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Archive for the ‘Arthritis’ Category

An Introduction to What Arthritis Is All About

Arthritis is a broad term that covers a group of over 100 diseases. It has everything to do with your joints -- the places where your bones connect -- such as your wrists, knees, hips, or fingers. But some types of arthritis can also affect other connective tissues and organs, including your skin.

About 1 out of 5 adults have some form of the condition. It can happen to anyone, but it becomes more common as you age.

With many forms of arthritis, the cause is unknown. But some things can raise your chances of getting it.

Arthritis mainly causes pain around your joints. You might also have:

The symptoms can be constant, or they may come and go. They can range from mild to severe.

More-severe cases may lead to permanent joint damage.

Osteoarthritis and rheumatoid arthritis are the most common kinds.

In osteoarthritis,the cushions on the ends of your bones, called cartilage, wear away. That makes the bones rub against each other. You might feel pain in your fingers, knees, or hips.

It usually happens as you age. But if underlying causes are to blame, it can begin much sooner. For example, an athletic injury like a torn anterior cruciate ligament (ACL) or a fracture near a joint can lead to arthritis.

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An Introduction to What Arthritis Is All About

Arthritis | Taking Charge of Your Health & Wellbeing

What is arthritis?

Arthritis is a general term that literally means "inflammation of the joints." The most common form of arthritis is osteoarthritis, which is caused by wear and tear on joint cartilage. Another form is rheumatoid arthritis, which causes joint inflammation due to an immune system disorder. This section only addresses osteoarthritis.

Osteoarthritis affects nearly 27 million Americans and is the most common cause of long-term disability. It is caused by degeneration of the cartilage in joints. Osteoarthritis, also called degenerative joint disease, not only reduces elasticity and lubrication in the joints, but weakens muscles and loosens ligaments. This degeneration of cartilage can occur in any joints, but is most common in the knees, hips, hands, neck, and lower back.

The biggest risk factors for osteoarthritis are simply aging and joint use, but osteoarthritis can also be due to obesity, injury, nutritional factors, metabolic disorders, and genetics.

Most people over age 60 have osteoarthritis to some degree, but its severity varies. Even people in their 20s and 30s can get osteoarthritis. In people over 50, more women than men get osteoarthritis.

Symptoms of osteoarthritis most often develop gradually and include:

The degree of arthritis seen on x-ray studies or arthroscopy doesn't directly correlate with the level of pain or disability someone experiences.

Conventional treatments for arthritis begin with protecting the joint from progressive joint degeneration, increasing joint movement, and providing pain control so that the individual can maintain a healthy, active lifestyle. When pain and disability from arthritis increase, surgery is an option.

Treatments that focus on pain control include:

When pain from arthritis cannot be controlled with medication, surgery is sometimes an option. The most common surgeries done for arthritis are:

Lifestyle changes that protect the joint from progressive cartilage degeneration include:

Studies done on people with mild to moderate osteoarthritis consistently show that regular exercise, including aerobics, strength training, and range of motion/flexibility, improves pain, increases walking tolerance, and decreases self-assessed disability.

This especially applies to those with knee arthritis. Using a cane, walker, or wedged insoles to help distribute the weight on joints can be helpful.

Staying physically active when you have arthritis is important because arthritis pain is typically worse after excessive activity as well as inactivity.

It is important to eliminate activities that cause joint wear and tear, such as running and high-impact aerobics.

Optimizing weight to reduce stress on the joints is important for both prevention and for decreasing symptoms and progression of disease. Losing weight helps reduce stress and strain on joints. In fact, for every pound of weight loss there is a four pound reduction in the load exerted on the knee.

In one study, a 10% weight loss led to a 28% improvement in function. Weight loss appears to alleviate more than just direct mechanical stress, because lowering body mass also improves the course of disease in the hand and wrist joints. Also, diabetics experience more severe osteoarthritis than those without diabetes, so if you have type 2 diabetes, losing weight could improve your arthritis both on its own and by possibly eliminating your diabetes.

An anti-inflammatory dietthat is, one low in saturated fats like red meat, dairy, and fried foodmay help reduce the inflammatory process in the joints. Increasing Omega-3 fatty acids may also help this balance. Some individuals may have symptomatic improvement with the elimination of nightshades (tomatoes, potatoes, eggplant, peppers, tobacco). A 2-3 week trial is worth considering.

In several US survey studies, many older patients with arthritis reported using complementary and alternative treatments. The most commonly used treatments were massage therapy (57%) and chiropractic (21%). The use of complementary therapies for arthritis was most common among those who considered themselves in poorer health and who also used traditional healthcare resources more.

Multiple studies have been done on the use of acupuncture for the pain of osteoarthritis. In a recent trial of almost 600 patients with knee arthritis, 26 weeks of acupuncture were compared to education sessions. Those receiving acupuncture showed significant improvement in function at 8 weeks, and in pain reduction at 26 weeks.

Mindfulness-Based Stress Reduction (MBSR) is a program of meditation and gentle yoga that has been scientifically validated. It is currently used in more than 200 hospitals and medical centers to complement the medical management of chronic pain and stress-related disorders. Research has studied individuals with many different kinds of pain (not just arthritis) and shown dramatic reductions in pain levels and an enhanced ability of individuals to cope with pain that may not go away.

Yoga is a holistic discipline, including mental, physical, and breathwork practices. A pilot study has shown that yoga may provide a feasible treatment option for obese patients over 50 years old and offers potential reductions in pain and disability caused by knee osteoarthritis.

The level of effectiveness of manual therapy with arthritis is under-researched; however, there are clinical reports of effectiveness, and some early studies are very promising.

One study of over 100 patients with osteoarthritis in the hip compared a five-week manual therapy program, including manipulations and joint mobilization, to an exercise program. Eighty-one percent of individuals had general perceived improvement after manual therapies, while only 50% experienced that in the exercise group. Patients in the manual therapy group had significantly better outcomes on pain, stiffness, hip function, and range of motion. These improvements lasted through at least 29 weeks.

There have been limited studies on the effectiveness of osteopathic manipulation alone. However, studies of osteopathy combined with conventional medical care show that the combination was more effective than conventional medical care alone for individuals with chronic pain syndromes from degenerative joint disease.

Early studies have shown massage therapy to be efficacious in the treatment of osteoarthritis of the knee, though long-term-costs studies have not yet been done.

Ice massage can be used to improve range of motion and strength of the knee, and improve function. Cold packs may be used to decrease swelling.

There are some naturally occurring substances with anti-inflammatory effects and a lower risk of gastrointestinal bleeding than NSAIDs. As with any medications, these should ideally be used for limited periods of healing, not for indefinite, long-term use.

Typical doses for each botanical are indicated below. However, you should talk with your healthcare provider before adding botanicals to your health regimen and ask about the right dosage for you.

Many people who suffer from arthritis experience either severe chronic pain or moderate chronic pain with occasional episodes of severe pain. Since the degree of pain and disability is highly influenced by an individual's perception of pain and not necessarily correlated with the degree of cartilage degeneration, a treatment plan that includes both conventional and integrative therapies can be very effective. As always, you should make sure that you communicate and share your treatment plan with all of your care providers.

Since obesity increases the risk for osteoarthritis of the knee and hip, maintaining ideal weight or losing excess weight may help prevent osteoarthritis of the knee and hip or decrease the rate of progression once osteoarthritis is established.

Acupuncture for pain relief may reduce the need pain medications, such as NSAIDs.

Maintaining activity as much as possible is helpful to delay disability and improve quality of life. A regular exercise program with stretching, strength training, and endurance and aerobic activities is important. Yoga is a good base activity for many people.

A regular meditation or relaxation practice can help you cope with pain, as can a self-reflection practice that honestly addresses emotional awareness and health.

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Arthritis | Taking Charge of Your Health & Wellbeing

Arthritis –

Arthritis is inflammation of a body joint. The two most common types are osteoarthritis (also known as degenerative joint disease) and rheumatoid arthritis (RA). Osteoarthritis occurs in older adults or after trauma and is caused in part by degeneration of the joint and increases with age. RA is an autoimmune disease that often occurs in younger adults where the bodys own defenses attack the joint lining.

Your doctor will likely conduct a complete physical and may perform blood tests to look for inflammation to help diagnose your condition. Additional tests may include bone x-ray, CT, MRI, or ultrasound. Treatment will depend on the type, severity and location of the arthritis and may include medication, therapy or surgery.

Arthritis means inflammation of one or more joints in the body. A joint is an area where two or more bones make contact and move against each other. The underlying cause varies with specific types of arthritis. There are over 100 forms of arthritis with the two most common being osteoarthritis and rheumatoid arthritis. Osteoarthritis, also known as degenerative joint disease, is caused in part by degeneration of parts of the joint such as cartilage and increases with age. The increasing wear and breakdown on parts of the affected joint can result in reactive inflammation. Rheumatoid arthritis (RA), on the other hand, is an autoimmune disease where the bodys own defenses attack the normal joint lining. In this type of arthritis, the inflammation of the lining of the joint develops first and over time damages the component parts of the joint. Other relatively common causes of arthritis include trauma, abnormal limb alignment, infections, autoimmune conditions other than rheumatoid arthritis and abnormal deposits in the joints, such as in gout.

Some type of arthritis affects over 40 million people in the United States. More than half of those people have degenerative joint disease. Almost 60 percent of those affected by arthritis are women. While arthritis mainly occurs in adults, children can be at risk of certain types of arthritis such as those caused from injury and autoimmune diseases. Although any joint in the body can be affected, particular forms of arthritis have a tendency to occur in certain parts of the body. For example, rheumatoid arthritis commonly affects the wrists and knuckles, feet, neck, and larger joints in the limbs while degenerative joint disease may affect the thumb bases, finger joints, knees, hips, shoulders, and lower spine.

Symptoms of arthritis include:

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When diagnosing arthritis, your doctor will likely do a complete physical examination of your entire body, including your spine, joints, skin and eyes. You may undergo blood tests to detect inflammation. In cases where an infection or gout is suspected, it may be useful to draw some fluid from a joint with a needle in order to analyze the contents of the material. In addition, your physician may order one or more of the following imaging tests:

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Treatment for arthritis depends on the type, severity and location of the disorder. Common treatments include:

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Arthritis -

Arthritis | Define Arthritis at

Contemporary Examples

Is that your spider sense tingling, or is that your arthritis?

And of course if you do have arthritis or other problems that make it hard to use a traditional grinder, this is a huge help.

Before Medicare, older people were trapped in wheelchairs, crippled by arthritis.

His arthritis, he told me, had been conquered by these weird maneuvers.

Nightshades have been associated with arthritis, fibromyalgia, autoimmune conditions and headaches.

Historical Examples

Tinkering with the diet has never been known to do any good for arthritis deformans and often does harm.

He knows the aspirin will not cure the arthritis, but he wants to alleviate the symptom.

Strangles occurs in the young principally and is not a frequent cause of synovitis or arthritis in the adult animal.

But you are in an advanced stage of arthritis deformans of the soul.

In hallux valgus, the metatarso-phalangeal joint of the great toe undergoes changes characteristic of arthritis deformans.

British Dictionary definitions for arthritis Expand

Derived Forms

arthritic (rtk) adjective, noun

Usage note

Rather than talking about an arthritic or arthritics, it is better to talk about a person with arthritis and people with arthritis

Word Origin

C16: via Latin from Greek: see arthro-, -itis

Word Origin and History for arthritis Expand

"inflammation of a joint," 1540s, from medical Latin arthritis, from Greek (nosos) arthritis "(disease) of the joints," from arthritis, fem. of arthrites (adj.) "pertaining to joints" (Greek nosos is a fem. noun), from arthron "a joint" (see arm (n.1)).

arthritis in Medicine Expand

arthritis arthritis (r-thr'ts) n. pl. arthritides (-thrt'-dz') Inflammation of a joint or joints resulting in pain and swelling. Also called articular rheumatism.

arthritis in Science Expand

Acute or chronic inflammation of one or more joints, usually accompanied by pain and stiffness, resulting from infection, trauma, degenerative changes, autoimmune disease, or other causes. See also osteoarthritis, rheumatoid arthritis.

arthritis in Culture Expand

The inflammation of tissues in the joints (such as osteoarthritis and rheumatoid arthritis), usually resulting in pain and stiffness.

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Arthritis | Define Arthritis at

Rheumatoid Arthritis Condition Center –


Free Pain Prevention Email Newsletter

Updates, news, special offers, and expert tips to stop aches and pains from interrupting your life.

Rheumatoid Arthritis Journey

By Maureen SalamonHealthDay Reporter THURSDAY, June 20 (HealthDay News) The common belief that rheumatoid arthritis patients dont benefit from knee replacement surgery as much as those with the more common osteoarthritis has been challenged by the findings from a pair of studies by New York City scientists. Researchers from the Hospital for Special Surgery also found, [...]

Eating lots of foods loaded with salt may do more than raise your blood pressure: Researchers report that it could also contribute to the development of autoimmune diseases, where the bodys immune system mistakenly mounts an attack upon some part of the body. Three new studies suggest salt may be a prime suspect in a wide range of autoimmune diseases, including multiple sclerosis (MS), psoriasis, rheumatoid arthritis and ankylosing spondylitis (arthritis of the spine).

TUESDAY, Feb. 5 (HealthDay News) Older women whove had regular exposure to sunlight may be less likely to develop rheumatoid arthritis, new findings indicate. This beneficial effect which is believed to be due to ultraviolet B (UV-B) in sunlight was only evident in older women. This may be because younger women are [...]

Genes specific to the X chromosome are among newly identified genes linked to rheumatoid arthritis and could help explain why women are more likely than men to develop the disease, researchers say. Women have two X chromosomes while men have an X and a Y chromosome.

WEDNESDAY, Nov. 28 (HealthDay News) Patients with rheumatoid arthritis are more likely to suffer hip dislocation after hip replacement surgery than those with osteoarthritis, a new study says. In addition, rheumatoid arthritis patients have a higher infection risk after total knee replacement than osteoarthritis patients, the study authors found. Rheumatoid arthritis, which is felt throughout the [...]

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Arthritis & Joint Conditions – Rehabilitation Institute of …

Arthritis and other rheumatic diseases are characterized by pain, swelling and limited movement in joints and connective tissues in the body. According to the Centers for Disease Control and Prevention, nearly 70 million people in the U.S. have some form of arthritis or chronic joint symptoms.

Unfamiliar with some arthritis terms? See our Arthritis Glossary

The Rehabilitation Institute of Chicago (RIC)is here to help you, whether you are noticing mild symptoms of arthritis or you have had joint pain for many years. Here at the Arthritis Center we are committed to treating you as a whole person, not just your condition, through a team effort carefully coordinated by a physician expert in arthritis care.

RIC offers comprehensive arthritis rehabilitation for people whose functional abilities have been affected by arthritis (osteoarthritis, psoriatic, rheumatoid), hip fractures, joint replacement, orthopedic conditions, osteoporosis, spine disfiguration as well as balance, rheumatologic or musculoskeletal disorders. Medical services are provided through all levels of care including inpatient and day rehabilitation and outpatient therapy.Some of the therapies offered at RIC include the newest arthritis drugs, injectable therapies, individual and group therapy and much more.

See the services offered dealing with arthritis

Our physiatrists and rheumatologists lead teams that include rehabilitation nurses, physical and occupational therapists, as well as alternative health providers who specialize in arthritis and joint pain.

RIC's Arthritis Experts

Our ongoing research into arthritis prevention and treatment puts the Rehabilitation Institute of Chicago at the forefront of the knowledge curve, allowing us to offer the benefits of that knowledge to you. In addition, if you are interested in arthritis and pain research, there may be opportunities to participate in research studies at RIC.

Current Arthritis Research

It is important for those living with arthritis to have all the tools necessary to build self-empowerment and determination to set goals and live life to the fullest.

Explore our resources for Living With Arthritis

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Arthritis & Joint Conditions - Rehabilitation Institute of ...

Fluoride Action Network | Arthritis

Current evidence strongly indicates that some people diagnosed with arthritis are in fact suffering from low-grade fluoride poisoning.

Joint pain and stiffness are well known symptoms of excessive fluoride intake. According to the U.S. Department of Health and Human Services, too much fluoride causes chronic joint pain and arthritic symptoms. (DHHS 1991). U.S. health authorities have long dismissed the relevance of this by insisting that fluoride only causes arthritic symptoms in patients with advanced forms of skeletal fluorosis, a bone disease caused by fluoride.Modern research clearly shows, however, that fluoride-induced joint pains can occur in theabsence of obvious skeletal fluorosis. This makes fluorides effects on joints extremely difficult to differentiate from common forms of arthritis. In fact, research has found that fluoride can be a direct cause of osteoarthritis, with or without the presence of classic skeletal fluorosis. (Bao 2003; Savas 2001; Tartatovskaya 1995; Czerwinski 1988; Chen 1988).

In cases where fluoride is the cause of a persons arthritic problems, reduction in daily fluoride intake for a period of several weeks or months can eliminate the symptoms in the absence of medical treatment. Correct diagnosis is thus critical to effective recovery.

Chronic fluoride exposure can cause a bone disease known as skeletal fluorosis. In the classic type of skeletal fluorosis, the lower spine and pelvis develop a hyper-dense bone condition known as osteosclerosis. U.S. health authorities have long ascribed to the view that this spinal osteosclerosiswill be evident on x-rayif a persons joint pains are caused by fluoride. When spinal osteosclerosis is absent, therefore, doctors have traditionally dismissed the possibility that a patients joint pain could be caused by fluoride.

Research, however, has nowrepeatedly shownthat fluoride can cause joint pain and stiffness, including frank osteoarthritis,before bone changes in the spine are detectable on x-ray. The traditional criteria for diagnosing skeletal fluorosis thus results in people with fluoride-induced joint problems being misdiagnosed as suffering from arthritis. The extent of this misdiagnosis remains unknown.

According to U.S. health authorities, a daily dose of 10 mg of fluoride for over 10 years is sufficient to cause crippling skeletal fluorosis. (NRC 1993). Since crippling skeletal fluorosis represents the most severe stage of the disease (a stage where bone changes are readily detectable in the spine), common sense alone should indicate that earlier stages of fluorosis can be produced by doses lower than 10 mg/day.No systematicresearch, however, has been conducted in the United States or any other fluoridating country to determine how low the arthritic dose might be, and how this dose varies based on an individuals age, nutritional status, health status, and exposure to repetititve stress.

Although there has been a lack of systematic research (in western countries), acase studypublished inThe Lancetfound that daily doses of 6 to 9 mg per day were sufficient to cause arthritis in an avidtea-drinker. (Cook 1971). The subject of the study, anEnglish woman witha 25-year history of debilitatingarthritis, experienced complete reliefin her symptoms within 6 months of stopping her tea consumption. In light of the womans recovery, the author concluded that some cases of pain diagnosed as rheumatism or arthritis may be due to subclinical fluorosis which is not radiologically demonstrable.

More recent, more comprehensive, research from China confirms thatdoses lower than 10 mg/day can cause early stages of fluorosis as well as osteoarthritis. In 2000, a group of Chinese health agencies conducted a large-scale study to determine the daily doses of fluoride that cause the various phases of fluorosis. (Experts Group 2000). They found thatdoses of 6.2 to 6.6 mg/day were consistently sufficient to produce x-ray evidence of skeletal fluorosis which is significant since fluoride can cause chronic joint pain prior to the development of x-ray changes. It stands to reason, therefore, that doses less than 6 mg/day may cause arthritic symptoms.

Another large-scale study from China recently investigated whether the incidence ofosteoarthritic symptomsrates in a population are increased in areas with elevated fluoride levels. (Ge 2006). After examining over 7,000 individuals from six regions, the authors found that the rate of osteoarthritis was significantly increased at water fluoride levels of just1.7 ppm a concentration that would be associated with daily doses in the 5 to 6 mg/day range.(Ge 2006) The following figure displays the rate of pain and rigidity in the knee and vertebrae that the study found:

The U.S. Department of Health and Human Services has estimated that adults living in fluoridated communities routinely ingest between 1.6 and 6.6 mg of fluoride per day. (DHHS 1991). In other words, the doses that many American adults routinely ingest overlap the doses that modern research indicates can cause arthritic symptoms and the early stages of skeletal fluorosis.

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Fluoride Action Network | Arthritis

Arthritis – UpToDate


Arthritis refers to inflammation of a joint. The inflammation can affect any of the important structures inside a joint, including the joint lining (synovium), bones, cartilage, or supporting tissues. Common symptoms of arthritis include pain, stiffness, and swelling of the joint. The condition may affect one or several joints throughout the body.

There are many possible causes of arthritis, although some are much more common than others. Some types of arthritis respond well to treatment and resolve without any lingering effects, whereas other types of arthritis are more difficult to control and can be disabling.

This topic provides an overview of arthritis; more detailed information about the various types of arthritis is also available. (See 'Where to get more information' below.)


There are many possible causes of arthritis, including age-related wear and tear, infections, autoimmune conditions, injuries, and others. Topic reviews that discuss specific types of arthritis are available separately. (See 'Where to get more information' below.)


Joint symptomsThe most common symptoms of arthritis include joint pain and stiffness. There may also be joint tenderness, swelling, and limited movement of one or more joints. The skin over the joint is sometimes red and warm.

There are two main types of arthritis: inflammatory and noninflammatory. Examples of inflammatory arthritis include infectious arthritis, rheumatoid arthritis, and gout. An example of noninflammatory arthritis is osteoarthritis, the most common type of arthritis. The location, timing, and pattern of joint pain, as well as the presence of swelling and symptoms outside the joint (such as rash), can help to distinguish between inflammatory and noninflammatory arthritis.

Inflammatory arthritisInflammatory arthritis usually causes joint stiffness with rest, especially morning stiffness. Certain types of inflammatory arthritis, such as rheumatoid arthritis and the arthritis of systemic lupus erythematosus (SLE), affect joints symmetrically (ie, affect the same joints on both sides of the body).

Noninflammatory arthritisNoninflammatory arthritis usually causes pain that is aggravated by movement and weightbearing and is relieved by rest. Joints on one or both sides of the body may be affected.


The process of diagnosing arthritis involves several steps. A medical history and physical examination usually provide the most helpful information; laboratory tests, imaging tests (such as x-rays), and other tests are sometimes needed.

Laboratory and imaging testsLaboratory and imaging tests are sometimes, but not always, needed to determine the cause of arthritis.

Blood tests may be recommended. For example, if rheumatoid arthritis or systemic lupus erythematosus (SLE) is suspected, it can be helpful to test the blood for antibodies that are commonly present in these diseases. Examples include the rheumatoid factor (RF) for rheumatoid arthritis and the antinuclear antibody (ANA) for SLE.

Testing of the fluid inside a joint, called the synovial fluid, is often helpful in determining the cause of a persons arthritis. After making the skin numb, the fluid is removed by inserting a needle inside the joint and withdrawing a sample of fluid. This procedure is sometimes called a joint tap. Analysis of the joint fluid is particularly helpful in confirming that the arthritis is inflammatory and in establishing a diagnosis of septic arthritis (due to bacterial infection), gout, or pseudogout.

X-rays provide detailed pictures of bones. Other imaging tests, such as ultrasound, magnetic resonance imaging (MRI), and computed tomography (CT scan), provide images of the tissues inside and surrounding the joints. One or more of these imaging tests may be recommended to detect erosions (bone damage due to arthritis), fractures, calcium deposits, or changes in the shape of a joint.

For many types of arthritis, changes in the joint are not visible on x-ray for months or even years. However, x-rays are often useful to monitor over time.


Some signs and symptoms of arthritis require urgent medical care. If you have one or more swollen joints and any of the following, you should seek medical care as soon as possible.


Weight loss

An inability to function due to joint pain

An overall sense of feeling ill

Sudden weakness of specific muscle groups


The treatment of arthritis depends upon the specific cause (see "Patient information: Osteoarthritis treatment (Beyond the Basics)" and "Patient information: Rheumatoid arthritis treatment (Beyond the Basics)"). Common treatments include physical and occupational therapy, pain relievers (such as acetaminophen), antiinflammatory medications (such as ibuprofen), and medications that suppress the immune system (such as prednisone or methotrexate).


Your healthcare provider is the best source of information for questions and concerns related to your medical problem.

This article will be updated as needed on our web site ( Related topics for patients, as well as selected articles written for healthcare professionals, are also available. Some of the most relevant are listed below.

Patient level informationUpToDate offers two types of patient education materials.

The BasicsThe Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.

Patient information: Bursitis (The Basics) Patient information: Ganglion cyst (The Basics) Patient information: Osteoarthritis (The Basics) Patient information: Arthritis and exercise (The Basics) Patient information: Knee replacement (The Basics) Patient information: Hip replacement (The Basics) Patient information: Knee pain (The Basics) Patient information: Hand pain (The Basics) Patient information: Hip pain in older people (The Basics) Patient information: Rheumatoid arthritis (The Basics) Patient information: Rheumatoid arthritis and pregnancy (Beyond the Basics) Patient information: Juvenile rheumatoid arthritis (The Basics) Patient information: Gout (The Basics) Patient information: Calcium pyrophosphate deposition disease (pseudogout) (The Basics) Patient information: Psoriatic arthritis in adults (The Basics) Patient information: Psoriatic arthritis in children (The Basics) Patient information: Reactive arthritis (The Basics) Patient information: Septic arthritis (The Basics)

Beyond the BasicsBeyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon.

Patient information: Osteoarthritis symptoms and diagnosis (Beyond the Basics) Patient information: Rheumatoid arthritis symptoms and diagnosis (Beyond the Basics) Patient information: Gout (Beyond the Basics) Patient information: Pseudogout (Beyond the Basics) Patient information: Systemic lupus erythematosus (SLE) (Beyond the Basics) Patient information: Ankylosing spondylitis and other spondyloarthritis (Beyond the Basics) Patient information: Psoriatic arthritis (Beyond the Basics) Patient information: Reactive arthritis (Beyond the Basics) Patient information: Osteoarthritis treatment (Beyond the Basics) Patient information: Rheumatoid arthritis treatment (Beyond the Basics) Patient information: Joint infection (Beyond the Basics)

Professional level informationProfessional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based. Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading.

Arthritis associated with gastrointestinal disease Clinical manifestations of rheumatoid arthritis Clinical manifestations and diagnosis of psoriatic arthritis Diagnosis and differential diagnosis of rheumatoid arthritis Imaging techniques for evaluation of the painful joint Evaluation of the adult with monoarthritis Evaluation of the adult with polyarticular pain General principles of management of rheumatoid arthritis in adults Overview of the systemic and nonarticular manifestations of rheumatoid arthritis Septic arthritis in adults Specific viruses that cause arthritis Treatment of psoriatic arthritis Non-radiographic axial spondyloarthritis, undifferentiated spondyloarthritis, and peripheral spondyloarthritis

The following organizations also provide reliable health information.

National Library of Medicine (, available in Spanish)

National Institute of Arthritis and Musculoskeletal and Skin Diseases (301) 496-8188 (

National Institute on Aging (, available in Spanish)

American College of Rheumatology (404) 633-3777 (http://

The Arthritis Foundation (800) 283-7800 (

Patient SupportThere are a number of online forums where patients can find information and support from other people with similar conditions. Arthritis Forum (

Literature review current through: Aug 2015. | This topic last updated: Mon Jun 09 00:00:00 GMT 2014.

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Arthritis - UpToDate

CDC – Arthritis – Physical Activity for Arthritis – Overview

Long gone are the days when health care providers told people with arthritis to rest their joints. In fact, physical activity can reduce pain and improve function, mobility, mood, and quality of life for most adults with many types of arthritis including osteoarthritis, rheumatoid arthritis, fibromyalgia, and lupus. Physical activity can also help people with arthritis manage other chronic conditions such as diabetes, heart disease, and obesity. Most people with arthritis can safely participate in a self-directed physical activity program or join one of many programs available in communities across the country. Some people may benefit from physical or occupational therapy. A 2-page fact sheet summarizing physical activity for people with arthritis is available.

Regular physical activity is just as important for people with arthritis or other rheumatic conditions as it is for all children and adults. Scientific studies have shown that participation in moderate-intensity, low-impact physical activity improves pain, function, mood, and quality of life without worsening symptoms or disease severity. Being physically active can also delay the onset of disability if you have arthritis. But people with arthritis may have a difficult time being physically active because of symptoms (e.g., pain, stiffness), their lack of confidence in knowing how much and what to do, and unclear expectations of when they will see benefits. Both aerobic and muscle strengthening activities are proven to work well, and both are recommended for people with arthritis.

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Adults with arthritis should follow either the Active Adult or Active Older Adult Guidelines, whichever meets your personal health goals and matches your abilities. People with arthritis should also include daily flexibility exercises to maintain proper joint range of motion and do balance exercises if they are at risk of falling.

Follow the Active Adult recommendations if you are younger than age 65, have normal function and no limitations in your usual activities, and do not have any other severe chronic conditions such as diabetes, heart disease, or cancer.

Aerobic activity per week =


Muscle strengthening activities at least 2 days per week.

Aerobic activity per week =


Muscle strengthening activities at least 2 days per week.

Follow the Active Older Adult recommendations if you are older than age 65, have poor function and are limited in some of your usual activities, or you have other chronic conditions besides arthritis.

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Aerobic activity per week =


Muscle strengthening activities at least 2 days per week.

Include activities that promote balance at least 3 days per week.

Aerobic activity per week =


Muscle strengthening activities at least 2 days per week.

Include activities that promote balance at least 3 days per week.

What types of activities count?

Aerobic activities. Aerobic activity is also called "cardio," endurance, or conditioning exercise. It is any activity that makes your heart beat faster and makes you breathe a little harder than when you are sitting, standing or lying. You want to do activity that is moderate or vigorous intensity and that does not twist or "pound" your joints too much. Some people with arthritis can do vigorous activities such as running and can even tolerate some activities that are harder on the joints like basketball or tennis. You should choose the activities that are right for you and that are enjoyable. Remember, each person is different, but there are a wide variety of activities that you can do to meet the Guidelines.

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Examples of Moderate and Vigorous Intensity Aerobic Activities

Muscle strengthening activities. You should do activities that strengthen your muscles at least 2 days per week in addition to your aerobic activities. Muscle strengthening activities are especially important for people with arthritis because having strong muscles takes some of the pressure off the joints.

You can do muscle strengthening exercises in your home, at a gym, or at a community center. You should do exercises that work all the major muscle groups of the body (e.g., legs, hips, back, abdomen, chest, shoulders, and arms). You should do at least 1 set of 812 repetitions for each muscle group. There are many ways you can do muscle strengthening activities:

Balance activities. Many older adults and some adults with arthritis and other chronic diseases may be prone to falling. If you are worried about falling or are at risk of falling, you should include activities that improve balance at least 3 days per week as part of your activity plan. Balance activities can be part of your aerobic or your muscle strengthening activities. Examples of activities that improve balance include the following

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Stay flexible. In addition to the activities recommended above, flexibility exercises are also important. Many people with arthritis have joint stiffness that makes daily tasks such as bathing and fixing meals difficult. Doing daily flexibility exercises for all upper (e.g., neck, shoulder, elbow, wrist, and finger) and lower (e.g., low back, hip, knee, ankle, and toes) joints of the body helps maintain essential range of motion.

If you have arthritis, you should follow either the Active Adult or Active Older Adult recommendations, whichever meets your personal health goals and matches your abilities. You should do this activity in addition to your usual daily activity. You may notice that the recommended amount and type of activity are the same for the Active Adult and Active Older Adult except for the additional recommendation to include activities that promote balance. Read some additional details for the Active Older Adult below:

Prevent falls. Have you fallen in the past? Do you have trouble walking? If so, you may be at high risk of falling. Activities that improve or maintain balance should be included in your physical activity plan. Examples of activities that have been proven to help balance include walking backwards, standing on one leg, and Tai Chi. Some exercise classes offered in many local communities include exercises that are good for balance.

Stay active. Any physical activity is better than none. If you cannot do 150 minutes of moderate intensity activity every week, it is important to be as active as your health allows. People with arthritis often have symptoms that come and go. This may mean that one week you can do 150 minutes of moderate intensity activity and the next week you cant. You may have to change your activity level depending on your arthritis symptoms, but try to stay as active as your symptoms allow. Learn how to modify your activity with these tips for S.M.A.R.T. activity.

Adjust the level of effort. Some activities take more effort for older adults and those with low fitness or poor function. For example, walking at a brisk pace for a 23-year-old healthy male is moderate intensity, but the same activity may be vigorous activity for a 77-year-old male with diabetes. You should adjust the level of effort during activity so that it is comfortable for you. Find out how to measure your level of effort.

Talk to your doctor. If you have arthritis or another chronic health condition, you should already be under the care of a doctor or other health care provider. Health care providers and certified exercise professionals can answer your questions about how much and what types of activity are right for you.

How hard are you working? Moderate intensity activity makes your heart beat a little faster and you breathe a little harder. You can talk easily while doing moderate intensity activity, but you may not be able to sing comfortably.

Vigorous intensity activity makes your heart beat much faster and you may not be able to talk comfortably without stopping to catch your breath.

Relative intensity can be estimated using a scale of 0 to 10 where sitting is 0 and 10 is the highest level of effort possible. Moderate intensity activity is a 5 or 6 and vigorous intensity activity is a 7 or 8. The talk test is a simple way to measure relative intensity. In general, if you're doing moderate-intensity activity you can talk, but not sing, during the activity. If you are doing vigorous-intensity activity, you will not be able to say more than a few words without pausing for a breath.

Read more about measuring physical activity intensity.

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Safe, enjoyable physical activity is possible for most every adult with arthritis. The most important thing to remember is to find out what works best for you. At first glance, 150 minutes of activity per week sounds like a lot, but if you pay attention to the following tips you will be well on your way to getting the recommended amount of activity in no time!

Studies show that some increase in pain, stiffness, and swelling is normal when starting an activity program. If you have increased swelling or pain that does not get better with rest then talk to your health care provider. It may take 68 weeks for your joints to accommodate to your increased activity level, but sticking with your activity program will result in long-term pain relief.

Here is an easy way to remember these tips: Make S.M.A.R.T choices!

Start low, and go slow.

Many adults with arthritis are inactive, even though their doctor may have told them being active will help their arthritis. You may want to be more active but just dont know where to start or how much to do. You may be worried that using your joints and muscles may make your arthritis worse. The good news is that the opposite is true, physical activity will help your arthritis! The first key to starting activity safely is to start low. This may mean you can only walk 5 minutes at a time every other day. The second key is to go slow. People with arthritis may take more time for their body to adjust to a new level of activity. For example, healthy children can usually increase the amount of activity a little each week, while older adults and those with chronic conditions may take 34 weeks to adjust to a new activity level. You should add activity in small amounts, at least 10 minutes at a time, and allow enough time for your body to adjust to the new level before adding more activity. Click here for real life examples of how to progress activity levels safely.

Modify activity as needed.

Remember, any activity is better than none. Your arthritis symptoms, such as pain, stiffness and fatigue, may come and go and you may have good days and bad days. You may want to stop activity completely when your arthritis symptoms increase. It is important that you first try to modify your activity to stay as active as possible without making your symptoms worse. Here are some ways you can do this:

When your symptoms have returned to normal, slowly increase your activity back to your starting level.

Activities should be "joint friendly."

People with arthritis can do many types of moderate or vigorous intensity activities, some people with arthritis can even run marathons! If you are unsure of what types of activity are best for you, a general rule is to do activities that are easy on the joints like walking, bicycling, water aerobics, or dancing. These activities have a low risk of injury and do not twist or "pound" the joints too much. It is also important to pick a variety of activities that you enjoy, this will help keep you from getting bored and make it easier to stick with your activity plan.

Recognize safe places and ways to be active.

Safety is important for starting and maintaining your activity plan. If you are currently inactive or do not have confidence in planning your own physical activity, a class designed just for people with arthritis may be a good option for you. Some people with arthritis feel safer by starting an activity program in a class with a trained instructor and get support from and gain confidence by participating with the other people with arthritis. Local chapters of the Arthritis Foundation offer 2 classes, the Arthritis Foundation Exercise Program and the Arthritis Foundation Aquatics Program, in many communities. For a list of more exercise programs, click here.

If you currently do some activity or feel confident that you can safely plan your own activity program, you should look for safe places to be physically active. For example, if you walk in your neighborhood or a local park make sure the sidewalks or pathways are level and free of obstructions, are well-lighted, and are separated from heavy traffic.

Talk to a health professional.

You should already be under the care of a health care professional for your arthritis, who is a good source of information about physical activity. Health care professionals and certified exercise professionals can answer your questions about how much and what types of activity match your abilities and health goals.

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I dont do any activity now, how do I start?

Meet Jean, a 48-year-old grandmother.

Jean is 48 years old and has rheumatoid arthritis. Her doctor has told her to increase her physical activity because it will help her arthritis. Jean wants to be able to walk to and from the park and play with her grandchildren. Right now, she does not have the stamina to walk to the park which is only a 15 minute walk from her house. Jean is also not very confident she knows how to safely start and increase her activity level. She is worried she will make her arthritis symptoms worse.

Start low.

The nurse in Jeans doctors office told her about group exercise programs that are just for people with arthritis. There are classes every week at the community center close to Jeans neighborhood. Jean works full-time but doesnt have to start work until 10:00AM. She found out one of the classes, the Arthritis Foundation Aquatics Program (AFAP), meets at 8:00AM on Mondays, Wednesdays and Fridays. The class lasts for 60 minutes, which allows her enough time to shower, dress, and get to work on time. Jean went to the community center to sign up but was concerned she may not be able to do 60 minutes of activity at one time. The instructor assured her that the exercises can be modified and the instructors are trained to help each person work at their own level.

Go slow.

For the next 4 months, Jean attends the AFAP class 3 days per week. The first 4 weeks she cannot do all the exercises and has to take a lot of breaks, so she was working at a moderate effort for about 1015 minutes each class (3045 minutes of aerobic activity per week). By the 7th week, she can do 20 minutes per class and by the 3rd month she is up to 30 minutes (90 minutes of aerobic activity per week). Jean feels great and can tell she has more stamina. Over the next 4 weeks Jean slowly increases the time she is working at a moderate effort each class until she can do the entire 60 minute class without stopping (180 minutes of moderate aerobic activity per week).

Get advice.

Although Jean feels the AFAP has helped strengthen her muscles and given her more stamina, she now feels she should do more muscle strengthening exercises. For Christmas, her children gave her a gift certificate for 4 free sessions with a certified exercise specialist at a local fitness center. At her first session, she asked for instructions on how she can do muscle strengthening exercises at home. The fitness professional gave her some elastic resistance bands and showed her how to use them to strengthen all the major muscle groups of the body. Jean is now using the resistance and 2 days per week in addition to her aquatics classes.

I do some activity now, how can I safely increase my activity to gain more health benefits?

Meet Steve, an active 69-year-old retiree.

Steve is a 69-year old-retired accountant who has been physically active all his life but has been diagnosed with osteoarthritis in his knee. Now that he is retired, Steve has the time to increase his activity level even more. Steves goal is to increase his total activity per week and to do some vigorous intensity activity because he knows it is good for his heart and may reduce his risk of getting some cancers. Steve currently does 180 minutes of moderate intensity activity each week including

Adding more activity.

Steve wants to increase his total activity to at least 300 minutes per week of moderate intensity activity. He decides that without too much trouble he can easily add 1 more day of golf, adding 60 minutes of moderate intensity activity each week. Steves wife recently joined a local seniors tennis league and has been bugging him to play tennis with her. Steve hasnt played tennis in a long time so he signed up for 4 weeks of tennis lessons at the parks and recreation department in his town. After the lessons, he and his wife started playing doubles tennis 2 days per week for an hour each time (60 minutes of moderate intensity activity, 120 minutes per week). He continues to lift weights 2 days per week. Steve has successfully added 180 minutes of moderate intensity activity and now gets a total of 360 minutes per week.

Trading up to vigorous activity.

After doing this level of activity for 4 months, Steve wants to trade some of the moderate intensity activity he does for vigorous intensity activity. He decides that on 2 of the 3 days he uses the stationary bicycle at home, he will instead use the stair climber or elliptical machines at his fitness center. Because one minute of vigorous intensity activity equals about 2 minutes of moderate intensity, Steve plans to do 20 minutes on 2 days each week when he is at the gym. Steves activity program now includes

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Some soreness or aching in joints and surrounding muscles during and after exercise is normal for people with arthritis. This is especially true in the first 4 to 6 weeks of starting an exercise program. However, most people with arthritis find if they stick with exercise they will have significant long-term pain relief. Here are some tips to help you manage pain during and after exercise:

Signs you should see your health care provider:

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CDC - Arthritis - Physical Activity for Arthritis - Overview

Arthritis | UW Orthopaedics and Sports Medicine, Seattle

The Orthopaedics and Sports Medicine clinics at UWMC-Rooseveltand the UW Medicine Eastside Specialty Center offer subspecialized surgical care for arthritis patients. UW surgeons provide the most current approaches for patients with arthritis affecting:

The Orthopaedics and Sports Medicine clinicsat UWMC-Roosevelt offer a specialty program for rheumatoid arthritis. The Rheumatoid Arthritis Service provides health care, support, and information to optimize the health, comfort, and productivity for individuals with:

Physicians in the Department of Orthopedics and Sports Medicine and on the Rheumatoid Arthritis Service work closely with the Arthritis Foundation's Washington/Alaska Chapter and with other UW specialists to provide information on the latest medical and surgical treatment methods.

You may make your own appointment with an arthritis surgeon in the Department of Orthopedics and Sports Medicine or with a physician on the Rheumatoid Arthritis Service or you may be referred by your physician or other specialist.

To make an appointment, please call: 206-520-5000 or Toll Free 877-520-5000.

The Hip and Knee Center at UWMC - Roosevelt, The Hand, Elbow & Shoulder Center at UWMC - Roosevelt, and The Foot and Ankle Center at UWMC - Roosevelt are locatedat UWMC-Roosevelt, an outpatient facility at 4245 Roosevelt Way N.E. in Seattle's University District. There is an underground parking garage in the building. A number of bus lines stop right outside or nearby, and there also is a free shuttle bus service from UW Medical Center.

The Eastside Specialty Center is located in Bellevue at 3100 Northup Way. Free parking is available on site.

Please be aware that many insurance programs will not pay for you to see a specialist without prior authorization, so check with your health insurance plan first.

Arthritis | UW Orthopaedics and Sports Medicine, Seattle

Natural Cures for Arthritis – Earth Clinic

Last Modified on Sep 07, 2015

Arthritis is defined as inflammation of one or more joints. The primary symptoms of the condition include joint stiffness and pain. The condition is typically considered progressive and worsens with age; however, the specific type of arthritis determines the rate and direction of progression.

The two main forms of arthritis are osteoarthritis and rheumatoid arthritis. Osteoarthritis is caused by wear and tear while rheumatoid arthritis is considered an autoimmune disorder.

Pain and stiffness are the most characteristic symptoms of the condition; however, additional symptoms are common. Swelling, redness, and decreased range of motion are other indicative symptoms.

While the exact type of medical treatment for arthritis depends on the type of arthritis, several medications are common. Analgesics, nonsteroidal anti-inflammatory drugs or NSAIDs, counterirritants, and biologics are among the most common treatment options. However, many of these treatments are limited at best and harmful at worst.

Treatments such as analgesics only treat pain and do nothing to reduce inflammation. Likewise, NSAIDs can cause stomach irritation and increase the risk of heart attack and stroke. Biologics put you at risk for more serious immune diseases and debilitate the immune system altogether.

As limited as traditional medical treatments are, we suggest treating arthritis from a natural perspective. This approach relies on natural remedies, such as apple cider vinegar, baking soda, and blackstrap molasses, as well as noninvasive practices, like weight loss, exercise, and acupuncture.

Apple cider vinegar is an effective treatment option for a variety of reasons. The treatment contains beta-carotene, which serves as an antioxidant, as well as acetic acid. The combination of these two helps relieve arthritis pain and reduce inflammation.

As an imbalance in the bodys natural pH level is one of the primary causes of arthritis, baking soda is an effective treatment option. Baking soda helps neutralize the bodys acidic state and return the body to alkalinity. As it does so, baking soda helps relieve arthritis pain and inflammation.

Blackstrap molasses is a nutrient-rich syrup with powerful healing qualities. The syrup contains a variety of nutrients including magnesium and calcium that regulate the nerve impulses in the body and relieve pain.

While no one likes to hear the W word, consider the fact that a single 1 pound loss takes 4 pounds of pressure off of your joints. When you look at it that way, it makes sense that losing weight would help effectively treat arthritis, a joint disease. Consider your current weight compared to you suggested weight and see if you need to make any changes.

Exercise helps strengthen the body, including the muscles and the bones. It also helps promote effective circulation. As such, it can help relieve inflammation and even pain associated with arthritis.

An ancient Chinese practice, acupuncture utilizes specific pressure points to relieve pain. This treatment can relieve pain and promote general movement.

Understanding your condition is one of the most important forms of treatment, but aside from that utilizing natural treatment options or at least support is vital as well. Give one of our suggestions a try or add your favorite remedy to a reader-contributed list below!

Additional Pages of Interest: Rheumatoid Arthritis Osteoarthritis Pain Remedies

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Natural Cures for Arthritis - Earth Clinic

Arthritis Advice | National Institute on Aging

The word "arthritis" makes many people think of painful, stiff joints. But, there are many kinds of arthritis, each with different symptoms and treatments. Most types of arthritis are chronic. That means they can go on for a long period of time.

Arthritis can attack joints in almost any part of the body. Some types of arthritis cause changes you can see and feelswelling, warmth, and redness in your joints. In some kinds of arthritis, the pain and swelling last only a short time, but are very uncomfortable. Other types of arthritis might be less painful, but still slowly cause damage to your joints.

Arthritis is one of the most common diseases in the United States. Older people most often have osteoarthritis, rheumatoid arthritis, or gout.

Osteoarthritis (OA) is the most common type of arthritis in older people. OA starts when tissue, called cartilage, that pads bones in a joint begins to wear away. When the cartilage has worn away, your bones rub against each other. OA most often happens in your hands, neck, lower back, or the large weight-bearing joints of your body, such as knees and hips.

OA symptoms range from stiffness and mild pain that comes and goes to pain that doesn't stop, even when you are resting or sleeping. Sometimes OA causes your joints to feel stiff after you haven't moved them for a while, like after riding in the car. The stiffness goes away when you move the joint. Over time, OA can make it hard to move your joints. It can cause a disability if your back, knees, or hips are affected.

Why do you get OA? Growing older is what most often puts you at risk for OA, possibly because your joints and the cartilage around them become less able to recover from stress and damage. Also, OA in the hands may run in families. Or, OA in the knees can be linked with being overweight. Injuries or overuse may cause OA in joints such as knees, hips, or hands.

Rheumatoid arthritis (RA) is an autoimmune disease, a type of illness that makes your body attack itself. RA causes pain, swelling, and stiffness that lasts for hours. RA can happen in many different joints at the same time. People with RA often feel tired or run a fever. RA is more common in women than men.

RA can damage almost any joint. It often happens in the same joint on both sides of your body. RA can also cause problems with your heart, muscles, blood vessels, nervous system, and eyes.

Gout is one of the most painful kinds of arthritis. It most often happens in the big toe, but other joints can also be affected. Swelling may cause the skin to pull tightly around the joint and make the area red or purple and very tender.

Eating foods rich in purines like liver, dried beans, peas, anchovies, or gravy can lead to a gout attack in people with the disease. Using alcohol, being overweight, and taking certain medications may make gout worse. In older people, some blood pressure medicines can also increase the chance of a gout attack. To decide if you have gout, your doctor might do blood tests and x-rays.

You might have some type of arthritis if you have:

If any one of these symptoms lasts more than 2 weeks, see your regular doctor or one who specializes in treating arthritis, called a rheumatologist. If you have a fever, feel physically ill, suddenly have a swollen joint, or have problems using your joint, see your doctor right away.

Getting enough rest, doing the right exercise, eating a healthy, well-balanced diet, and learning the right way to use and protect your joints are keys to living with any kind of arthritis. The right shoes and a cane can help with pain in the feet, knees, and hips when walking. But make sure the cane is fitted by a professional. Dont borrow one from a friend or neighbor. There are also gadgets to help you open jars and bottles or to turn the doorknobs in your house.

Some medicines can help with pain and swelling. Acetaminophen might ease arthritis pain. Some people find NSAIDs (nonsteroidal anti-inflammatory drugs), like ibuprofen, naproxen, and ketoprofen, helpful. Some NSAIDs are sold without a prescription, while others must be prescribed by a doctor. Be very careful about possible side effects of some NSAIDs, whether sold with or without a prescription. Read the warnings on the package or insert that comes with the drug. Talk to your doctor about if and how you should use acetaminophen or NSAIDs for your arthritis pain. The U.S. Food and Drug Administration has more information about drugs such as those mentioned here.

Osteoarthritis (OA). Medicines can help you control the pain. Rest and exercisemay make it easier to move your joints. Keeping your weight down is a good idea. If pain from OA is very bad, there are shots your doctor can give you.

Rheumatoid arthritis (RA). Treatment can help the pain and swelling. This might slow down or stop joint damage. You may feel better and find it easier to move around. Your doctor might also suggest anti-rheumatic drugs called DMARDs (disease-modifying antirheumatic drugs). These can slow damage from the disease. Other medicines known as corticosteroids (like prednisone) can ease swelling. These are strong medicine and should only be taken with a doctors prescription. Another kind of drug, called a biologic response modifier, blocks the damage done by the immune system. These may help people with mild-to-moderate RA when other treatments have not worked.

Gout. The most common treatment for an acute attack of gout is NSAIDs or corticosteroids. They can bring down the swelling, so you may start to feel better within a few hours after treatment. The pain usually goes away within a few days. If you have had an attack of gout, talk to your doctor to learn why you had the attack and how to prevent future attacks. If you have had several attacks, your doctor might prescribe medicines to prevent future ones.

Along with taking the right medicine and properly resting your joints, exercise might help with arthritis symptoms. Daily exercise, such as walking or swimming, helps keep joints moving, lessens pain, and makes muscles around the joints stronger.

Three types of exercise are best if you have arthritis:

The National Institute on Aging (NIA) has created the Go4Life campaign to help you start and stick with a safe exercise program. You can learn all about it by going to There youll find exercises, tip sheets, personal success stories, and more! You can even keep track of progress in your exercise program. You can also order Go4Life materials in English and Spanish by calling the NIA at 1-800-222-2225 (toll-free).

Along with exercise and weight control, there are other ways to ease the pain around joints. You might find comfort by using a heating pad or a cold pack, soaking in a warm bath, or swimming in a heated pool.

Your doctor may suggest surgerywhen damage to your joints becomes disabling or when other treatments do not help with pain. Surgeons can repair or replace some joints with artificial (man-made) ones.

Recent studies suggest that acupuncture may ease OA pain for some people. Research also shows that two dietary supplements, glucosamine and chondroitin, may help lessen moderate to severe OA pain, but they seem to have no effect on changes to cartilage in the knee. Scientists continue to study these kinds of alternative treatments. Always check with your doctor before trying any new treatment for arthritis.

Many people with arthritis try remedies that have not been tested or proven helpful. Some of these, such as snake venom, are harmful. Others, such as copper bracelets, are harmless, but also unproven.

How can you tell that a remedy may be unproven?

See below for more information about getting NIA's AgePage called Beware of Health Scams.

Pain and arthritis do not have to be part of growing older. You can work with your doctor to safely lessen the pain and stiffness and to prevent more serious damage to your joints.

Here are some helpful resources:

American College of Rheumatology/Association of Rheumatology Health Professionals 2200 Lake Boulevard, NE Atlanta, GA 30319 1-404-633-3777

Arthritis Foundation P.O. Box 7669 Atlanta, GA 30357-0669 1-800-283-7800 (toll-free) or check the telephone directory for your local chapter

Food and Drug Administration 10903 New Hampshire Avenue Silver Spring, MD 20993 1-888-463-6332

National Center for Complementary and Alternative Medicine NCCAM Clearinghouse P.O. Box 7923 Gaithersburg, MD 20898 1-888-644-6226 (toll-free) 1-866-464-3615 (TTY/toll-free)

National Institute of Arthritis and Musculoskeletal and Skin Diseases NIAMS Information Clearinghouse 1 AMS Circle Bethesda, MD 20892-3675 1-877-226-4267 (toll-free) 1-301-565-2966 (TTY)

To get the NIA's exercise guide or Beware of Health Scams or for more information on health and aging, contact:

National Institute on Aging Information Center P.O. Box 8057 Gaithersburg, MD 20898-8057 1-800-222-2225 (toll-free) 1-800-222-4225 (TTY/toll-free)

Sign up for regular email alerts about new publications and find other information from the NIA.

Visit, a senior-friendly website from the National Institute on Aging and the National Library of Medicine. This website has health and wellness information for older adults. Special features make it simple to use. For example, you can click on a button to make the type larger.

National Institute on Aging National Institutes of Health NIH...Turning Discovery into Health U.S. Department of Health and Human Services

July 2009 Updated February 2012

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Arthritis News — ScienceDaily

Common Mental Health Drug Could Be Used to Treat Arthritis July 16, 2015 Lithium chloride which is used as a mood stabiliser in the treatment of mental health problems, mainly bipolar disorder, could be used to treat arthritis according to a new ... read more Rheumatoid Arthritis: Novel Approach Identifies Unique DNA Signature July 14, 2015 Researchers have for the first time identified disease-associated changes to the DNA epigenome in joint fluid cells from patients with rheumatoid ... read more Arthritis Drug Could Be Used to Treat Blood Cancer Sufferers July 5, 2015 Scientists have discovered that a common drug given to arthritis sufferers could also help to treat patients with blood cancers, and is one thousandth of the cost of another drug that works in the ... read more New Test Could Predict Arthritis Drug Failure in Patients July 3, 2015 It may be possible to predict early which rheumatoid arthritis patients will fail to respond to the biologic drugs given to treat them, a study of 311 patients has found.These findings could help ... read more Vitamin B12 Supplement Linked to Pimply Skin June 24, 2015 Vitamin B12 tweaks how genes behave in the facial bacteria of some people who normally enjoy clear skin, leading to pimples, new research ... read more Patients With Primary Hand Osteoarthritis Should Not Be Prescribed Hydroxychloroquine, Study Suggests June 13, 2015 The results of an interventional trial showed that use of the disease-modifying anti-rheumatic drug hydroxychloroquine for 24 weeks did not diminish mild-moderate pain from primary hand ... read more Biologics Improve Productivity and Reduce Missed Workdays in Rheumatic Disease June 12, 2015 The results of a systematic review of published studies showed that biologics improve both absenteeism (not showing up for work) and presenteeism (being at work but not functioning fully) in patients ... read more Low Birth Weight and Childhood Infections Predict Ankylosing Spondylitis June 11, 2015 The results of a new study showed that a diagnosis of ankylosing spondylitis can be predicted by low birth weight, having older siblings and hospitalization for infection between the ages of 5-16 ... read more Physical Trauma Associated With Onset of Psoriatic Arthritis Among Psoriasis Patients June 11, 2015 The results of a large population study showed an increased risk of developing Psoriatic Arthritis among psoriasis patients exposed to physical trauma, particularly when the trauma involved bone ... read more Ultrasound-Defined Tenosynovitis Identified as Strong Predictor of Early Rheumatoid Arthritis June 10, 2015 A new study showed that ultrasound diagnosis of tenosynovitis (inflammation of the tendon sheath) was superior to clinical symptoms and signs in the prediction of early Rheumatoid ... read more Intensive Initial Therapy With Triple DMARDs Improves Functional Ability in Early Rheumatoid Arthritis June 10, 2015 New research showed that initial therapy with combination DMARDs significantly improves measures of disease activity and functional ability in patients with early rheumatoid ... read more Stem Cell Discovery Paves Way for Targeted Treatment for Osteoarthritis June 9, 2015 Scientists have made a significant advance that could make cell-based treatments for arthritis less of a lottery. Researchers have identified individual stem cells that can regenerate tissue, ... read more June 3, 2015 A world-first vaccine-style therapeutic approach to treat rheumatoid arthritis has been developed by researchers. Rheumatoid arthritis is a disease in which the immune system attacks healthy tissues, ... read more New UK Research 'Challenges the Assumption That Arthritis Patients Take Their Medication Regularly' May 26, 2015 40% of UK arthritis patients scored low on an adherence questionnaire at least once during their time in a recent study, indicating that they might not be taking their expensive biological therapies ... read more Compound Has Potential for Treating Rheumatoid Arthritis May 21, 2015 A new study outlines a chemical compound with potential for treating rheumatoid arthritis. Rheumatoid arthritis is a chronic autoimmune disorder that affects an estimated 1.3 million people in the ... read more Scientists Reveal Potential New Drug Target for the Treatment of Rheumatoid Arthritis May 20, 2015 A novel drug target for the treatment of rheumatoid arthritis has been identified, which focuses on the cells that are directly responsible for the cartilage damage in affected joints. Rheumatoid ... read more May 12, 2015 An important discovery has been made about an immune cell that is already being used in immunotherapy to treat diseases such as type I diabetes. The work details how regulatory T cells can cure ... read more Rheumatoid Arthritis Patients at Increased Risk of Surprise Heart Attack May 4, 2015 Patients with rheumatoid arthritis are at increased risk of a surprise heart attack, according to new research. Risk was increased even when patients had no symptoms and was independent of ... read more Gene Variants Show Potential in Predicting Rheumatoid Arthritis Disease Outcomes Apr. 29, 2015 Scientists have identified a new way in which genotyping can be used to predict disease outcomes among sufferers of rheumatoid ... read more Caterpillar Fungus Could Hold the Key to Relieving the Pain of Osteoarthritis Apr. 25, 2015 A drug from a parasitic mushroom that lives on caterpillars could become an effective new painkiller for people with osteoarthritis within the next six ... read more

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About Arthritis

You've probably heard the word "arthritis" before. And now, you may be wondering if it could be affecting you. By definition, arthritis means "joint inflammation," and it's used to describe more than 100 different diseases and conditions that affect joints, the tissues that surround joints, and other connective tissue.

Arthritis can affect people differently. It's common in adults 65 and older, but it can affect people of all ages, races, and ethnic groups. In fact, about 1 out of every 5 adults in the United States around 50 million people has reported being diagnosed by their doctor with some form of arthritis.

Osteoarthritis and rheumatoid arthritis have different causes, risk factors, and effects on the body:

Even though they have these differences, osteoarthritis and rheumatoid arthritis often share common symptoms:

Sometimes arthritis symptoms make it harder to do certain activities. By talking to your doctor about your symptoms, he or she may help you find other ways to continue doing some of those activities.

Your doctor can also help evaluate your current treatment and may recommend other, more effective ways to help you manage your arthritis. The sooner you take action and talk to your doctor, the sooner you can start managing your arthritis symptoms more effectively.

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About Arthritis

Arthritis | At A Glance Reports | Publications | Chronic …

About 1 out of every 5 US adults has doctor-diagnosed arthritis. The term arthritis includes more than 100 different rheumatic diseases and conditions, the most common of which is osteoarthritis. Other forms of arthritis that occur often are rheumatoid arthritis, lupus, fibromyalgia, and gout.

Symptoms include pain, aching, stiffness, and swelling in or around the joints. Some forms of arthritis, such as rheumatoid arthritis and lupus, can affect multiple organs and cause widespread symptoms.

Many people think of arthritis as a disease that only affects the elderly, but it affects people of all ages, including children. Although the risk of developing arthritis increases with age, nearly two-thirds of people with arthritis are younger than 65. Arthritis is more common among women (26%) than men (19%), and it affects members of all racial and ethnic groups.

As the US population ages, the number of adults with arthritis is expected to increase to 67 million by 2030. The Centers for Disease Control and Prevention (CDC) is leading the nations efforts to help the millions of adults with arthritis to live well and manage their condition.

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Arthritis, Causes, Tests, Diagnosis & Treatment

What Is It?

Arthritis is a joint disorder that causes mild to severe inflammation, stiffness, and pain. The condition is common among older adults but can also affect younger adults and even children. The condition can limit your flexibility and range of motion and can cause pain that ranges from mild to extreme. The symptoms tend to be more common and pronounced among older adults as a result of the natural aging process.

There are over one hundred types of arthritis that occur for a variety of reasons. Some result from underlying conditions like autoimmune attacks, infections, or viruses, and others result from injury or old age. For some people, arthritis is a lifelong condition that is incurable and untreatable. For others, arthritis is treatable or can resolve itself.

Arthritis can be difficult to live with. For most people, the condition becomes worse and difficult to treat. It is unhealthy to keep taking over-the-counter medications, and prescription drugs are not feasible options for everyone.

Emotionally, living with arthritis can be tough. Slowly and steadily, you may notice that you have more trouble with your occupation and other daily activities. You may not be able to control flare-ups that limit your range of motion by causing stiffness and pain.

There are more than one hundred types of arthritis, making arthritis one of the most common chronic conditions in the world. Arthritis can occur for a variety of reasons that include autoimmune diseases, viruses, bacterial infections, old age, and injury. The most common types of arthritis include osteoarthritis, rheumatoid arthritis, gout, ankylosing spondylitis, psoriatic arthritis, systemic lupus erythematosus, and juvenile arthritis.

Some forms of arthritis occur naturally as a result of age because of wear and tear on the bones, while other forms of arthritis occur because of an underlying condition that is a virus, bacterial infection, or inheritable disease.

Arthritis types run in the family, so there is a likelihood that you will develop the types of arthritis that your parents or immediate family members experienced.

Some autoimmune conditions can cause arthritis in addition to a low-grade fever.

Swelling, joint pain, limited joint movement, stiffness, redness, extreme tenderness, and warmth over the joint are some of the common symptoms of arthritis. In rheumatic forms of arthritis, swollen glands, fatigue, weight loss, and other general symptoms are present. Kidney problems can also be a symptom if systemic forms of arthritis. If you start to experience chronic pain and swelling in the same joint areas, you may have arthritis. Over time, mild symptoms can worsen.

It is normal for people with some forms of arthritis to develop a low-grade fever during a flare-up, especially if the condition is autoimmune. If your fever persists, or if your fever spikes, you should see a doctor as soon as possible since you may be experiencing another underlying infection.

The causes and risk factors depend on the type of arthritis. Injury and age put a person more at risk for osteoarthritis, while systemic diseases like lupus and rheumatoid arthritis don't have clear cut causes or risks. Heredity is also a major risk factor. Diseases like rheumatoid arthritis can affect children as well as adults, while osteoarthritis is more likely to affect an older person.

Certain types of arthritis, such as autoimmune conditions, are genetic. Check to see whether arthritis runs in your family.

Regular, low impact exercise can help prevent arthritis. If you are moving and stretching, you are less likely to feel stiff. In any case, most types of arthritis are impossible to prevent, especially if they are related to an autoimmune condition, disease, or injury.

Treatment for arthritis will vary based on the type of arthritis. Physical therapy can effectively treat some forms of arthritis. Other treatments include medications, anti-inflammatory drugs, herbal supplements, support splints, immunosuppressant drugs, paraffin wax drips, hot packs, cold packs, and surgery.

To diagnose arthritis, a doctor will conduct a physical examination and ask questions about your personal and family medical history. X-rays can show damage from osteoarthritis and group. Blood and urine tests can assess damage to organs and other bodily systems. A rheumatologist is a specialist who treats arthritis and related conditions.

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Arthritis, Causes, Tests, Diagnosis & Treatment

Arthritis Symptoms, Diagnosis, and Treatment

chronicpain. Photo by Frances Twitty (iStockphoto) Recognizing Early Symptoms

Early arthritis symptoms can be vague and confusing, but they are important to recognize. Newly diagnosed patients quickly realize that early symptoms are just the first layer to be uncovered before a definitive diagnosis and treatment plan for arthritis can be established.

Arthritis can affect any joint. Certain types of arthritis are associated with a specific pattern of joint disease. For example, rheumatoid arthritis is usually symmetric -- affecting the same joint on both sides of the body. Other types of arthritis typically affect a single joint. It's important to tell the doctor about all of your symptoms and every joint that hurts.

An accurate diagnosis precedes appropriate treatment of arthritis. With over 100 types of arthritis, early symptoms can overlap and diagnosis can be difficult. Your doctor will look for very specific signs, symptoms, and disease characteristics. Your doctor will also consider your medical history, physical examination, blood tests, and imaging studies.

Doctors play an essential role in the diagnosis and treatment of arthritis. Good communication between a doctor and patient is essential. It's important to know what to expect from your doctor and what your doctor expects from you. It's your doctor's job to assess your symptoms, gain more information from your medical history and a current physical examination, order diagnostic tests, and put together a treatment plan. It's your job to provide your doctor with as much pertinent information as possible. The goal is mutual - to improve your health.

Arthritis literally means joint inflammation. Arthritis is not a single disease. Arthritis refers to a group of more than 100 rheumatic diseases and other conditions that can cause pain, stiffness and swelling in the joints. Some types of arthritis affect more than the joints. There can be systemic effects associated with rheumatoid arthritis, lupus, and other types of arthritis.

Rheumatoid arthritis (RA) is an autoimmune inflammatory type of arthritis. Rheumatoid arthritis affects 2.1 million Americans and three times as many women as men. There are important facts you should know about rheumatoid arthritis.

Osteoarthritis is considered the most common type of arthritis. About 21 million Americans have osteoarthritis. The disease causes limited range of motion, joint pain, and stiffness which affect daily living activities. Osteoarthritis is caused by progressive deterioration of joint cartilage. Typically, osteoarthritis develops gradually.

Psoriatic arthritis is an inflammatory type of arthritis associated with the chronic skin condition psoriasis. Psoriatic arthritis usually develops when people are between 30 and 50 years old, but it can begin in childhood. Men and women seem to be equally affected by psoriatic arthritis. Psoriatic arthritis symptoms occur in variable patterns and with variable intensity.

Gout symptoms can develop when there is excess uric acid in the body. Monosodium urate crystals that form in the joints due to excess uric acid cause gout symptoms. Uric acid is a waste product normally present in the blood as a result of the breakdown of purines. Pseudogout is a condition that develops when calcium pyrophosphate crystals accumulate in a joint and the surrounding tissues.

Ankylosing spondylitis is a type of arthritis which is primarily characterized by chronic inflammation of the joints and ligaments of the spine, causing pain and stiffness in the spine. In severe cases, bones in the spine may fuse (also referred to as ankylosis) resulting in a rigid and inflexible spine. Abnormal posture may be a consequence. Other joints may also be involved including hips, knees, ankles, neck, or shoulders. The disease may also have systemic effects.

The most popular misconception about arthritis is that it is an old person's disease. In reality, arthritis affects people of all ages including over 285,000 American children. The course of juvenile rheumatoid arthritis, or JRA, in children is usually different than is the course of arthritis in adults. Children experience different symptoms and generally have a more favorable prognosis.

In lupus, the immune system of the body attacks its own cells and tissues. The joints, skin, kidneys, lungs, heart, nervous system, and other organs of the body may be affected. There are 5 types of lupus - a disease that affects 10 times more women than men.

Fibromyalgia is an arthritis-related syndrome which can be difficult to diagnose. Fibromyalgia syndrome is a chronic condition characterized by body aches, widespread pain, sleep problems, extreme fatigue, depression, anxiety, and other symptoms, in combination with tenderness of specific areas (muscles and tender points) on the body.

Scleroderma literally means "hard skin". Referred to often as a single disease, scleroderma is actually a symptom of a group of diseases complicated by an abnormal growth of connective tissue which supports the skin and internal organs.

Arthritis and joint pain can occur during late stage Lyme disease. Learn how an infectious disease transmitted by a tick bite can lead to arthritis in some people.

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Arthritis Symptoms, Diagnosis, and Treatment

arthritis | disease |

Arthritis,inflammation of the joints and its effects. Arthritis is a general term, derived from the Greek words arthro-, meaning joint, and -itis, meaning inflammation. Arthritis can be a major cause of disability. In the United States, for example, data collected from 2007 to 2009 indicated that 21 million adults were affected by arthritis and experienced limited activity as a result of their condition. Overall, the incidence of arthritis was on the rise in that country, with 67 million adults expected to be diagnosed by 2030. Likewise, each year in the United Kingdom, arthritis and related conditions caused more than 10 million adults to consult their doctors. Although the most common types of arthritis are osteoarthritis and rheumatoid arthritis, a variety of other forms exist, including those secondary to infection and metabolic disturbances.

Osteoarthritis, also known as degenerative joint disease, is the most common form of arthritis, affecting nearly one-third of people over age 65. It is characterized by joint pain and mild inflammation due to deterioration of the articular cartilage that normally cushions joints. Joint pain is gradual in onset, occurring after prolonged activity, and is typically deep and achy in nature. One or multiple joints may be affected, predominantly involving the knee, hips, spine, and fingers.

Approximately 90 percent of individuals experience crepitus (crackling noises) in the affected joint with motion. Muscle weakness and joint laxity or stiffness can occur as people become reluctant to move painful joints. Patients tend to have decreased joint stability and are predisposed to injuries such as meniscal and anterior cruciate ligament tears. Hip arthritis can affect gait, while arthritis of the hands can lead to decreased dexterity. Enlargement of the bony processes surrounding affected joints, called osteophytes (bone spurs), are common.

Joint trauma, increased age, obesity, certain genetic factors and occupations, and hobbies or sports that result in excessive joint stresses can result in the cartilaginous changes leading to osteoarthritis. Damage begins with the development of small cracks in the cartilage that are perpendicular to the joint. Eventually, cartilage erodes and breaks off, facilitating painful bone-on-bone contact. In due course, pathologic bony changes, such as osteophytes and subchondral bone cysts, develop and further restrict joint movement and integrity.

Osteoarthritis may be divided into two types, primary and secondary osteoarthritis. Primary osteoarthritis is age-related, affecting 85 percent of individuals 7579 years of age. Although the etiology is unknown, primary osteoarthritis is associated with decreased water-retaining capacity in the cartilage, analogous to a dried-up rubber band that can easily fall apart. Secondary osteoarthritis is caused by another condition, such as joint trauma, congenital joint malalignment, obesity, hormonal disorders, and osteonecrosis. Treatment for osteoarthritis is directed toward reducing pain and correcting joint mechanics and may include exercise, weight loss, nonsteroidal anti-inflammatory drugs, steroids, and total joint replacement surgery.

Autoimmune arthritis is characterized by joint inflammation and destruction caused by ones own immune system. Genetic predisposition and inciting factors, such as an infection or trauma, can trigger the inappropriate immune response. Rheumatoid arthritis, which is an autoimmune disease, is often associated with elevations in the serum level of an autoantibody called rheumatoid factor, whereas the seronegative arthropathies are not.

Rheumatoid arthritis is a progressive inflammatory condition that can lead to decreased mobility and joint deformities. The worldwide prevalence is 0.8 percent, with a 2:1 predilection for women over men. Disease onset, mainly occurring in the third and fourth decades of life, may be acute or slowly progressive with initial symptoms of fatigue, weakness, malaise, weight loss, and mild, diffuse joint pain. Rheumatoid arthritis tends to affect the hips, knees, elbows, ankles, spine, hands, and feet symmetrically. The disease course is characterized by periods of remission, followed by progressive exacerbations in which specific joints become warm, swollen, and painful. Morning stiffness, typically lasting about two hours, is a hallmark feature of rheumatoid arthritis. Patients with rheumatoid arthritis tend to complain of joint pain after prolonged periods of inactivity, whereas osteoarthritis is typically exacerbated with extended activity. Rheumatoid arthritis can be severely debilitating, resulting in a variety of deformities. Some patients experience complete remission, which typically occurs within two years of disease onset.

Although the exact cause is unknown, rheumatoid arthritis results from the inflammation of the tissues surrounding the joint space. The thin lining of the joint space becomes thick and inflamed, taking on the form of a mass with fingerlike projections (pannus), which invades the joint space and surrounding bone. Initially, this results in joint laxity. However, with progression, the bones can actually undergo fusion (ankylosis), limiting motion.

The effect rheumatoid arthritis has on the hands is a defining characteristic. Clinically, it can be distinguished from osteoarthritis based on the distribution of joints affected in the hands. Rheumatoid arthritis tends to affect the more proximal joints, whereas osteoarthritis tends to affect the more distal joints of the hands and fingers. In severe cases, joint laxity and tendon rupture result in a characteristic deformity of the fingers and wrist.

Rheumatoid nodules are thick fibrous nodules that form as a result of excessive tissue inflammation in rheumatoid arthritis. These nodules are typically present over pressure points, such as the elbows, Achilles tendon, and flexor surfaces of the fingers. Destruction of peripheral blood vessels (vasculitis) from the inflammatory process can occur in any organ, leading to renal failure, myocardial infarction (heart attack), and intestinal infarction (death of part of the intestine). In addition, rheumatoid arthritis is also associated with an increased risk of infections, osteoporosis (thinning of bones), and atherosclerosis (hardening of arteries).

Diagnosis of rheumatoid arthritis is based on the presence of several clinical features: rheumatoid nodules, elevated levels of rheumatoid factor, and radiographic changes. Although rheumatoid factor is found in 70 to 80 percent of people with rheumatoid arthritis, it cannot be used alone as a diagnostic tool, because multiple conditions can be associated with elevated levels of rheumatoid factor.

Since no therapy cures rheumatoid arthritis, treatment is directed toward decreasing symptoms of pain and inflammation. Surgical treatment may include total joint replacement, carpal tunnel release (cutting of the carpal ligament), and tendon repair. Hand splints are used to slow the progression of finger and wrist deformations.

The overall life span of individuals with rheumatoid arthritis is typically shortened by 510 years and is highly dependent on disease severity. Disease severity and the likelihood of extra-articular manifestations are each directly related to serum rheumatoid factor levels.

Several rheumatoid arthritis variants exist. In Sjgren syndrome the characteristic symptoms include dry eyes, dry mouth, and rheumatoid arthritis. Felty syndrome is associated with splenomegaly (enlarged spleen), neutropenia (depressed white blood cell levels), and rheumatoid arthritis. Juvenile rheumatoid arthritis is the most common form of childhood arthritis. Disease etiology and clinical course typically differ from that of adult-onset rheumatoid arthritis, and sufferers are prone to the development of other rheumatologic diseases, including rheumatoid arthritis.

Ankylosing spondylitis, Reiter syndrome, psoriatic arthritis, and arthritis associated with inflammatory bowel disease are a subset of conditions known as spondyloarthropathies. Typically affected are the sacrum and vertebral column, and back pain is the most common presenting symptom. Enthesitis, inflammation at the insertion of a tendon or ligament into bone, is a characteristic feature of spondyloarthropathy. Unlike rheumatoid arthritis, spondyloarthropathies are not associated with elevated levels of serum rheumatoid factor. Spondyloarthropathies occur most frequently in males and in individuals with a genetic variation known as HLA-B27.

Ankylosing spondylitis is the most common type of spondyloarthropathy, affecting 0.1 to 0.2 percent of the population in the United States. In a region of Turkey, prevalence was found to be 0.25 percent, and in the United Kingdom prevalence is estimated to range from 0.1 to 2 percent. In all regions, the condition occurs more frequently in males than in females and typically strikes between ages 15 and 40. Genetic studies have shown that more than 90 percent of all patients with ankylosing spondylitis who are white and of western European descent are HLA-B27 positive.

Ankylosing spondylitis is characterized by arthritis of the spine and sacroiliac joints. Extensive inflammation of the spinal column is present, causing a characteristic bamboo spine appearance on radiographs. Arthritis first occurs in the sacroiliac joints and gradually progresses up the vertebral column, leading to spinal deformity and immobility. Typical symptoms include back pain, which lessens with activity, and heel pain due to enthesitis of the plantar fascia and Achilles tendon. Hip and shoulder arthritis may occur early in the course of the disease.

Reiter syndrome, a type of reactive arthritis, is characterized by the combination of urethritis, conjunctivitis, and arthritis. Patients typically develop acute oligoarthritis (two to four joints affected) of the lower extremities within weeks of gastrointestinal infection or of acquiring a sexually transmitted disease. Reiter arthritis is not considered an infectious arthritis, because the joint space is actually free of bacteria. Instead, an infection outside the joint triggers this form of arthritis. Other symptoms can include fever, weight loss, back pain, enthesitis of the heel, and dactylitis (sausage-shaped swelling of the fingers and toes). Most cases resolve within one year; however, 1530 percent of patients develop chronic, sometimes progressive arthritis. Occurring almost exclusively in men, Reiter syndrome is strongly linked to the HLA-B27 gene variant, which is present in 65 to 96 percent of symptomatic individuals.

Psoriasis is an immune-mediated inflammatory skin condition characterized by raised red plaques with an accompanying silvery scale, which can be painful and itchy at times. Though typically seen on the elbow, knees, scalp, and ears, plaques can occur on any surface of the body. About 10 percent of people with psoriasis (possibly as many as 30 percent in some regions of the world) develop a specific type of arthritis known as psoriatic arthritis.

Psoriatic arthritis typically occurs after psoriasis has been present for many years. In some cases, however, arthritis may precede psoriasis; less often, the two conditions appear simultaneously. Estimates on the prevalence of psoriatic arthritis vary according to population. However, overall, it is thought to affect nearly 1 percent of the general population, with a peak age of onset between 30 and 55. Usually less destructive than rheumatoid arthritis, psoriatic arthritis tends to be mild and slowly progressive, though certain forms, such as arthritis mutilans, can be quite severe. Occasionally the onset of symptoms associated with psoriatic arthritis is acute, though more often it is insidious, initially presenting as oligoarthritis with enthesitis. Over time, arthritis begins to affect multiple joints (polyarthritis), especially the hands and feet, resulting in dactylitis. Typically, the polyarticular pattern of psoriatic arthritis affects a different subset of finger joints than rheumatoid arthritis. It is not until years after peripheral arthritis has occurred that psoriatic arthritis may affect the axial joints, causing inflammation of the sacroiliac joint (sacroiliitis) and intervertebral joints (spondylitis).

Arthritis mutilans is a more severe and much less common pattern (seen in fewer than 5 percent of psoriatic arthritis cases) resulting in bone destruction with characteristic telescoping of the fingers or toes. In addition, individuals with psoriatic arthritis necessitate more aggressive treatment if the onset of the condition occurs before age 20, if there is a family history of psoriatic arthritis, if there is extensive skin involvement, or if the patient has the HLA-DR4 genotype.

Crohn disease and ulcerative colitis, two types of inflammatory bowel disease, are complicated by a spondyloarthropathy in as many as 20 percent of patients. Although arthritis associated with inflammatory bowel disease typically occurs in the lower extremities, up to 20 percent of cases demonstrate symptoms identical to ankylosing spondylitis. Arthritis is usually exacerbated in conjunction with inflammatory bowel disease exacerbations and lasts several weeks thereafter.

Joint inflammation, destruction, and pain can occur as a result of the precipitation of crystals in the joint space. Gout and pseudogout are the two primary types of crystalloid arthritis caused by different types of crystalloid precipitates.

Gout is an extremely painful form of arthritis that is caused by the deposition of needle-shaped monosodium urate crystals in the joint space (urate is a form of uric acid). Initially, gout tends to occur in one joint only, typically the big toe (podagra), though it can also occur in the knees, fingers, elbows, and wrists. Pain, frequently beginning at night, can be so intense that patients are sensitive to even the lightest touch. Urate crystal deposition is associated with the buildup of excess serum uric acid (hyperuricemia), a by-product of everyday metabolism that is filtered by the kidneys and excreted in the urine. Causes of excess uric acid production include leukemia or lymphoma, alcohol ingestion, and chemotherapy. Kidney disease and certain medications, such as diuretics, can depress uric acid excretion, leading to hyperuricemia. Although acute gouty attacks are self-limited when hyperuricemia is left untreated for years, such attacks can recur intermittently, involving multiple joints. Chronic tophaceous gout occurs when, after about 10 years, chalky, pasty deposits of monosodium urate crystals begin to accumulate in the soft tissue, tendons, and cartilage, causing the appearance of large round nodules called tophi. At this disease stage, joint pain becomes a persistent symptom.

Gout is most frequently seen in men in their 40s, due to the fact that men tend to have higher baseline levels of serum uric acid. In the early 21st century the prevalence of gout appeared to be on the rise globally, presumably because of increasing longevity, changing dietary and lifestyle factors, and the increasing incidence of insulin-resistant syndromes.

Pseudogout is caused by rhomboid-shaped calcium pyrophosphate crystals deposition (CPPD) into the joint space, which leads to symptoms that closely resemble gout. Typically occurring in one or two joints, such as the knee, ankles, wrists, or shoulders, pseudogout can last between one day and four weeks and is self-limiting in nature. A major predisposing factor is the presence of elevated levels of pyrophosphate in the synovial fluid. Because pyrophosphate excess can result from cellular injury, pseudogout is often precipitated by trauma, surgery, or severe illness. A deficiency in alkaline phosphatase, the enzyme responsible for breaking down pyrophosphate, is another potential cause of pyrophosphate excess. Other disorders associated with synovial CPPD include hyperparathyroidism, hypothyroidism, hemochromatosis, and Wilson disease. Unlike gout, pseudogout affects both men and women, with more than half at age 85 and older.

Infectious arthritides are a set of arthritic conditions caused by exposure to certain microorganisms. In some instances the microorganisms infiltrate the joint space and cause destruction, whereas in others an infection stimulates an inappropriate immune response leading to reactive arthritis. Typically caused by bacterial infections, infectious arthritis may also result from fungal and viral infections.

Septic arthritis usually affects a single large joint, such as the knee. Although a multitude of organisms may cause arthritis, Staphylococcus aureus is the most common pathogen. Neisseria gonorrhoeae, the bacteria that causes gonorrhea, is a common pathogen affecting sexually active young adults.

The most common way by which bacteria enter the joint space is through the circulatory system after a bloodstream infection. Microorganisms may also be introduced into the joint by penetrating trauma or surgery. Factors that increase the risk of septic arthritis include very young or old age (e.g., infants and the elderly), recent surgery or skin infection, preexisting arthritic condition, immunosuppression, chronic renal failure, and the presence of a prosthetic joint.

Postinfectious arthritis is seen after a variety of infections. Certain gastrointestinal infections, urinary tract infections, and upper respiratory tract infections can lead to arthritic symptoms after the infections themselves have resolved. Examples include Reiter syndrome and arthritis associated with rheumatic fever.

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Arthritis, or inflammation of the joints, is the most common extraintestinal complication of IBD. It may affect as many as 25% of people with Crohns disease or ulcerative colitis. Although arthritis is typically associated with advancing age, in IBD it often strikes the youngest patients. In addition to joint pain, arthritis also causes swelling of the joints and a reduction in flexibility.

In IBD, arthritis may appear in three different forms. These are:

Peripheral arthritis usually affects the large joints of the arms and legs, including the elbows, wrists, knees, and ankles. The discomfort may be migratory, moving from one joint to another. If left untreated, the pain may last from a few days to several weeks. Peripheral arthritis tends to be more common among people who have ulcerative colitis or Crohns disease of the colon. The level of inflammation in the joints generally mirrors the extent of inflammation in the colon. Although no specific test can make a definitive diagnosis, various diagnostic methodsincluding analysis of joint fluid, blood tests, and X-raysare used to rule out other causes of joint pain. Fortunately, IBD-related peripheral arthritis usually does not cause any lasting damage.

Also known as spondylitis or spondyloarthropathy, axial arthritis produces pain and stiffness in the lower spine and sacroiliac joints (at the bottom of the back). Interestingly, and especially in young people, these symptoms may come on months or even years before the symptoms of IBD appear. Unlike peripheral arthritis, axial arthritis may cause permanent damage if the bones of the vertebral column fuse togetherthereby creating decreased range of motion in the back. In some cases, a restriction in rib motion may make it difficult for people to take deep breaths. Active spondylitis generally subsides by age 40. Therapy for people with axial arthritis is geared toward improving range of motion in the back. Stretching exercises are recommended, as is the application of moist heat to the back.

A more severe form of spinal arthritis, ankylosing spondylitis (AS) is a rare complication, affecting between 2% and 3% of people with IBD. It is seen more often in Crohns disease than in ulcerative colitis. In addition to causing arthritis of the spine and sacroiliac joints, ankylosing spondylitis can cause inflammation of the eyes, lungs, and heart valves. The cause of AS is not known, but most affected individuals share a common genetic marker. In some cases, the disease occurs in genetically predisposed people after exposure to bowel or urinary tract infections. Occasionally, AS foretells the development of IBD. AS typically strikes people under the age of 30, mainly adolescents and young adult males, appearing first as a dramatic loss of flexibility in the lower spine. Rehabilitation therapy is essential to help maintain joint flexibility. But even with optimal therapy, some people will develop a stiff or ankylosed spine. Symptoms of AS may continue to worsen even after surgical removal of the colon.

It is not always easy to determine whether the arthritis is linked to the intestinal condition. In general, the arthritis that complicates IBD is not as severe as rheumatoid arthritis. The joints do not ordinarily undergo destructive changes, and joint involvement is not symmetric (affecting the same joints on both sides of the body). Except for ankylosing spondylitis, arthritis associated with IBD usually improves as intestinal symptoms improve.

In the general population, people with peripheral arthritis may use nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and swelling of the joints. However, as a rule, these medicationswhich include aspirin and ibuprofen are not an option for everyone with IBD because they can prompt a disease flare by irritating the intestinal lining and intensifying the inflammation. (It should be noted, though, that some people with IBD can tolerate NSAIDs and find these medications helpful in relieving symptoms of arthritis.) Corticosteroids also may be used to treat the arthritis symptoms as well as IBD.

In most cases, doctors manage the symptoms of peripheral arthritis by controlling the inflammation within the colon. Once that has subsided after a course of a medication such as prednisone or sulfasalazine, joint pain generally disappears. Similarly, the newer biologic agents such as infliximab (Remicade) have also been shown to be effective in reducing joint inflammation and swelling. Infliximab has even shown good results as a treatment for ankylosing spondylitis. Only axial arthritis seems not to improve as the intestinal inflammation resolves. Unlike peripheral arthritis, there is no correlation between treatment of the underlying IBD and improvement in axial arthritis symptoms.

In addition to medication, doctors may recommend resting the affected joint as well as the occasional use of moist heat. Range of motion exercises, as demonstrated by a physical therapist, may also be helpful.

The Crohns & Colitis Foundation of America provides information for educational purposes only. We encourage you to review this educational material with your health care professional. The Foundation does not provide medical or other health care opinions or services. The inclusion of another organizations resources or referral to another organization does not represent an endorsement of a particular individual, group, company or product.

For further information, call CCFA at our IBD Help Center: 888.MY.GUT.PAIN (888.694.8872).

The Crohn's & Colitis Foundation of America provides information for educational purposes only. We encourage you to review this educational material with your health care professional. The Foundation does not provide medical or other health care opinions or services. The inclusion of another organization's resources or referral to another organization does not represent an endorsement of a particular individual, group, company or product.

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Arthritis | ASPCA

Canine arthritis, also known as osteoarthritis or degenerative joint disease, is characterized by pain and inflammation in a dogs joints. Arthritis is caused by the breaking down of smooth cartilage that covers and protects the bones that form a joint. Once the bones are exposed, painful wear and tear can occur.

Dogs who have canine arthritis may:

A veterinarian may conduct a physical exam, take radiographs and perform other diagnostic tests to help determine the cause of your dogs pain. He or she will also check your dogs medical history for previous injuries and consider possible inherited conditions.

Canine arthritis can occur as a result of:

Note: If a larger dog suffers any injuries or sprains during his growth period, this can cause him to develop arthritis later in life.

Although certain larger breed dogs such as mastiffs and Great Danes are susceptible to arthritis, the condition can develop in all breeds and mixed breeds as the result of joint infection, dislocation, trauma or family genetics. Elder dogs also often develop arthritis as a result of aging.

Keeping your dog fit with exercise and proper nutrition may, in some cases, help prevent arthritis, or possibly slow its progression once the condition has set in. In fact, if your dog is a larger breed, it's necessary to monitor the type and amount of food given when his bones are still growing. However, arthritic conditions cannot always be predicted or prevented, especially those that are inherited.

Once symptoms of arthritis set in, there is no cure. Its important for you to work with your veterinarian to create a program to minimize your dogs pain while keeping him healthy. Some general treatment options may include:

Note: Please do not give your dog human medication without first checking with your vet.

Generally, dogs with arthritis should engage in daily low-impact exercise such as walking or, if possible, swimming.

If your dog has arthritis, here are a few ways that you can make her more comfortable.

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Arthritis | ASPCA

Arthritis – KidsHealth

You may have heard about arthritis (say: ar-thry-tis), which is a disease that causes swelling and pain in a person's joints.

But isn't it something that only old people get?

Actually, kids can get a kind of arthritis called juvenile idiopathic arthritis or JIA (it's also called juvenile rheumatoid arthritis, or JRA). Juvenile means young, so this means that JIA is different from the arthritis that adults get. Kids can have many different types of arthritis, but this is the most common.

Joints are the places where bones meet. Arthritis can prevent people from moving their joints properly. JIA affects kids under age 16, who have arthritis in one or more joints.

Many problems can cause pain and swelling of the joints, so a doctor will want to know how long these problems have been going on. To be considered JIA, a kid must have swelling and pain for at least 6 weeks.

Seven types of juvenile idiopathic arthritis can affect kids:

No one really knows what causes JIA. Something in the environment such as a virus may trigger the disease in kids that already have certain genes that make it more likely for them to get it. JIA is not contagious, so you can't catch it from someone else.

Arthritis is an autoimmune (say: aw-toe-i-myoon) disease. Normally, a kid's immune system sends out white blood cells to protect the body and fight outside invaders like bacteria and viruses that can make a kid sick. With JIA, the immune system makes a mistake and targets healthy cells as if they were harmful.

Instead of recognizing the healthy cells and saying, "Hi, nice to see you," the immune system thinks the healthy cells need to be destroyed and releases chemicals to fight the healthy cells. The chemicals the immune system releases cause the pain and swelling that a kid with arthritis experiences.

Just because a joint hurts doesn't mean a kid has JIA. A joint might hurt for a lot of different reasons, which is why it's important to see a doctor to figure out what the problem is.

The doctor will ask a lot of questions: How long has the kid had joint problems? Does he or she feel stiff when getting up or after resting? Are the joints swollen? Was there an injury? Could another problem be causing arthritis, such as Lyme disease? Is there a family history of arthritis or other autoimmune diseases?

Getting these answers and doing a physical exam, blood tests, and X-rays will help the doctor figure out if it is JIA. If your doctor suspects that you may have it, he or she may send you to see a doctor who specializes in the diagnosis and treatment of arthritis. This kind of doctor is called a rheumatologist (say: roo-muh-tol-oh-jist).

Some kids who have JIA might take medicine such as ibuprofen to help control pain and inflammation. If the arthritis is more severe, they may need to take additional medicines to decrease pain and inflammation and to slow the progression of the disease. Some of these medicines are pills, but others are shots.

It is important that kids with JIA keep their joints moving. Often a kid will see a physical therapist or occupational therapist. In addition to working with children to move their joints and strengthen their muscles, these therapists can help create special exercise programs for home or school that can help a kid stay active.

In addition to joint problems, JIA may cause uveitis (say: yoo-vee-eye-tus), an inflammation of the eye that can lead to problems with vision if it's not treated. It's more common in kids with oligoarticular arthritis but all kids diagnosed with JIA should get their eyes checked by an ophthalmologist, a doctor who specializes in diagnosing and treating eye problems. If the eyes are affected, they may be treated with eye drops.

A kid can do a few things to help with the symptoms of JIA besides taking medicines:

Kids with JIA can have a lot of stiffness when they first wake up in the morning. Once their joints warm up, they can usually move more easily. That's why you might notice that someone with JIA has trouble moving early in the day, but seems better later on.

It's important to find a good balance between activity (which helps kids stay flexible) and rest (which everyone needs). Swimming is a great exercise for someone with JIA. It stretches a lot of different muscles and tendons and helps keep a kid moving and flexible. It's important to stay active even when a kid isn't having symptoms.

Sometimes kids with JIA can go a long time, even months or years, without the disease bothering them. Then it comes back. This is called a flare-up or flare. Flare-ups just happen and can't be prevented. It can be frustrating if a flare-up happens on a day when the kid would like to be doing something fun, like attending a birthday party.

If you know someone with JIA, you may offer to carry books or give other help, if needed. It's also OK if the person doesn't want help.

The good news is that many kids with JIA will outgrow it. Kids with oligoarticular JIA generally do better than kids with polyarticular arthritis, but as many as 7 out of 10 kids with polyarticular JIA may not require treatment as adults.

And even when the arthritis is active, almost all kids with JIA can control it with medicine and other treatments, which means they can do most things that other kids can do.

Reviewed by: AnneMarie C. Brescia, MD Date reviewed: January 2012

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Arthritis - KidsHealth

Rheumatoid Arthritis: Medication, Treatment and Diet Facts

Rheumatoid Arthritis Rheumatoid Arthritis Overview

Rheumatoid arthritis is a chronic joint disease that damages the joints of the body. It is also a systemic disease that potentially affects internal organs of the body and leads to disability. The joint damage is caused by inflammation of the joint lining tissue. Inflammation is normally a response by the body's immune system to "assaults" such as infections, wounds, and foreign objects. In rheumatoid arthritis, the inflammation is misdirected to attack the joints. Rheumatoid arthritis is often referred to as RA.

Rheumatoid arthritis can be confused with other forms of arthritis, such as osteoarthritis or arthritis associated with infections. Rheumatoid arthritis is an autoimmune disease. This means that the body's immune system mistakenly attacks the tissues it is supposed to protect.

Rheumatoid arthritis most often affects the smaller joints, such as those of the hands and/or feet, wrists, elbows, knees, and/or ankles, but any joint can be affected. The symptoms often lead to significant discomfort and disability.

Although rheumatoid arthritis most often affects the joints, it is a disease of the entire body. It can affect many organs and body systems besides the joints. Therefore, rheumatoid arthritis is referred to as a systemic disease.

Medically Reviewed by a Doctor on 5/11/2015

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Rheumatoid Arthritis: Medication, Treatment and Diet Facts

Arthritis Information from

Arthritis is a condition associated with swelling and inflammation of the joints, which often results in pain and restriction of movement. The most common forms of arthritis are osteoarthritis, which is a breakdown of the cartilage in the joints, and rheumatoid arthritis, which is an inflammation of the tissue lining the joints and in severe cases inflammation of other body tissues. In the joints, sustained inflammation leads to hypertrophy of the synovium and the formation of a "pannus", which spreads over the joint causing erosive destruction of the bone and cartilage. Rheumatoid arthritis occurs when the body's immune system starts attacking it's own organs (joints, bones, internal organs).

Arthritis is a result of a breakdown in cartilage or inflammation.

Cartilage protects joints and enables smooth movement by absorbing shock when pressure is placed on a joint. Without the usual amount of cartilage, the bones rub together and this causes pain, swelling (inflammation), and stiffness.

Joint inflammation can occur for a variety of reasons, including:

Often, the inflammation goes away once the injury has healed, the disease is treated, or once the infection has been cleared. However, with some injuries and diseases, the inflammation does not go away or the cartilage is destroyed and long-term pain and deformity results. When this happens, the disease is called chronic arthritis.

Osteoarthritis is the most common type of arthritis and is more likely to occur with increasing age. It can occur in any of the joints but is most common in the hips, knees or fingers.

Risk factors for osteoarthritis include:

Arthritis can occur in both men and women and in individuals of all ages. Some forms of arthritis also affect children.

As mentioned earlier, the most common forms of arthritis are Osteoarthritis and Rheumatoid arthritis. However, there are numerous forms of arthritis, including:

A person suffering from arthritis may experience any of the following:

A doctor will first note your symptoms and will then look at your medical history in detail to see if arthritis or another musculoskeletal problem is the likely cause of those symptoms.

Your doctor will then perform a thorough physical examination to see if there is any fluid collecting around the joint (an abnormal build up of fluid around a joint is called "joint effusion."). The joint may be tender when gently pressed, and it may also be warm and red (especially if you have infectious arthritis or autoimmune arthritis). You may also find it painful or difficult to rotate the joints in some directions (this is known as "limited range-of-motion").

After this initial physical examination, your doctor may then ask you to undertake a number of different tests, depending on what they suspect to be the cause of your symptoms. Often, you will need to have a blood test and joint x-rays. You may also need to have a test where joint fluid is removed from the joint with a needle; the fluid will then be examined under a microscope to check for infection and for other causes of arthritis, such as crystals, which cause gout.

If arthritis is diagnosed and treated early, you can prevent joint damage. Find out if you have a family history of arthritis and share this information with your doctor, even if you have no joint symptoms. In some autoimmune forms of arthritis, the joints may become deformed if the disease is not treated. Osteoarthritis may be more likely to develop if you over-use your joints. Take care not to overwork a damaged or sore joint. Similarly, avoid excessive repetitive motions. Excess weight also increases the risk for developing osteoarthritis in the knees, and possibly in the hips and hands.

The treatment of arthritis depends on the particular cause of the disease, on the joints that are affected, on the severity of the disorder and on the effect it has on your daily activities. Your age and occupation will also be taken into consideration when your doctor works with you to create a treatment plan.

If possible, treatment will focus on eliminating the underlying cause of the arthritis. However, sometimes the cause is NOT curable, as with osteoarthritis and rheumatoid arthritis. In this case, the aim of treatment will be to reduce pain and discomfort and prevent further disability. Symptoms of osteoarthritis and other long-term types of arthritis can often be improved without medications. Making lifestyle changes without medications is preferable for osteoarthritis and other forms of joint inflammation. If needed, medications should be used in addition to lifestyle changes.

Your doctor will select the most appropriate medication for your form of arthritis.

Most people can take acetaminophen without any problems so long as they do not exceed the recommended dose of 4 grams in 24 hours (taken in 4 divided doses every 4 to 6 hours). It reduces mild pain but does not help with inflammation or swelling. Acetaminophen is available as a combination with other mild pain relief medicines for mild osteoarthritic pain, and with narcotics for severe pain. Acetaminophen with aspirin and or caffeine are over-the-counter medicines. Acetaminophen with codeine, propoxyphene or narcotics are prescription medicines.

Although NSAIDs work well, long-term use of these medicines can cause gastrointestinal problems, such as stomach ulcers and bleeding. In April 2005, the FDA asked manufacturers of NSAIDs to include a warning label on their products that alerts users of an increased risk of cardiovascular events (heart attacks and strokes) and gastrointestinal bleeding.

Taking a combination of NSAIDs or NSAIDs and aspirin together increases the incidence of stomach ulcers or bleeding.

These contain a non steroidal anti-inflammatory drug and a stomach protecting agent, to prevent or treat the gastrointestinal side effects which may be caused by NSAIDs.

COX-2 inhibitors block an inflammation-promoting enzyme called COX-2. This class of drugs was initially believed to work as well as traditional NSAIDs, but with fewer stomach problems. However, numerous reports of heart attacks and strokes have prompted the FDA to re-evaluate the risks and benefits of the COX-2 inhibitors. Rofecoxib (Vioxx) and valdecoxib (Bextra) have been withdrawn from the U.S. market following reports of heart attacks in some patients taking the drugs. The available medicines in this class have been labeled with strong warnings and a recommendation that these be prescribed at the lowest possible dose and for the shortest duration possible.

Corticosteroids have been used to reduce inflammation in rheumatoid arthritis for more than 40 years but it is not known whether they can slow down the progression of disease. It can be used in conjunction with other rheumatoid arthritis medicine.

Potential long-term side effects of corticosteroids limit the use of oral corticosteroids to short courses and low doses where possible. Side effects may include bruising, psychosis, cataracts, weight gain, susceptibility to infections and diabetes, high blood pressure and thinning of the bones (osteoporosis). A number of medications can be administered with steroids to minimize the risk of osteoporosis.

Intra-articular steroid injections can effectively relieve pain, reduce inflammation, increase mobility and reduce deformity in one or a few joints. If repeated injections are required then the dose of DMARDs should be increased.

Corticosteroids suppress the immune system and also reduce pain and inflammation. They are commonly used in severe cases of osteoarthritis and they can be given orally or by injection. Steroid injections are given directly into the joint (intra-articular). Steroids are used to treat autoimmune forms of arthritis but they should be avoided if you have infectious arthritis. Steroids have multiple side effects, including upset stomach and gastrointestinal bleeding, high blood pressure, thinning of bones, cataracts, and increased infections. The risks are most pronounced when steroids are taken for long periods of time or at high doses. Close supervision by a physician is essential.

DMARDs are the most effective agents available for controlling rheumatoid arthritis, but they all have a slow onset of action. Mechanisms of action for most of these agents are not known and they all are different but they all appear to slow or stop the changes in the joints. They can alter laboratory characteristics of disease activity and delay the progression of bone damage.

Patients taking DMARDs generally show some response within 8 to 10 weeks. However, this is variable depending on the patient and drug. Dose of DMARDs is titrated up as far as side effects allow. An additional DMARD is added when the maximum dose is reached, or the initial DMARD is stopped and switched to another.

Most DMARDs require monitoring (such as full blood count, liver function test, urea and electrolyte level test) to ensure drug safety, as the majority can cause bone marrow toxicity and some can cause liver toxicity as well. Regular blood or urine tests should also be done to determine how well medications are working.

Methotrexate is probably the most commonly used DMARD. It is effective in reducing signs and symptoms of rheumatoid arthritis and slows down damage to the joint. Results can be seen in 6 to 8 weeks. Other DMARDs such as hydroxychloroquine and sulfasalazine can used in conjunction with methotrexate.

Hydroxychloroquine, an antimalarial drug, is effective in the treatment of rheumatoid arthritis. It is usually used in combination with methotrexate and sulfasalazine for added benefits.

Sulfasalazine is also an effective DMARD. It can reduce symptoms and slow down the joint damage.

Leflunomide shows similar effectiveness to methotrexate and can be used in patients who cannot take methotrexate.

Tumor necrosis factor (TNF) inhibitors are a relatively new class of medications used to treat autoimmune disease. They include etanercept, infliximab, adalimumab, tocilizumab, certolizumab and golimumab. TNF Inhibitors are also called "Biologics" biological response modifiers.

Tumor necrosis factor alpha is produced by macrophages and lymphocytes, and acts on many cells in the joints and in other organs and body systems. It is a pro-inflammatory cytokine known to mediate most of the joint damage. In rheumatoid arthritis it is produced by the synovial macrophages and lymphocytes. By inhibiting TNF alpha the inflammation process, which attacks or damages the joint tissue, is halted or slowed.

Methotrexate can be used with TNF inhibitors to increase the effectiveness of therapy.

Gold is also effective in the treatment of rheumatoid arthiritis, particularly when given intramuscularly. It isn't used as often now due to its side effects and slow onset of action. Oral gold preparation is available but is less efficacious compared to the intramuscular preparation.

Abatacept decreases T cell proliferation and inhibits the production of the cytokines tumor necrosis factor (TNF) alpha, interferon-?, and interleukin-2.

Rituximab depletes the B cells, which have several functions in the immune response. Rituximab has reduced signs and symptoms of rheumatoid arthritis, and manages to slow down the joint destruction.

The Interleukin-1 Inhibitor, Anakinra, is a new synthetic protein that blocks the inflammatory protein interleukin-1. Anakinra is used to slow progression of moderate to severe active rheumatoid arthritis in patients who have not responded to one or more of the DMARDs.

Alkylating agents, such as cyclophosphamide, are drugs that suppress the immune system and are sometimes used in people who have failed other therapies. These medications are associated with toxic side effects and usually reserved for severe cases of rheumatoid arthritis.

Many people find that over-the-counter nutraceuticals and vitamins, such as glucosamine and chondroitin sulfate help relieve the symptoms of osteoarthritis. There is some evidence that these supplements are helpful in controlling pain, although they do not appear to grow new cartilage.

Bioflavonoids are found in the rind of green citrus fruits and in rose hips and black currants. They have been used historically in a variety of disease states including rheumatic fever, habitual abortion, poliomyelitis, prevention of bleeding, rheumatoid arthritis, periodontal disease, diabetic retinitis, and others.

Diclofenac topical is a non-steroidal anti-inflammatory drug. Although it is applied topically it is still absorbed systemically and may cause systemic effects such as gastrointestinal side effects.

Trolamine salicylate is a topical salicylate pain reliever, used for minor pain and inflammation. It works by reducing swelling and inflammation in the muscle and joints.

Capsaicin is extracted from chillies (genus Capsicum). Capsaicin topical causes a decrease in a substance (substance P) in the body that causes pain. It is used to relieve minor aches and pains of muscle and joints associated with arthritis, simple backache, strains and sprains.

Hyaluronic acid is normally present in joint fluid, and in osteoarthritis sufferers this gets thin. Hyaluronic acid can be injected into the joint to help protect it. This may relieve pain for up to six months.

Non-drug treatment is also important. It is important to make lifestyle changes. Exercise helps maintain joint and overall mobility. Ask your health care provider to recommend an appropriate home exercise routine. Water exercises, such as swimming, are especially helpful. You also need to balance rest with activity. Non-drug pain relief techniques may help to control pain. Heat and cold treatments, protection of the joints and the use of self-help devices are recommended. Good nutrition and careful weight control are important. Weight loss for overweight individuals will reduce the strain placed on the knee and ankle joints.

Physical therapy can be useful for improving muscle strength and motion at stiff joints. Therapists have many techniques for treating osteoarthritis. If therapy does not make you feel better after 3-6 weeks, then it is likely that it will not work at all.

Splints and braces can sometimes support weakened joints. Some prevent the joint from moving, while others allow some movement. You should use a brace only when your doctor or therapist recommends one. The incorrect use of a brace can cause joint damage, stiffness and pain.

Surgery to replace or repair damaged joints may be needed in severe, debilitating cases.

Surgical options include:

Arthroplasty - total or partial replacement of the deteriorated joint with an artificial joint e.g. knee arthroplasty, hip arthroplasty.

Arthroscopic - surgery to trim torn and damaged cartilage and wash out the joint.

Cartilage Restoration - For some younger patents with arthritis, cartilage restoration is a surgical option to replace the damaged or missing cartilage.

Osteotomy - change in the alignment of a bone to relieve stress on the bone or joint.

Arthrodesis - surgical fusion of bones, usually in the spine.

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Arthritis Information from

Arthritis – Arthritis Causes – Symptoms, Treatments, and …

Arthritis is a general term for more than 100 diseases that cause inflammation, pain, stiffness and swelling of joints. Common types of arthritis include:

Osteoarthritis - an ongoing, progressive disease that affects the joints as cartilage breaks down over time. Osteoarthritis is also called degenerative joint disease.

Rheumatoid arthritis - an autoimmune disease that affects the joints of the body with episodes of painful inflammation. Rheumatoid arthritis also affects other organs of the body and can result in the destruction of joints, disability, and, in severe cases, life-threatening complications.

Septic arthritis - arthritis caused by the infection of a joint by microorganisms, such as bacteria or fungi.

Complications of all forms of arthritis can be serious and include destruction of the joints, leading to disability. Rheumatoid arthritis and septic arthritis can also lead to serious or life-threatening complications that can affect almost any organ in the body.

Seek prompt medical care if you have symptoms of arthritis, such as inflammation, pain, stiffness, and swelling of joints. Early diagnosis and treatment can minimize discomfort and reduce the risk of serious complications.

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Arthritis & Joint Pain – Orthopedics Advice from

Image Medical Multimedia Group What is Arthritis?

Arthritis is a condition that causes inflammation of joint. While there are many types of arthritis, all types cause joint inflammation. Common complaints of people with arthritis include joint pain, swelling, and stiffness.

Arthritis come in many different types, and can affect any joint. Determining the best treatment for your arthritis will depend on identifying the type of arthritis and determining which joints are affected.

Common symptoms of arthritis include joint pain, swelling, and limited movement. The severity of symptoms of arthritis tends to correspond to the degree of inflammation of the joint.

Once you have determined the type of arthritis, you can review potential treatments for your condition. Most often, doctors will recommend trying simpler treatments for arthritis first to determine if your condition can be managed with minimal intervention.

Joint replacement surgery is generally considered a last-step treatment for the most severe cases of joint arthritis. Joint replacement surgery uses artificial joints to take the place of your worn out joint.

The best way to avoid problems associated with arthritis is to try to prevent progression of the condition. For people who have had arthritis in one joint, it is important to prevent the progression of arthritis in other joints.

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Arthritis & Joint Pain - Orthopedics Advice from