Arthritis

Arthritis is a common condition that causes pain and inflammation (swelling) of the joints and bones. The main symptoms of  arthritis include:

  • pain
  • stiffness
  • restricted movements of the joints
  • inflammation and swelling
  • warmth and redness of the skin over the joint

One in every six people in Ireland is affected by arthritis

The most common forms of arthritis are:

The characteristics of these two conditions are discussed below. Other types of arthritis are listed in the box, below left.

What is osteoarthritis?

The majority of people over 55 in Ireland have x ray evidence of osteoarthritis at some joint in their body.However,it can develop at any age as a result of an injury or another joint-related condition

In people affected by osteoarthritis, the cartilage (connective tissue) between their bones gradually wastes away (degenerates), leading to painful rubbing of bone on bone in the joints. The most frequently affected joints are in the:

  • hands
  • spine
  • knees
  • hips

Osteoarthritis often develops in people who are over 50 years of age. However, it can develop at any age as a result of an injury or another joint-related condition.

The cause of osteoarthritis is not fully understood. One theory is that some people are genetically predisposed to developing osteoarthritis, which means that they have an increased likelihood of inheriting it from their parents. However, this theory has not yet been proven.

See the A-Z topic about osteoarthritis for more information and advice about the condition.

What is rheumatoid arthritis?

Rheumatoid arthritis is a more severe, but less common, form of arthritis than osteoarthritis. It occurs when the body's immune system attacks and destroys the affected joints, causing pain and swelling to occur. This can lead to a reduction in movement and the breakdown of bone and cartilage. Women are three times more likely to be affected by the condition than men.

Rheumatoid arthritis is caused by a fault in the immune system (the body's natural defence against illness and infection) that makes the body attack its own tissues. The fault may be inherited genetically (passed on from a family member).

See the A-Z topic about rheumatoid arthritis for more information and advice about the condition.

Arthritis and children

Arthritis is often associated with older people, but sometimes it can also affect children. This is known as juvenile idiopathic arthritis (JIA). However, JIA is uncommon, affecting about one in 1,000 children.

The main types of JIA are discussed briefly below.

Oligo-articular JIA

Oligo-articular JIA is the most common type of JIA. It affects four or fewer joints in the body, most commonly in the knees, ankles and wrists.
Oligo-articular JIA has good recovery rates and long-term effects are rare.

However, there is a risk that children with the condition may develop eye problems, so it is advised that they should have regular eye checks with an eye care specialist (ophthalmologist).

Polyarticular JIA (or polyarthritis)

Polyarticular JIA (or polyarthritis) is type of JIA that affects five or more joints. It can develop at any age during childhood.

The symptoms of polyarticular JIA are similar to those of adult rheumatoid arthritis. The condition is often accompanied by a rash and a high temperature (fever) of 38C (100.4F) or above.

Systemic onset JIA

Systemic onset JIA begins with symptoms such as a fever, rash, lethargy (a lack of energy) and enlarged glands. Later on, joints may become swollen and inflamed. Like polyarticular JIA, systemic onset JIA can affect children of any age.

Enthesitis-related arthritis

Enthesitis-related arthritis is a type of juvenile arthritis that affects older boys or teenagers. The condition can cause pain in the soles of the feet and around the knee and hip joints, where the ligaments attach to the bone.

Outlook

There is no cure for arthritis, but there are a number of treatments that can help to slow down the condition's progress. Medication can help to relieve the symptoms of arthritis and, in severe cases, surgery may be recommended.

For osteoarthritis, analgesics (painkillers), non-steroidal anti-inflammatory drugs (NSAIDs), and corticosteroids are often prescribed. In very severe cases, surgical procedures may be recommended such as:

  • arthroplasty (joint replacement therapy
  • arthodesis (joint fusion)
  • osteotomy (the addition or removal of bone)

See the A-Z topic about Osteoarthritis - treatment for more information about how the condition is treated.

In treating rheumatoid arthritis, the aim is to slow down the condition's progress and minimise joint damage. Treatments that may be recommended for rheumatoid arthritis include:

  • analgesics (painkillers)
  • disease modifying anti-rheumatic drugs (DMARDs)
  • physiotherapy
  • regular exercise

See the A-Z topic about Rheumatoid arthritis - treatment for more information about how the condition is treated.

Support groups

Arthritis Ireland

 

Joints
Joints are the connection point between two bones that allow movement.
Spine
The spine supports the skeleton and surrounds and protects the delicate spinal cord and nerves. It is made up of 33 bones called the vertebrae.
Pain
Pain is an unpleasant physical or emotional feeling that your body produces as a warning sign that it has been damaged.
Inflammation
Inflammation is the body's response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.
Chronic
Chronic usually means a condition that continues for a long time or keeps coming back.

Useful Links

Arthritis Ireland

 

Other types of arthritis

There are over 200 different types of rheumatic diseases (conditions that cause aches and pains in a person’s bones, joints and muscles).

Some of the most common types of arthritis include:

  • ankylosing spondylitis- a chronic (long-term) type of arthritis that affects the bones, muscles and ligaments of the spine
  • cervical spondylitis - also known as degenerative osteoarthritis, cervical spondylitis affects the joints and bones in the neck
  • fibromyalgia - a condition that causes pain in the muscles, ligaments and tendons, as well as all over the body
  • lupus - a chronic (long-term) condition that causes inflammation in the body's tissues
  • gout - a type of arthritis that usually affects the big toe, but can develop in any joint in the body
  • psoriatic arthritis- joint inflammation that affects people with the skin condition, psoriasis
  • reactive arthritis - can cause inflammation of the joints, eyes, and urethra (the tube that runs from the bladder through the penis in men, or vulva in women, through which urine is passed)
  • secondary arthritis- a type of arthritis that can develop after a joint injury; it sometimes occurs many years after the injury
  • polymyalgia rheumatica - a condition where the immune system attacks healthy tissue, causing muscle pain, stiffness and joint inflammation

This page gives information on the symptoms of the two main types of arthritis: osteoarthritis and rheumatoid arthritis.

Symptoms of osteoarthritis

The main symptoms of osteoarthritis are:

  • pain, especially when doing load-bearing activities, such as walking
  • short-lived stiffness in the morning, which improves in 30 minutes or less when you start to move
  • difficulty moving your affected joints or doing certain activities 

However, in some cases of osteoarthritis, you may not have any symptoms at all, as the pain can come in episodes. Often, you will only experience symptoms in one joint or a few joints at any one time. Your symptoms may also develop slowly.

Other features you or your doctor may notice include:

  • joint tenderness
  • increased pain and stiffness when you have not moved your joints for a while
  • joints appearing slightly larger or more 'knobbly' than usual
  • a grating or crackling sound or sensation in your joints
  • limited range of movement in your joints
  • weakness and muscle wasting (loss of muscle bulk)

You are most likely to develop osteoarthritis in the joints of your knees, hips or hands.

For more information about how osteoarthritis can affect the knees, hips and hands, see Osteoarthritis - Symptoms 

Symptoms of rheumatoid arthritis

The symptoms of rheumatoid arthritis usually develop gradually. The first symptoms are often felt in small joints, such as your fingers and toes, although shoulders and knees can be affected early, and muscle stiffness can be a prominent early feature.

The symptoms of rheumatoid arthritis vary from person to person, but are usually:

  • pain and stiffness in the joints
  • warmth and redness
  • inflammation around the joints and in other areas

These symptoms can come and go, and they may change over time. You will experience flare-ups when from time to time, your condition will worsen and your symptoms will be more intense and severe.

You can experience a flare-up at any time of the day or night. However, it is likely that your symptoms will be more painful in the morning, when you first wake up. Usually, your symptoms will begin to ease as the day progresses and you start using and flexing your joints.

For more information, see Rheumatoid arthritis - Symptoms

 

Useful Links

 

Arthritis Ireland

There are things that you can do to manage your condition, ease your symptoms and improve your quality of life. For example:

  • Controlling your weight can help to ease pressure on joints.
  • Avoiding stress or injury to your joints can help to prevent or reduce the severity of osteoarthritis.
  • Good posture can strengthen healthy joint structure.
  • Physiotherapy and use of a walking stick or cane can help prevent worsening of existing conditions.
  • Weight-bearing exercise, such as walking, will help to prevent osteoarthritis by increasing the strength of muscles that support your joints. It's not true that avoiding exercise will help reduce joint problems in later life.

Your GP can refer you to an occupational therapist who will be able to advise you on the equipment you may need to assist your independent living. They can also write supporting letters to your local social services department. If you need to adapt your home, a range of services and merchandise is available, so it's important to shop around.

Protect yourself

Arthritis can sometimes make you less flexible and mobile. This can increase your risk of having an accident. There are several measures you can take to limit this risk.

  • Eliminate home hazards. Always keep your home well lit and remove all loose wires and cords that you may trip over. Make sure treads, rugs and carpets are secure. Keep rubber mats by the sink and in the bath to prevent slipping, and always clean up spills immediately. Install grab rails in the bathroom and toilet to help you stand up without falling. Your GP or local authority may be able to give you support or advice about safety in the home.
  • Improve your balance. Exercise that helps improve your balance can prevent a fall. Being physically active can prevent up to 25% of falls. Ideal forms of exercise for improving balance include t'ai chi, yoga and dance.
  • Exchange high heels for flats. High heels are bad for your posture and make you more prone to take a fall, so try to wear flat, comfortable footwear.
  • Don't drink too much. Alcohol can affect your balance, making you more likely to take a knock or a fall. Try to keep within the government recommended daily amounts of alcohol of no more than two to three units for women and three to four for men. A unit of alcohol is half a pint of normal strength lager or beer, one pub measure of a spirit or one small glass of wine.
  • Check your sight. As we get older, most of us will experience some deterioration in our eyesight. It's important to get your sight checked regularly by a qualified optician. Poor eyesight can increase your risk of accident and injury.
  • Ask for help. If you know you have arthritis, avoid standing on chairs to reach high cupboards or change a light bulb. Also, try to avoid chores that you know lead to more pain. Write a list of the jobs that need doing around the house and save it for the next time you have a visit from friends or family.

 

 

Useful Links

Arthritis Ireland

 

Will I lose my driving licence?

If you suffer from a condition which could inetrfere with your ability to drive you should inform your doctor and the Road Safety Authority.www.rsa.ie

There are many food myths surrounding arthritis. Some people say that dairy products cause arthritis. Some say that cider vinegar and honey will cure it. Others say that acidic fruits (such as lemons, oranges and grapefruit) and nightshade vegetables (such as potatoes, aubergines and peppers) can make symptoms worse. Many people living with arthritis, especially rheumatoid arthritis, also say there's a link between certain foods and the flare-ups they experience.

There's little evidence to support these claims, but some studies suggest that certain foods may help reduce inflammation and pain, and slow the progression of arthritis. These foods all contribute to a healthy balanced diet, which will help with the arthritis, and can also reduce your risk of developing health complications, such as heart disease, osteoporosis and obesity.

  • People taking steroids over a long period of time are more likely to develop osteoporosis. You can reduce your risk of this by eating foods that are rich in calcium and vitamin D. Calcium-rich foods include dairy products (milk, cheese and yoghurt), nuts and seeds (especially sesame seeds) and fish such as sardines or whitebait (especially if you eat the bones). The sun on our skin is our main source of vitamin D. However, vitamin D can also be found in oily fish and fortified foods, such as cereals and margarines.
  • Certain foods, such as patés, uncooked meats and unpasteurised dairy products, can increase the risk of developing food poisoning. People taking immunosuppressant drugs are advised to avoid them.
  • There is increasing evidence that the Mediterranean diet is good for arthritis and a number of other conditions. This diet includes plenty of fruit, vegetables, fish, grains and pulses, with a moderate amount of red meat. Foods rich in omega-3 are believed to have an anti-inflammatory effect, which may reduce the pain associated with inflamed joints. Omega-3 is found in oily fish, such as sardines, mackerel and salmon. Try to eat at least two portions of oily fish a week. Omega-3 is also found in nuts and seeds (especially linseed or flax seed), and is regularly used to fortify margarines, cereals and bio-live yoghurt drinks.

 

Useful Links

Arthritis Ireland

 

'Some studies suggest that certain foods may help reduce pain and inflammation, and slow the progression of arthritis'

Foods that may help with rheumatoid arthritis

  • apples
  • berries
  • cherries
  • citrus fruits
  • nuts
  • all leafy green vegetables
  • low-fat dairy products
  • oily fish
  • wholegrains

Finding the right sort of exercise is important for people with arthritis. Regular exercise can help you manage the disease. It can help you maintain a healthy weight, improve your posture and reduce your chance of getting osteoporosis. 

Three types of exercise combine to make up a good fitness regime:

  • Range of movement. This helps improve strength and flexibility, and promotes good posture. Try swimming, t'ai chi and golf.
  • Strengthening. This will help build the muscles, which in turn provide better support for your joints. Try weight training. 
  • Aerobic. This raises your heartbeat, which helps to improve your level of fitness by strengthening your heart. Some of the best forms of aerobic exercise are brisk walking, cycling and tennis.

Remaining physically active gives you the best possible chance of managing the symptoms of arthritis effectively. It's also essential for minimising your risk of experiencing a number of other health problems. Maintaining an appropriate level of physical activity is key to reaping the health benefits of exercise. Try to be realistic about the amount of exercise that you're able to do and choose a form of activity that you enjoy.

When you first start your exercise programme you may experience some pain. This is often due to new muscles being used. However, if you feel pain for longer than two hours after the exercise or any pain in the joints, you must consult your GP or physiotherapist before performing that exercise again.

Tips for exercising with osteoarthritis

  • Regular exercise can be the best way to help reduce the symptoms of osteoarthritis. By keeping active you will strengthen the muscles surrounding the joints, which reduces further joint deterioration.
  • Exercise helps you maintain a healthy weight, meaning you put less strain on your joints.
  • A moderate exercise programme is far more beneficial than a strenuous programme. Too much exercise can cause further pain and joint degeneration.
  • Try to do small exercises every day that improve your range of movement. Arthritis Care provides a very comprehensive list of exercises for you to try. 
  • Never force a painful joint.

Tips for exercising with rheumatoid arthritis

  • It's very important for people with rheumatoid arthritis to get the right balance between rest and activity.
  • You can still exercise during a flare-up, but you should reduce the intensity of your workout.
  • Exercise when you're least tired.
  • Try to do small exercises every day that improve your range of movement.
  • Exercising in the morning can help reduce morning stiffness.
  • Exercises that build and strengthen muscles can help protect and support your joints.
  • Swimming, cycling and brisk walking are known as low impact exercises. They're particularly good for people with rheumatoid arthritis.
  • Concentrate on maintaining good posture at all times.

Useful Links

Arthritis Ireland

 

Caring for someone with arthritis can be a varied and demanding job. This is because of the broad range of medical, personal and emotional needs that a person with arthritis can have.

If you're caring for a family member, you may not consider yourself a carer because you're just doing what needs to be done. You might feel that you have no other options. This can be stressful and you may feel resentful towards the person you're caring for, which can also leave you feeling guilty. You may have been forced to leave your job, give up hobbies and stop socialising, which can be very isolating.

Being a carer means that you may be entitled to certain financial benefits.For information on benefits for carers go to www.citizensinformation.ie



Useful Links

Arthritis Ireland

 

People respond differently to treatments, but some people find that complementary therapies can ease the discomfort and pain caused by arthritis. There are also complementary therapies that reportedly improve flexibility and mobility.

Most of the evidence regarding the beneficial effects of complementary therapies for treating the symptoms of arthritis is anecdotal and hasn't been clinically proven to be effective. However, if you're suffering pain, and arthritis is having a detrimental effect on your life, then trying out complementary therapies is a positive way of taking control of your symptoms and may help you manage your pain.

Your GP or consultant will be able to advise you about your different treatment options, including some complementary therapies.

How do I know which complementary therapy is safe?
The following checklist will help you ensure your treatment is safe and reliable.

  • Ask how long the treatment is likely to last and how much it will cost.
  • Find out if there is a governing body for the treatment you plan to receive and whether your chosen therapist is a member.
  • Make sure they have insurance cover.
  • Ask about their training, how long they have practised and if they have any particular areas of expertise.
  • Tell them about any medication you're taking.
  • Don't stop taking any medication until you have discussed it with your GP or consultant.
  • If you don't trust a therapist, don't use them.

I have heard that acupuncture may help treat the symptoms of arthritis and prevent further deterioration, is this true?
There's no clinical proof of this, or that acupuncture will prevent the progression of the disease. Some people report that acupuncture has helped them to manage the pain that's associated with arthritis. If you're interested in trying acupuncture, talk to your doctor.

Useful Links

 

Arthritis Ireland

 

 
The cause of arthritis is not fully known. One theory is that some people are genetically predisposed to developing the disease, but this is not yet proven. Factors that may contribute to the development of osteoarthritis include:obesity, which puts added strain on joints, jobs that involve repetitive movements of a particular joint, or previous damage to joint, such as from a sports injury.

Rheumatoid arthritis is thought to be caused by a fault in the immune system that causes the body to attack its own tissues. This may be inherited genetically.People with a family history of osteoarthritis seem to be more prone to developing the condition, although the reason why has not been fully established. Arthritis caused by a virus is called 'reactive arthritis'. It's very difficult to diagnose and can develop at any age, but is more commonly seen in younger people. Reactive arthritis can last between a few weeks and six months. Antibiotics are often the first line of treatment for reactive arthritis. A steroid injection may also be offered to alleviate inflamed joints.

 

Useful Links

Arthritis Ireland

 

Content provided by NHS Choices www.nhs.uk and adapted for Ireland by the Health A-Z.

Browse Health A-Z