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What is arthritis?
What is arthritis?
This booklet provides
information and answers to your
questions about this condition.
www.arthritisresearchuk.org
Arthritis Research UK
What is arthritis?
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Arthritis Research UK
What is arthritis?
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Arthritis Research UK
What is arthritis?
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damage to the joint, for example a fracture Sometimes back pain may be caused
or previous inflammation in that joint (see by a slipped disc (the disc itself doesn’t
Figure 1). really slip; the central part of the disc
bulges through the outer ring) but this
See Arthritis Research UK booklets more commonly causes pain in a limb.
Osteoarthritis; Osteoarthritis Osteoporosis (thinning of the bones)
of the knee. can cause sudden back pain if one of
the bones in the spine crunches down.
In the majority of cases it isn’t possible
Soft tissue musculoskeletal pain to identify the exact cause of the pain,
Soft tissue musculoskeletal pain is often and doctors often describe this as non-
felt in tissues other than your bones and specific or simple back pain.
joints. Typically it’ll come from the muscles
or soft tissues supporting the joints, See Arthritis Research UK booklets
including the bursa which can sometimes Back pain; Osteoporosis.
become inflamed. You may find this type
of pain is localised to one particular part
of the body following an injury or overuse. Connective tissue disease (CTD)
You might find that the pain is more Connective tissues support, bind together
widespread and, if associated with other or separate other body tissues and organs.
symptoms, a diagnosis of fibromyalgia They include tendons, ligaments and
may be made. Often the causes of these cartilage. Joints are usually involved in
symptoms are not fully understood. CTD, but there may also be inflammation
in other tissues such as your skin, muscles,
See Arthritis Research UK booklets lungs and kidneys, so you may feel a range
Elbow pain; Fibromyalgia; Hip pain; of other symptoms besides painful joints.
Neck pain; Shoulder pain; Work-related Examples of this type of disease include
joint disorders. systemic lupus erythematosus (SLE or
lupus), scleroderma and dermatomyositis.
Your healthcare team will often include
Back pain different specialists along with your GP
Back pain is a very common problem because these diseases often affect many
that has a number of different causes. organs.
Pain can arise from muscles, discs,
ligaments, bones and joints. It may See Arthritis Research UK booklets
even be caused by problems with other Lupus (SLE); Polymyositis and
organs inside the body (this is known dermatomyositis; Scleroderma.
as ‘referred pain’). Sometimes there’s a
specific cause such as the degenerative
condition osteoarthritis, (often known as
spondylosis when it occurs in the spine).
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Arthritis Research UK
What is arthritis?
Excess fluid
(effusion)
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Other types of arthritis What are the symptoms
Joint inflammation and pain can also
be due to infection within the joint of arthritis?
itself (septic arthritis) or because of the As there are many types of arthritis,
formation of crystals within the joint, there’s also a wide range of symptoms.
for example gout. Septic arthritis can be With inflammatory arthritis there’s likely
a serious condition, and treatment usually to be more swelling of the joints and
requires long courses of antibiotics. more variation in the pain (which can’t be
Gout can be extremely painful and explained simply by the level of physical
most often affects the joint at the base activity). Other common symptoms
of the big toe. It can usually be treated include early morning joint stiffness,
effectively with medication which prevents tiredness, a general feeling of being
the acute attacks. unwell, weight loss, mild fevers or night
sweats, and skin rashes. But remember
See Arthritis Research UK booklets these symptoms aren’t specific to arthritis
Calcium crystal diseases including acute and can be caused by other illnesses.
CPP crystal arthritis (pseudogout) and
acute calcific tendinitis; Gout.
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Arthritis Research UK
What is arthritis?
It’s common to experience aches and adolescents will suffer from juvenile forms
pains in your muscles and joints from time of arthritis (see Figure 3).
to time, particularly if you take part in
unusual or strenuous physical activities. Figure 3 Approximate numbers of
people affected by some of the rheumatic
So how can you distinguish the early signs diseases in the UK. This is based on those
of arthritis from normal pain and stiffness? seeking treatment from their doctor.
And how do you know when you should
Rheumatic disease People affected
see your doctor about your symptoms?
(see Figure 2). Osteoarthritis 8.5 million (estimate)
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Arthritis Research UK
What is arthritis?
How is arthritis diagnosed?
Your doctor will diagnose
your arthritis by asking you
about your symptoms and how
they’ve developed (your history);
examining you (physical
examination); and possibly
arranging for tests to be done
(investigations).
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Arthritis Research UK
What is arthritis?
1. Symptoms
• Your doctor will need to know the about any swelling in or around your
site of your pain (whether in the joints, including any warmth, redness
joint or between the joints) and and tenderness
which joints are involved • Arthritic conditions can affect
• Separating inflammatory arthritis other organs in your body, so your
from degenerative is important. doctor will ask about other aspects
To do so your doctor will ask you of your health.
2. Examination
Your doctor will be able to tell a lot • Soft tissue disease will usually
from examining you. For example: cause tenderness and pain in
these tissues
• Inflammatory arthritis is likely
to cause swelling in the joints • Because some forms of arthritis
have other signs and symptoms
• Degenerative arthritis will usually
(for example a rash or mouth ulcers),
cause pain and restricted movement,
your doctor may need to examine
but with less swelling, and often
other parts of your body.
a grating feeling (crepitus)
3. Tests
Tests may be carried out to help • Synovial fluid analysis looks at the
confirm the diagnosis, to rule out other lubricating fluid from joints. It can
possible causes or assess the severity help to diagnose inflammation,
of your condition: infection and gout
• Blood tests help make a diagnosis, • A biopsy is when a small amount
and monitor your condition or of tissue is removed and analysed.
drug treatments It’s only done when absolutely
• X-rays show bone abnormalities or necessary
damage but aren’t very good for • Urine tests help with a diagnosis
detecting early signs of arthritis and monitor drug treatments.
• MRI scans, computerised
tomography (CT) and ultrasound
record ‘slices’ of the body to give
detailed pictures of the skeleton
and other tissues to detect early
problems and show inflammation
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Figure 4 Some drugs are used in all types of arthritis, while others are only used in certain
types of disease. Many people may benefit from a combination of drug treatments.
Drugs that treat the symptoms
Type Examples Used for
Analgesics • paracetamol all types of arthritis
• co-codamol
• tramadol
Non-steroidal Standard NSAIDs: all types of arthritis (including
anti-inflammatory • aspirin osteoarthritis if there’s
drugs (NSAIDs) • ibuprofen inflammation)
• naproxen
• diclofenac
COX-2 NSAIDs:
• celecoxib
• etoricoxib
Steroids • prednisolone, tablets or given as tablets in inflammatory
injections arthritis or connective tissue
disease; may be given
as an injection into any swollen,
painful joint
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Arthritis Research UK
What is arthritis?
Femoral component
Tibial component
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Arthritis Research UK
What is arthritis?
Surgery
Physical therapies Surgery may be necessary and advisable
Often your doctor will recommend a
if the damage to a joint is severe enough
course of physical therapies to help you to cause difficulties with everyday life,
overcome some of the symptoms of and when other treatment isn’t reducing
your arthritis. the pain. Joint replacements are now
very sophisticated and successful.
See Arthritis Research UK booklets Many different joints, including hips,
Hydrotherapy and arthritis; knees, shoulder and elbow joints,
Occupational therapy and arthritis; are routinely replaced in people with
Physiotherapy and arthritis. advanced arthritis (see Figure 5). There
are also a number of other pain-relieving
Physiotherapy helps to improve your or reconstructive operations which are
general fitness and muscle strength, helps sometimes helpful. Some surgery can be
to manage your pain and restore the performed with needles and implements
function of parts of your body affected without fully opening the joint up.
by arthritis. A course of physiotherapy will This is called arthroscopy or is sometimes
referred to as keyhole surgery. The
include a detailed assessment, following
surgeon will make small (less than
which you’ll be given specific exercises
1 cm) incisions to allow a special light
tailored to your needs.
and camera to look at the inside of a
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joint. This can be seen by the surgeon on Hospital doctors
a television screen. Arthroscopy can be • Consultant rheumatologists may be
used to help with diagnosis or can form supported by specialist registrars and
part of treatment. junior doctors.
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Orthotists: with your employer to ensure a smooth
• specialise in the use of appliances to transition back into the workplace.
support weakened joints A Disability Employment Adviser (DEA) at
• will recommend specialist shoes or your local JobCentre Plus can help you find
insoles for problems in the feet or legs, a job or gain new skills and tell you about
and splints for hands and wrists disability friendly employers in your area.
• specialist orthotists can assist with At a JobCentre Plus you can enquire
custom-made devices. about the Access to Work grant, which
Help is also available from a variety of can pay for practical support if you have
other sources, for example, pain clinics, a disability. The grant is aimed at helping
social services and voluntary sector people to start work, stay in work, move
organisations such as Arthritis Care. into self-employment or start a business.
It can pay for special equipment and fares
See Arthritis Research UK booklets to work if you can’t use public transport.
Caring for a person with arthritis; You could also contact your local branch
Feet, footwear and arthritis; Looking of the Employment Medical Advisory
after your joints when you have arthritis; Service (EMAS), which is part of the Health
Meet the rheumatology team; Sex and and Safety Executive (HSE) and is staffed
arthritis; Work and arthritis. by doctors and nurses who offer advice
on health matters relating to work.
There are many treatments and
therapies available which can help
with your arthritis. Make sure you seek
How can I help myself?
professional advice and be prepared There are many ways that you can help
to follow it. yourself if you have arthritis. Some of
these are described below, and further
information can be found in the Arthritis
Research UK booklets and leaflets
Support at work referred to.
Work is good for you. It helps your
physical and mental wellbeing by giving Rest and exercise
you a sense of worth. If you’re off work, it It’s important to keep your joints moving
can be hard to return, especially if you’re and your muscles strong – whether
absent for a long period of time. you have arthritis or not. Generally the
Occupational therapists are health and stronger the muscles which support a
social care professionals who can improve joint, the less pain you’ll have in that joint.
your capabilities in the workplace, by If a joint is very inflamed, a short period of
helping you deal with issues related to rest may help the swelling to settle down.
your condition and its impact on your You should protect inflamed or damaged
work. Occupational therapists will work joints. It’s better to use them little but
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Arthritis Research UK
What is arthritis?
often rather than persisting with activities group gives them extra motivation, and
that cause lasting pain. It’s also important it can be a good way to meet people with
not to rest the joints too much. the same interests.
Try to put your joints through a full range Swimming is an excellent all-round form of
of motion at least once a day, to prevent exercise for people with arthritis because
them stiffening up. Your body is designed the joints are supported in the water,
to move, and not doing so is harmful to which makes it easier to move them.
the tissues in and around the joints. To Cycling is good for strengthening your
increase the life of your joints, you should knees and for general fitness. You can use
stay active. Keeping active is good for your a static exercise bike at home or in a gym,
cardiovascular system (heart and lungs) or there are many traffic-free cycle paths
and for your general health. if you want to go outside. If you get a lot
If you have a flare-up of your arthritis, of knee pain you may have to take it very
which may occur as a result of overdoing gently to start off with, and stop if your
it, applying ice to the painful joints may pain gets worse after cycling.
help reduce the inflammation (make sure In terms of amount of exercise, little and
the ice pack is wrapped in a damp towel often is the right approach. You could
to protect your skin). Packs to warm in the build exercises into your daily routine. For
microwave are available and may ease example, every time you wash your hands,
aching joints. take a few minutes to do some simple
Exercise doesn’t need to involve exercises. It may sound silly, but it’ll help
equipment, and often the simplest you remember.
exercises are the best. A physiotherapist will be able to advise you
Stretching exercises help ease aches and further about specific exercises which will
pains and get the best movement from help you more.
your joints.
Strengthening exercises are important
as we rely on our muscles to support See Arthritis Research UK booklets
our joints and keep them in the right Keep moving; Physiotherapy
position when we move. If muscles are and arthritis.
weak, joints can become unstable and
this can be painful.
Healthy eating
Fitness exercises, which can be as simple
If you have arthritis it’s important to
as walking a bit further or faster than you
avoid being overweight, as this puts extra
normally would, are very important to
strain on the joints. If you’re overweight,
keep your heart healthy. You might like
losing two stone (about 13 kg) can reduce
to join a sports team or a leisure centre
pain in the knee by 50 per cent and even
so you can exercise with other people.
a little weight loss can reduce pain. A
Some people find doing exercise in a
healthy, balanced, low-fat and nutritional
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diet with plenty of fruit, vegetables and on whether you notice any improvement.
fibre is good for your general health. You may find that changing only one
Avoiding too much meat or animal fat is thing at a time helps you to tell which
a good idea. therapies are having an effect.
If you’re on drugs for arthritis you may
need to avoid alcohol or limit the amount See Arthritis Research UK booklet
you drink. If you’re in doubt, check with and special reports Complementary
your doctor. and alternative medicine for arthritis;
Complementary and alternative
Beware of books, articles and advice medicine for the treatment of rheumatoid
about diets that claim to cure arthritis. arthritis, osteoarthritis and fibromyalgia;
Many of them recommend quite different Practitioner-based complementary and
things, and most people do not benefit alternative therapies for the treatment
from them. An unusual diet can do more of rheumatoid arthritis, osteoarthritis,
harm than good. fibromyalgia and low back pain.
Managing Stress
Chronic arthritis can get you down, and Will moving to a warmer
constant pain may lead to anxiety and climate help?
depression. Counselling from your doctor, Many people with arthritis feel changes in
or from someone they recommend, the weather affect the level of pain they
may help. You may find that sharing the feel. Most people prefer hot, dry climates,
problem with friends and others who but some people feel better in the cold
are affected can also be helpful. You may and damp. The weather will probably
be able to learn relaxation techniques make a difference to how you feel –
with the help of a physiotherapist or warmth and sunshine tend to lift your
occupational therapist. Support groups spirits. However, although the weather
and telephone support lines allow you to may affect the symptoms of your arthritis
talk to others with similar issues. or the way you feel, it won’t cause the
condition or affect the way it develops.
Complementary medicine
Complementary therapies such as
osteopathy and chiropractic can help Research and new
in some arthritic conditions, especially
back pain. There’s a huge range of other
developments
Arthritis Research UK aims to be at the
therapies, for example homeopathy
forefront of international efforts to
and herbalism, and a range of food
develop new treatments for arthritis.
supplements you may be tempted to try.
By funding world-class research into
Most of these are harmless, but if in doubt
developing treatments that accurately
you should ask your doctor. If you decide
target arthritis, patients should be able
to try therapies or supplements, you
to experience reduced pain, increased
should be critical of what they’re doing for
mobility and a normal quality of life.
you, and base your decision to continue
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Arthritis Research UK
What is arthritis?
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Glossary in all of us as we get older, often without
causing any symptoms.
Bursa – a small pouch of fibrous tissue
lined (like a joint) with a synovial Tendons – strong fibrous cords that
membrane. Bursae help to reduce friction; connect muscles to bones.
they occur where parts move over one Ultrasound – a type of scan which uses
another, for example where tendons high-frequency sound waves to build up
or ligaments pass over bones. Others, pictures of the inside of the body.
however, form in response to unusual
pressure or friction.
Cartilage – a tough, slippery tissue which Where can I find out more?
covers the bone ends. It acts as a shock You can download all of our booklets
absorber and allows smooth movement and leaflets from our website or order
between bones. them by contacting:
Computerised tomography (CT) Arthritis Research UK
scan – a type of scan that records Copeman House
images of sections or ‘slices’ of the body St Mary’s Court
using x-rays. These images are then St Mary’s Gate
transformed by a computer into cross- Chesterfield
sectional pictures. Derbyshire S41 7TD
Phone: 0300 790 0400
Ligaments – tough, fibrous bands which
www.arthritisresearchuk.org
hold two bones together in a joint.
MRI (Magnetic Resonance Imaging) Related organisations
– a type of scan which uses radio waves The following organisations may
in a strong magnetic field to build up be able to provide additional advice
pictures of the inside of the body. It works and information:
by detecting water molecules in the body
tissues which give out a particular signal Arthritis Care
in the magnetic field. Floor 4, Linen Court
10 East Road
Osteoporosis – a condition where bones London N1 6AD
become less dense and more fragile, Phone: 020 7380 6500
which means they break or fracture Helpline: 0808 800 4050
more easily. Email: info@arthritiscare.org.uk
Spondylosis – the term used to describe www.arthritiscare.org.uk
the x-ray appearance of mechanical or
degenerative changes of the small joints
in the neck and back, commonly present
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Arthritis Research UK
What is arthritis?
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We’re here to help
Arthritis Research UK is the charity funding and giving insight into the latest
leading the fight against arthritis. treatment and self-help available.
We fund scientific and medical We often feature case studies and
research into all types of arthritis and have regular columns for questions
musculoskeletal conditions. and answers, as well as readers’ hints
We’re working to take the pain away and tips for managing arthritis.
for sufferers with all forms of arthritis
and helping people to remain active.
Tell us what you think
We’ll do this by funding high-quality
research, providing information
of our booklet
and campaigning. Please send your views to:
feedback@arthritisresearchuk.org
Everything we do is underpinned
or write to us at:
by research.
Arthritis Research UK, Copeman
We publish over 60 information booklets House, St Mary’s Court, St Mary’s Gate,
which help people affected by arthritis Chesterfield, Derbyshire S41 7TD.
to understand more about the condition,
its treatment, therapies and how
to help themselves. A team of people contributed to this booklet.
The original text was written by Dr David
We also produce a range of separate
Walker, who has expertise in the subject. It was
leaflets on many of the drugs used
assessed at draft stage by physiotherapists
for arthritis and related conditions.
Colin Waldock and Angela Reilly, general
We recommend that you read the
practitioner Dr Lisa le Roux and occupational
relevant leaflet for more detailed therapist Dr Elizabeth White. An Arthritis
information about your medication. Research UK editor revised the text to make
Please also let us know if you’d like it easy to read, and a non-medical panel,
to receive an email alert about our including interested societies, checked
online quarterly magazine, Arthritis it for understanding. An Arthritis Research
Today, which keeps you up to date with UK medical advisor, Dr Ben Thompson, is
current research and education news, responsible for the content overall.
highlighting key projects that we’re
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Get involved
You can help to take the pain away
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• supporting our campaigns
• taking part in a fundraising event
• making a donation
• asking your company to support us
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© Arthritis Research UK 2012
Published May 2015 2020/INTRO/15-1