After running a marathon or hitting the gym after a few months off, you expect some aches and soreness. But what if the pain you’re experiencing isn’t related to strenuous activity? If you have swelling, pain, and stiffness in the joints, it is likely arthritis. Arthritis is a prevalent condition that impacts more than 54 million people in the United States and often worsens with age. It’s not a one catch-all, though. There are more than 100 different types of arthritis that impact joints, tissues surrounding the joints, and connective tissue, according to the U.S. Centers for Disease Control and Prevention (CDC).
8 types of arthritis
There are two main categories of arthritis: degenerative and inflammatory. “Degenerative arthritis includes osteoarthritis, which is the most common form of arthritis, while inflammatory arthritis includes immune-mediated arthritic conditions that involve the immune system,” explains Jenny Bennett, ND, founder of Aria Integrative Medicine. The symptoms and parts of the body that are affected depends significantly on the type of arthritis you have. Here’s an overview.
|Types of arthritis|
|Arthritis type||Prevalence||Body part(s) affected||Symptoms||Learn more|
|Osteoarthritis (OA)||Most-common; affecting 32.5 million U.S. adults||Hands, knees, hips, and spine||Joint soreness, morning stiffness, lack of coordination, increasing disability||Learn more|
|Rheumatoid arthritis (RA)||1.2 million U.S. adults (twice as common for women)||Hands, wrists, knees. Over time, eyes, heart, lungs, skin, and blood vessels can also be affected. RA impacts both sides of the body, unlike other forms of arthritis.||Morning stiffness and joint pain. Joint deformities can develop, sleep difficulties
rheumatoid nodules under the skin and near joints,
numbness, warmth, tingling in the hands and feet. RA increases risk for osteoporosis and fragility fractures.
|Juvenile arthritis (JA)||300,000 kids and teens in the U.S.||Varies. JA is an umbrella term for all arthritis impacting children.||Muscle and soft tissue tighten
bones to erode
growth patterns to change
joints to misalign
|Ankylosing spondylitis (AS)||About 300,000 U.S. adults||Spine, pelvis, and back||Pain in the lower spine that gets worse with inactivity||Learn more|
|Systemic lupus erythematosus (SLE)||Between 322,000 and 1.5 million people in the U.S.||Joints, skin, kidneys, blood cells, brain, heart, and lungs||Fatigue, joint pain, swelling, chest pain, fever, hair loss, mouth sores, facial pain, skin rash, sensitivity to sunlight, swollen lymph nodes||Learn more|
|Gout||9 million people in the U.S.||Toes, feet, ankles, knees, hands, wrists||Redness, swelling, and intense pain||Learn more|
|Reactive arthritis||30 per 100,000 people in the U.S.||Heels, toes, fingers, low back, and joints, especially of the knees or ankles||Pain and stiffness; eye inflammation, urinary problems, swollen toes or fingers, skin problems||Learn more|
|Psoriatic arthritis (PsA)||1 million people in the U.S.||Fingers, but may involve other body parts as it progresses, including the spine.||Stiffness, fatigue, painful joints, swollen fingers and deterioration of fingernails||Learn more|
1. Osteoarthritis (OA)
Osteoarthritis (OA), the most common type of arthritis, impacts more than 30 million adults in the United States. It fits into the degenerative arthritis category and is often referred to as wear and tear arthritis because it worsens over time. OA primarily affects the hands, hips, and knees, causing pain, stiffness, and swelling. While older populations are most at risk, OA can occur at any age. Additionally, “increased BMI also increases the risk of OA, especially in weight-bearing joints such as the knee,” explains Bennet. Patients with previous injuries also tend to be more at risk for OA at a younger age.
Diagnosis of OA typically occurs when a patient complains of joint pain. A healthcare provider will often request an X-ray or MRI to get a better picture of the joint damage and breakdown of the cartilage in the joint. While there is no cure for OA, there are several treatment options that can help patients manage the symptoms and chronic pain. Surgery to replace the joint is the last resort. Anti-inflammatory drugs help reduce painful symptoms and inflammation, but non-drug therapies, including exercise and stretching, are highly productive. “If there has been a previous joint injury or there are the beginning stages of osteoarthritis present, stabilization in the form of physical therapy, Kinesio-taping and stretching and strengthening will reduce the likelihood of further damage to the joint,” says Bennet. Patients with OA should aim to maintain a healthy weight and practice self-care habits.
2. Rheumatoid arthritis (RA)
Rheumatoid arthritis falls into the inflammatory arthritis category. It is an autoimmune disorder that causes joint pain and damage in all areas of the body. While joint pain and stiffness are among the most common symptoms, RA sufferers may also experience general fatigue, weakness, anemia, dry mouth, or sensation of pins and needles. Women are three times as likely to have RA, and “women predisposed to rheumatoid arthritis are especially likely to flare three months postpartum,” explains Bennett.
RA is often challenging to diagnose because its symptoms are incredibly similar to other conditions. A combination of blood tests, imaging, and physical exams—checking for swelling and redness in the joints—will often be performed to make the diagnosis. While there is no cure for RA, patients can manage symptoms with immunosuppressants and physiotherapy. Most people who have RA are prescribed a class of medications called anti-rheumatic drugs (DMARDS). Those with RA should get screened for osteoporosis, a bone disorder with bone loss, that results in fragility fractures.
Just like with OA, movement is beneficial for RA, but because fatigue is a common symptom, it’s crucial that patients balance rest with daily movement. “Applying heat to the affected body part also helps patients to help get the blood flow moving, especially before movement,” says Kerry McLaughlin, physical therapist.
3. Juvenile arthritis (JA)
Juvenile arthritis is the overarching term to describe types of arthritis that impact children under the age of 16. Most forms of JA are types of inflammatory arthritis or autoimmune diseases that cause joint inflammation, swelling, pain, and tenderness. However, some kinds of JA cause inflammation in the blood vessels and internal organs or hardening of the skin. In many cases, a pediatrician will refer a patient to a rheumatologist for imaging and exams to make a diagnosis.
Like other forms of arthritis, there is no cure for JA, but children can experience little to no symptoms with early detection and treatment. Treatment often includes a combination of medication, including corticosteroids and DMARDS, exercise, a balanced diet, and therapies like acupuncture and massage.
RELATED: What is juvenile arthritis?
4. Ankylosing spondylitis (AS)
Ankylosing spondylitis (AS) is a condition that primarily impacts the back, pelvis, neck, and some larger joints. Symptoms typically first manifest in the hips and lower back and worsen with inactivity. In addition to pain in the joints, other symptoms may include redness and pain in the eyes, swelling along the toes or fingers, psoriasis (skin rash and inflammatory skin disease), stomach pain or bloating including symptoms of Crohn’s disease, ulcerative colitis, or inflammatory bowel disease. Men are more at risk of developing AS, which often develops between 17 and 45 years old. AS is thought to be tied to genetics, so diagnosis will often rely on the patient’s medical history. In addition to a physical exam, an X-ray and MRI may be needed to identify changes in the sacroiliac joints.
There is no cure, but the right treatments can reduce symptoms. Medications including nonsteroidal anti-inflammatory drugs (NSAIDs) help reduce arthritis pain and inflammation, but if joint swelling is isolated, a corticosteroid shot is an option for quicker relief. Healthcare providers may also prescribe DMARDs to minimize symptoms and preserve the joint. For patients with psoriasis or other skin-related symptoms, topical treatments can help. In addition to medication, “daily movement is the best medicine. Gentle aerobic movement like biking, swimming, and yoga help manage pain and increase mobility,” says McLaughlin.
5. Systemic lupus erythematosus (SLE)
Lupus is an autoimmune type of arthritis that affects the joints, skin, kidneys, blood cells, brain, heart, and lungs. Symptoms vary from patient to patient but typically include fatigue, joint pain, rash, and fever. Hair loss can also periodically occur. Patients may experience flare-ups that worsen symptoms, then improve. Lupus is 10 times more likely to occur in women and most commonly occurs in people between the ages of 25 and 60. There’s not one single test that can diagnose lupus. A combination of blood and urine tests, imaging, evaluation of symptoms, and in some cases, a biopsy of the kidney can be used to diagnose a patient.
Like other types of arthritis, a cure does not exist for lupus, but with the right approach, symptoms can be managed and flare-ups minimized. Some of the medications commonly prescribed to treat lupus include NSAIDs (sometimes stronger versions may be prescribed), antimalarial drugs that affect the body’s immune system, corticosteroids, immunosuppressants, and biologics. Additionally, patients with lupus need to wear UV protective clothing and sunscreen, as sun exposure can trigger symptoms.
Goat is an inflammatory condition that causes redness and pain in the joints. This type of arthritis affects one joint at a time, most commonly the big toe joint. Patients with gout often experience sudden bouts of extreme pain, coming on at night and lasting up to 12 hours. Gout can only be diagnosed during a symptom flare when the affected joint is hot, swollen, and painful. This pain comes from uric acid crystals in the joints, which can be tested in a lab to confirm the diagnosis. During flare-ups, the recommended treatment is anti-inflammatory drugs (NSAIDs) for pain management and to reduce swelling. But for patients who experience regular attacks, lifestyle changes are recommended, including dietary changes, exercise, and elimination of alcohol. The medication colchicine is often prescribed to prevent gout attacks.
7. Reactive arthritis
Reactive arthritis is a rare type of inflammatory arthritis caused by an infection in another part of the body, often the genitals or bowel. Symptoms include joint pain and swelling in the knees and the joints of your ankles and feet and occasionally inflammation in the eyes, skin, and urethra. Reactive arthritis is most commonly diagnosed based on symptoms, but doctors may also order a test to determine the initial bacterial infection.
While reactive arthritis can go away on its own, symptoms may be extreme enough to require treatment. Antibiotics and anti-inflammatory drugs are often used to relieve symptoms and clear the infection.
8. Psoriatic arthritis (PsA)
Psoriatic arthritis is a type of inflammatory arthritis that affects about 30% of people with the skin condition psoriasis. Symptoms include joint pain, stiffness (especially in the morning), swelling of the fingers, and changes in the fingernails. It can impact people at any age but is most common between 30 and 50 years old. There isn’t a single test that will determine if you have PsA, but a diagnosis can be made with a combination of medical history, physical exam, blood tests, and X-rays to look for changes in the joints. Testing of the fluid around a joint is often done to rule out gout or reactive arthritis.
Treatment of PsA requires treating both the skin condition, psoriasis, as well as arthritic symptoms. A combination of medication and lifestyle changes is often recommended to avoid the worst-case scenario of joint replacement surgery. Medications include anti-inflammatory drugs (NSAIDs), both oral and topical, corticosteroids, taken orally or as an injection, DMARDs, taken as pills, self-injected or given as an infusion, and biologics.
Lifestyle and self-care practices like daily low-impact exercise, a healthy diet, and stress management are all essential to consider as well. Because PsA is linked to psoriasis, care of the skin is equally important. Skincare recommendations include regular moisturizing, baths with Epsom salts, avoiding any fragrances in detergents or lotions, and wearing natural fibers to keep the skin comfortable.
Are you at risk?
Arthritis is a widespread disease, and risk factors depend on the type. Age increases the risk of arthritis types like osteoarthritis, while women are more predisposed to rheumatoid arthritis and lupus. Family history also plays a role in the amount of risk you may have. If you think you may have arthritis, make an appointment with your primary care physician.