Arthritis is a condition where various joints can be affected, including the hands, knees, feet, back. Generally it manifests as pain in those joints.
There are different types of arthritis. The most common is wear-and-tear arthritis, which affects many Americans and people around the world.
In terms of arthritis, we as rheumatologists classify arthritis as inflammatory versus non-inflammatory.
Non-inflammatory arthritis includes degenerative arthritis, osteoarthritis, degenerative joint disease and various others. They essentially come naturally due to aging. It can be worsened if you’ve had an injury or you’ve had trauma to a joint. But it occurs with most patients over time.
For a lot of patients, it’s things like activity. Sometimes weather changes really affect our patients. Cold weather and rainy weather seems to make pain and stiffness worse.
It occurs equally across both groups of patients.
It really depends on the type of arthritis. For degenerative wear-and-tear arthritis, which is the most common type of arthritis, symptoms tend to occur more slowly over time, first occurring every now and then, and then becoming more chronic, more persistent.
For rheumatoid arthritis patients, they tend to see joint swelling. Sometimes it comes on more slowly, and sometimes it comes on more suddenly.
Rheumatoid arthritis is an arthritis of the immune system. The immune system is going after your joints, trying to essentially take out something that it feels like shouldn’t be there. I often tell patients, think of it like a cut that gets infected that your immune system goes after. Red, hot, angry, tender, swollen are often what rheumatoid arthritis patients feel.
Degenerative or osteoarthritis behaves differently. There tends to be more of a low level of inflammation, although it’s still there.
Psoriatic arthritis is another immune driven arthritis that behaves a bit differently than rheumatoid arthritis. Often these patients have a history of psoriasis. It can occur in various different parts of the body, including the hands, the feet, the back.
No, there are fantastic treatments for psoriatic arthritis, rheumatoid arthritis and gout. We’ve really come a long way in the past decade in terms of helping our patients live relatively symptom-free lives.
Gout is also an immune-driven arthritis. It’s very inflammatory. Your body is reacting to gout crystals that are occurring in your joints. In joints that have gout, the symptoms come on very suddenly, generally over the course of a night. Very painful, very tender, very swollen. Often times patients can’t even walk because the pain is so severe.
There’s not a direct correlation between osteoarthritis and gout, but we do know that joints that have had gout inflammation tend to get early osteoarthritis in those joints.
Osteoarthritis can occur anywhere. In the hands, it occurs toward the middle or end of your fingers. Rheumatoid arthritis likes the area closer to your hand, and the middle as well. Osteoarthritis really likes the thumb as well.
Gout can technically occur anywhere. Although generally for most patients, their first episode of gout will be in the feet. We often see it in the feet, the ankles, sometimes the knees as well.
Injuries tend to be more acute in nature. Arthritis tends to be more chronic. I’ve had several patients who initially thought their symptoms were related to injury, but the longer they went on gave them a clue that something else was going on.
Some injuries can take a long time to heal. But if something is lasting for several months, that would definitely be a reason to have a provider check you out. If there’s any swelling in your joints, that’s a reason to have someone take a look.
It depends on the type of arthritis. For osteoarthritis or degenerative arthritis, our goal is for you to remain as active and independent for as long as possible. The treatment for this involves a combination approach.
Often times physical therapy, over-the-counter or prescription anti-inflammatories help reduce pain. At times, injections of steroids into joints can help relieve pain.
Typically as a last resort, surgery can sometimes be indicated for some patients in the form of joint replacement as the most common type of surgery.
In regards to physical activity for osteoarthritis, it really depends on the patient and where they are. Anything that’s causing a significant amount of pain, definitely pain that’s lasting several hours after you complete an activity, is probably too much.
Sometimes you have to modify what you’re doing when you have osteoarthritis. I often will encourage patients to cross train. That could be weight-bearing activities that they enjoy, such as running, but also mix it up a little and do some aquatic-based activities to take pressure off those joints.
A stationary bike works. Walking in a pool works. There are lots of different ways to approach that.
Anything that you’re concerned about is something that you should see a physician about. Anything that’s limiting your ability to be active, that’s something that we want to address and try and help with.
Rheumatologists specialize in treating autoimmune types of arthritis, including rheumatoid arthritis, psoriatic arthritis, gout, and others. We use sophisticated medications, injections, imaging, physical therapy, a combination of approaches, to help our patients with autoimmune disease live a more active life.
Lightly edited for clarity.