All about arthritis

Researchers estimate that 36% of adults have arthritis or a similar disorder. Despite being extremely common, much confusion remains. As a rheumatologist that evaluates and treats many forms of arthritis, I am frequently asked, “How did I get this?” “What can I do to help myself?” and “Are medications safe and effective?”

The term “arthritis” is often broadly used to describe pain in the arms, legs, and spine. However, joint pain may result from a disease of the joint, the soft tissue structures around the joint, or pain referred from elsewhere in the body. Additionally, arthritis is different from arthralgia. Arthritis implies a degree of inflammation, but joint pain without inflammation is called arthralgia.

Yet to add more confusion, the classification of arthritis includes inflammatory or noninflammatory subtypes. Clues for inflammation are pain, redness, swelling, and warmth. While noninflammatory arthritis also causes pain, the other features are usually absent.

Examples of noninflammatory arthritis include osteoarthritis and fibromyalgia. In contrast, rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus, and gout are a few examples of inflammatory arthritis.

If you have painful joints, ask yourself the following:

• Are my joints red, warm, or swollen?
• Does it take longer than 1 hour to “loosen up?”
• When my joints hurt, am I fatigued or have a fever?

If you answered yes: 

Inflammatory arthritis may be the cause. Often, it is the result of an autoimmune disease. An evaluation by a rheumatologist for a physical examination, blood work, and X-ray may discover the cause. Treatments include medications in the form of pills or injections in addition to physical therapy. Medications for inflammatory arthritis affect the immune response to decrease inflammation. These may include disease modifying antirheumatic drugs (DMARDs) or biologic therapies. These medications carry risks, so it is important to have a discussion with a rheumatologist about what is best for you.

If you answered no: 

You most likely have arthralgia or noninflammatory arthritis. Still, an evaluation is important, and you should talk to your health care provider. However, treatment differs from inflammatory arthritis and may include pain relievers, physical therapy, joint injections, and surgery. Treatment will not include DMARDs or biologic agents.