Arthritis explained

Arthritis is a general term for many musculoskeletal conditions that affect the muscles, bones and joints. It can affect people of all backgrounds, ages and lifestyles — anyone can get arthritis, including children and young people.

Some common conditions that fall under the banner of arthritis include osteoarthritis, back pain, rheumatoid arthritis, fibromyalgia, osteoporosis, gout, polymyalgia rheumatica, lupus and ankylosing spondylitis.

Your musculoskeletal system#

To understand how arthritis works, it helps to know a little about the parts of your body it affects.

• Joints are places where bones meet. Bones, muscles, ligaments and tendons work together so you can bend, twist, stretch and move.
• Cartilage is a thin layer of smooth tissue covering the ends of your bones. It acts like a slippery cushion so the joint moves smoothly.
• The joint capsule surrounds most joints and helps keep the bones in place. Inside it is a thick fluid that nourishes and lubricates the joint, much like oil for a squeaky hinge.
• Ligaments hold the joint together by joining one bone to another.
• Tendons attach your muscles to the bones. As the muscles contract, they pull on the bones to move the joint.

Arthritis and other musculoskeletal conditions affect how the joints, muscles, bones and surrounding structures work. Exactly how this happens depends on the condition.

Symptoms#

Arthritis affects people in different ways, and each condition has its own specific symptoms. Common symptoms include:

• pain
• swelling, redness and warmth in a joint
• muscular aches and pain
• stiffness or reduced movement of a joint
• general symptoms such as fatigue and feeling unwell

Sometimes these symptoms are loosely called “rheumatism”. Rheumatism is not a disorder in itself; the word is occasionally used to describe any sort of joint or muscle pain.

Getting a diagnosis#

If you have been experiencing joint or muscle pain and think you may have arthritis, it is important to discuss your symptoms with your doctor. Getting a diagnosis as soon as possible means treatment can start quickly, which gives you the best possible outcome. A correct diagnosis also means you get the most appropriate care, because treatment — especially medication — can differ greatly depending on the type of arthritis.

Because there are so many types of arthritis, your doctor may carry out a number of assessments, including:

• Medical history – your symptoms, family history and other health problems you have had.
• Physical examination – checking for redness and swelling in and around the joint and assessing your range of movement. Depending on the suspected type, the doctor may also look for rashes, check your eyes and throat, and measure your temperature.
• Scans and other tests – blood tests to check levels of inflammation or specific genetic markers, and imaging such as x-rays, ultrasound, CT (computed tomography) or MRI (magnetic resonance imaging) to see inside the joints.
• Referral to a specialist – if appropriate, your doctor may refer you to a specialist, often a rheumatologist, for diagnosis and specialised management.

Managing arthritis#

Living with arthritis differs from person to person, and symptoms can vary from day to day. Treatment and management options depend on the type of arthritis, its severity and the parts of the body affected. There is no cure for arthritis, so care focuses on controlling symptoms, protecting the joints and self-management.

Your healthcare team#

A range of health professionals can help you manage arthritis, including:

• Your primary care doctor – central to your care, helping you day to day and connecting you with other services.
• Rheumatologist – a doctor who specialises in diagnosing and treating musculoskeletal conditions.
• Physiotherapist – uses physical means, including exercise, to help keep your body moving and functioning well.
• Occupational therapist – helps you find better ways to do everyday activities such as bathing, dressing, cooking, working or driving, and can advise on aids and home modifications.
• Exercise physiologist – designs exercise programs tailored to your situation.
• Dietitian – provides advice on food and nutrition.
• Podiatrist – assesses and treats any foot and lower-limb problems.
• Pharmacist – offers information and advice about prescription and over-the-counter medications.
• Psychologist – can help you work through your feelings, particularly if you feel anxious or depressed.

Medications#

Different types of arthritis are treated with different medications. Some aim to reduce pain and inflammation, while others work on the disease process itself to slow or stop joint damage. What your doctor prescribes depends on your type of arthritis and the severity of your symptoms. Let your doctor know about any other medications or treatments you are using, even those bought from a supermarket, health store or complementary therapist.

Common types of medication used for arthritis include:

• Pain-relieving medications (analgesics), such as paracetamol (acetaminophen), for temporary pain relief.
• Corticosteroids, to quickly control or reduce inflammation.
• Disease-modifying anti-rheumatic drugs (DMARDs), which act on an overactive immune system.
• Biologic and biosimilar medicines (bDMARDs), biological disease-modifying drugs that target the immune system in a more focused way.

Self-management#

There is a lot you can do yourself to live well with arthritis:

• Learn about your condition – understand what type of arthritis you have, the treatment options and what to expect, so you can make informed decisions and play an active role in your care.
• Stay active – physical activity is key to maintaining muscle strength and joint flexibility and to managing pain. A physiotherapist or exercise physiologist can design an individual program, which your doctor can arrange as part of a care plan for managing chronic illness.
• Learn ways to manage pain – different strategies suit different situations. Heat packs can ease muscle pain, cold packs can help with inflammation, and gentle exercise can relieve muscle tension. Try different techniques until you find what works for you.
• Watch your diet – keeping to a healthy weight is important, as extra weight puts added strain on joints, particularly load-bearing joints such as the hips, knees and ankles.
• Protect your joints – find out about aids, equipment and gadgets that make tasks easier; an occupational therapist can advise.
• Work with your healthcare team – the best way to live well with arthritis is to work closely with all the practitioners involved in your care.
• Stay at work or school – both are good for your health and wellbeing. Talk to your doctor or an allied health professional about ways to keep going or get back to it.
• Join a peer support group – a chronic condition can feel isolating, and speaking with others who understand can be a great relief. Support groups exist for people with all forms of arthritis.

Key points#

• Arthritis affects people in different ways, and each condition has its own specific symptoms.
• Common symptoms include joint pain, swelling, stiffness, and general fatigue or feeling unwell.
• Getting a diagnosis as soon as possible means treatment can start quickly, giving the best outcome.
• There is no cure, but medication, physical activity, pain-management strategies and a good healthcare team help you live well.
• Knowing your type of arthritis lets you make informed decisions and take an active role in your care.

Where to get help and trusted information#

For evidence-based global health guidance, see Source: World Health Organization (WHO).