Arthritis is a common condition that causes pain and inflammation in a joint. In the UK, around 10 million people have arthritis. It affects people of all ages, including children.
Types of
arthritis
The two most common types of arthritis are:
- osteoarthritis
- rheumatoid arthritis.
Osteoarthritis
Osteoarthritis is the most common type of arthritis
in the UK, affecting around 8 million people. It most often develops in adults who are in
their late 40s or older. It's also more common in women and people with a
family history of the condition. However, it can occur at any age as
a result of an injury or be associated with other joint-related conditions,
such as gout or rheumatoid arthritis.
Osteoarthritis initially affects the smooth
cartilage lining of the joint. This makes movement more difficult than usual,
leading to pain and stiffness.
Once the cartilage lining starts to roughen and thin out, the tendons and ligaments have to work harder. This can cause swelling and the formation of bony spurs, called osteophytes.
Severe loss of cartilage can lead to bone rubbing
on bone, altering the shape of the joint and forcing the bones out of their
normal position. The most commonly affected joints are those in
the:
- hands
- spine
- knees
- hips.
Rheumatoid
arthritis
In the UK, rheumatoid arthritis affects more than
400,000 people. It often starts when a person is between 40 and 50 years old.
Women are three times more likely to be affected than men.
Rheumatoid and osteoarthritis are two different
conditions. Rheumatoid arthritis occurs when the body's immune system targets
affected joints, which leads to pain and swelling.
The outer covering (synovium) of the joint is the first place affected. This can then spread across the joint, leading to further swelling and a change in the joint's shape. This may cause the bone and cartilage to break down. People with rheumatoid arthritis can also develop problems with other tissues and organs in their body.
Schematic diagram showing how a normal joint differs from one with rheumatoid arthritis.
Other
types of arthritis and related conditions
- Ankylosing spondylitis – a long-term
inflammatory condition that mainly affects the bones, muscles and
ligaments of the spine, leading to stiffness and joints fusing
together. Other problems can include the swelling of tendons, eyes
and large joints.
- Cervical spondylosis – also known as degenerative
osteoarthritis, cervical spondylitis affects the joints and bones in the
neck, which can lead to pain and stiffness.
- Fibromyalgia – causes pain in the body's muscles,
ligaments and tendons.
- Lupus – an autoimmune condition that can affect many
different organs and the body's tissues.
- Gout – a type of arthritis caused by too much uric acid in
the body. This can be left in joints (usually affecting the big toe) but
can develop in any joint. It causes intense pain, redness and
swelling.
- Psoriatic
arthritis – an
inflammatory joint condition that can affect people with psoriasis.
- Enteropathic
arthritis – a form of
chronic, inflammatory arthritis associated with inflammatory bowel disease
(IBD), the two best-known types being ulcerative colitis and Crohn's disease. About one
in five people with Crohn's or ulcerative colitis will develop
enteropathic arthritis. The most common areas affected by inflammation
are the peripheral (limb) joints and the spine.
- Reactive arthritis – this can cause inflammation of the
joints, eyes and urethra (the tube that urine passes through). It
develops shortly after an infection of the bowel, genital tract or, less
frequently, after a throat infection.
- Secondary
arthritis – a type of
arthritis that can develop after a joint injury and sometimes occurs many
years afterwards.
- Polymyalgia rheumatica – a condition that almost always
affects people over 50 years of age, where the immune system causes muscle
pain and stiffness, usually across the shoulders and tops of the
legs. It can also cause joint inflammation.
Symptoms
of arthritis
The symptoms of arthritis you experience will vary depending on the type you have. This is why it's important to have an accurate diagnosis if you have:
- joint
pain, tenderness and stiffness
- inflammation
in and around the joints
- restricted
movement of the joints
- warm,
red skin over the affected joint
- weakness and muscle wasting.
Schematic diagram showing how a healthy joint is different from one with osteoarthritis and from one with rheumatoid arthritis.
Arthritis and children
Arthritis is often associated with older people,
but it can also affect children. In the UK, about 15,000 children and
young people are affected by arthritis.
Most types of childhood arthritis are known as
juvenile idiopathic arthritis (JIA). JIA causes pain and inflammation in
one or more joints for at least six weeks.
Although the exact cause of JIA is unknown, the symptoms often improve as a child gets older, meaning they can lead a normal life. The main types of JIA are discussed below.
Oligo-articular
JIA
Oligo-articular JIA is the most common type of JIA. It affects fewer than five joints in the body – most commonly in the knees, ankles and wrists.
Oligo-articular JIA has good recovery rates and
long-term effects are rare. However, there's a risk that children with the
condition may develop eye problems, so regular eye tests with an ophthalmologist
(eye care specialist) are recommended.
Polyarticular JIA (polyarthritis)
Polyarticular JIA, or polyarthritis, affects five
or more joints. It can develop at any age during childhood. The symptoms of polyarticular JIA are similar to
the symptoms of adult rheumatoid arthritis. The
condition is often accompanied by a rash and a high temperature of 38C (100.4F)
or above.
Systemic
onset JIA
Systemic onset JIA begins with symptoms such as a fever, rash, lethargy (a lack of energy) and enlarged glands. Later on, joints can become swollen and inflamed. Like polyarticular JIA, systemic onset JIA can affect children of any age.
Enthesitis-related
arthritis
Enthesitis-related arthritis is a type of juvenile arthritis that affects older boys or teenagers. It can cause pain in the soles of the feet and around the knee and hip joints, where the ligaments attach to the bone.
Treating
arthritis
There's no cure for arthritis, but there are many treatments that can help slow down the condition. For osteoarthritis, medications are often prescribed, including:
- painkillers
- non-steroidal anti-inflammatory drugs (NSAIDs)
- corticosteroids.
In severe cases, the following surgical procedures
may be recommended:
- arthroplasty
(joint replacement)
- arthodesis
(joint fusion)
- osteotomy
(where a bone is cut and re-aligned).
Treatment for rheumatoid arthritis
aims to slow down the condition's progress and minimise joint inflammation
or swelling. This is to try and prevent damage to the joints. Recommended
treatments include:
- analgesics
(painkillers)
- disease
modifying anti-rheumatic drugs (DMARDs) – a combination of
treatments is often recommended
- physiotherapy
- regular exercise.
