — grip as loosely as is safe or use padded handles to widen your grip
Don't sit in the same position for long periods of time

At home

You can make some simple changes at home to help manage your condition, such as:

Keeping things in easy reach
Installing handrails on the staircase to help you climb up and down
Installing levers to your taps so they are easier to turn
Using electric kitchen equipment when preparing food eg electric tin openers
Using reachers (long-handled tools) to help you with cleaning or to pick up objects

Frequently asked questions

What does arthritis pain feel like?

Arthritis pain often feels like a dull, throbbing ache in your joints. It can also feel hot or burning. Pain can come on gradually or suddenly, depending on the type of arthritis you have.

What causes arthritis?

Arthritis refers to a group of conditions and the causes vary depending on which type of arthritis you have. In some cases, the exact cause is unknown. Osteoarthritis is caused by wear and tear as you get older. Gout is caused by high levels of uric acid in your blood. Rheumatoid arthritis is an autoimmune condition — this is when your immune system starts attacking your own healthy tissues. Septic arthritis is caused by an infection.

What are the early signs of arthritis?

Early signs of arthritis include joint pain, stiffness and mild swelling. You may also notice that your joints feel warm and that the skin around your joints is red. These symptoms often start in your hands, hips, knees and/or spine. Depending on the type of arthritis you have, symptoms can occur suddenly and develop quickly or develop gradually.

Which foods make arthritis worse?

Foods that promote inflammation can worsen your arthritis symptoms. These include foods high in sugar, as sugar can increase the production of chemicals that promote inflammation called cytokines. Foods high in omega-6 fatty acids, trans fats and saturated fats also promote inflammation. It is therefore helpful to avoid or reduce your intake of processed and fried foods, red meat, dairy, foods with added sugar (eg chocolate, sweets, tomato ketchup and other sauces) and foods containing corn oil.

What are the five worst foods to eat if you have arthritis?

Certain foods can promote inflammation and are therefore not good for arthritis. Try to avoid foods high in:

Omega-6 fatty acids eg corn oil, which is often found in margarine
Salt
Saturated fats eg dairy and red meat
Sugar
Trans fats eg fried and processed foods

What is the best vitamin for arthritis?

Arthritis targets your joints and can affect the bones and cartilage inside them. Vitamins that support the health of your bones and cartilage may therefore be helpful. Vitamins D and K support bone strength and vitamin K supports cartilage structure. If you have arthritis, speak to your doctor before taking any supplements.

Is vitamin B12 good for arthritis?

Research suggests that vitamin B12 may benefit individuals with osteoarthritis. If you have osteoarthritis, speak to your doctor before taking vitamin B12 supplements.

What vitamin deficiency causes arthritis?

There is no vitamin deficiency that is known to cause arthritis. However, people with rheumatoid arthritis often have vitamin D deficiency. Vitamin D is important in maintaining your immune system, and the strength and integrity of your bones.

What is the best thing to take for stiff joints?

Stiff joints are often caused by inflammation. Inflammation can be reduced by taking over-the-counter anti-inflammatories eg ibuprofen and applying ice packs for up to 20 minutes at a time. Reduced inflammation can improve stiffness and also reduce joint pain.

Where does arthritis usually start?

Arthritis often starts in your hands, hips, knees or spine. However, gout commonly starts in your big toes.

At what age does arthritis usually start?

Arthritis can occur at any age, although the two most common types — osteoarthritis and rheumatoid arthritis — usually develop after age 40. Children and teenagers can develop juvenile idiopathic arthritis (JIA) but this is rare.

How is arthritis diagnosed?

To reach a diagnosis of arthritis, your GP will ask you about your symptoms and carry out a physical examination of your joints. They'll check for fluid around your joints, red or warm joints, and whether your range of movement is reduced. They may then refer you to a doctor who specialises in diagnosing and treating arthritis called a rheumatologist. They may recommend a blood test. There is no definitive blood test for arthritis but checking for markers of inflammation and an autoimmune response can provide strong indicators of whether you have arthritis.

Can arthritis go away?

In adults, arthritis is usually a lifelong condition. However, it can come and go, with periods of time when symptoms are reduced. Certain types of juvenile idiopathic arthritis, which affects children and teenagers, can go away completely over time.