Arthritis is a term used to describe pain and inflammation affecting a joint. Any joint in the body can be affected by arthritis but the most commonly affected joints are those of the fingers and thumb, wrist, hip, knee, shoulder, lower back and neck. There are two main types of arthritis; osteoarthritis and inflammatory (rheumatoid) arthritis.
Osteoarthritis is the most common form of arthritis and is associated with increasing age – often from the mid-40s onwards -though it is a distinct entity from the changes associated with ageing. It’s more common in women, and if you have a family history of the condition. Osteoarthritis is a disease affecting the cartilage layer that covers the ends of bones at a joint and normally functions to provide a smooth surface that allows friction-free joint movement.
In osteoarthritis, there is a breakdown of the smooth cartilage layer which then tries to heal itself. There is gradual thinning of the cartilage layer with complete loss eventually. Osteoarthritis is characterised by pain and stiffness that is usually worse with movement and tends to be worst at the end of the day or after intense activity.
The joints most commonly affected by osteoarthritis are the hands, knees, hips and spine.
Inflammatory arthritis describes a group of disorders where inflammation causes joint damage and is less common than osteoarthritis. The most common type of inflammatory arthritis is rheumatoid arthritis, a condition where the body’s own immune system initially causes damage to the inner lining of the joint, then damage to the smooth cartilage overlying the bone ends. Women are affected more than men, and it typically starts between the ages of 30 and 50. Pain and stiffness is usually worse in the morning, gradually improving throughout the day. Unlike osteoarthritis, we have very effective medications that can help reduce the severity and slow the progression of rheumatoid arthritis. Also, unlike osteoarthritis, rheumatoid arthritis can cause problems with other body organs and tissues.
Osteoarthritis is best treated initially with simple measures including low impact exercise, strengthening, painkillers and walking sticks or supports. For osteoarthritis affecting your lower back or joints of your legs, you should try to lose weight as this can be very effective at reducing the severity of your symptoms. Joint replacements may sometimes be needed in severe osteoarthritis.
Inflammatory arthritis is usually treated by a specialist with a combination of medications – including specialist disease-modifying anti-rheumatic drugs (DMARDs) to help improve your symptoms and control the disease along with physiotherapy and occasionally surgery.
If you have a painful joint or multiple painful joints that haven’t started to improve after a few weeks you should arrange to see your doctor who will examine you and arrange further investigations if needed.
If your symptoms are severe you may be referred to see a specialist. Inflammatory arthritis is most often treated with specialised medications to reduce your symptoms and prevent progression. Osteoarthritis can be managed with medication, injections or surgery depending on the joints affected.
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