Different Types Of Arthritis Explained
The Many Faces of Arthritis; What Kind of Arthritis Do You Have?
Did you know that there are over 100 types of arthritis and related conditions? In fact, the Arthritis Foundation lists arthritis as the leading cause of disability among Americans. People of all ages may be affected by this condition to varying degrees, even children, and while its effects may be merely an annoyance to some, to others it can interfere greatly with everyday tasks. As arthritis progresses, simple things like getting out of bed, opening a tight jar, or going up stairs can become more difficult.
So what is arthritis? The term arthritis is actually an umbrella term for conditions involving inflammation and pain in the joints. This article will introduce you to the different categories of arthritis and some of the more common types of arthritis.
WHAT’S IN A NAME–CLASSIFYING ARTHRITIS
All arthritic conditions can be typically classified as degenerative, inflammatory/autoimmune, infectious or metabolic. While each of these affects the joints, their underlying physiologic mechanisms differ. Let’s take a closer look at each category:
Degenerative arthritis: Degenerative arthritis is more commonly known as osteoarthritis (OA) and is the most common type of arthritis. This condition refers to the wear and tear of the cartilage that cushions the ends of the bone. It can happen in any joint but is more common in joints like the hips, knees, spine, and hands. OA typically develops slowly and may worsen over time. It can be diagnosed via an x-ray to evaluate the integrity of the joint surfaces but the presence of OA does not necessarily mean you will be symptomatic.
Symptoms of OA include joint pain during or after movement and stiffness that often worsens after a period of inactivity. You may feel tenderness when applying pressure over the joint and notice swelling in the soft tissue nearby. Flexibility or range of motion of the joint may also decrease. You may even feel a grating sensation or hear popping or cracking in the joint when you move it though even healthy joints can make noise sometimes.
Inflammatory (autoimmune) arthritis: Much less common than OA, inflammatory arthritis is typically caused by an auto-immune response in which the body begins to attack its own joints. These conditions are usually managed in part with medications to modulate the immune response. Unlike the gradual wear and tear mechanism of OA, this type of inflammation can quickly affect the cartilage and surrounding tissues causing morning stiffness that lasts more than an hour, joint pain, swelling, tenderness and warmth.
The pain and discomfort felt in this type of arthritis is often multifactorial. Sources of pain may include:
Erosion of the bone beneath the cartilage
Inflammation of the synovial lining of the joints which releases chemicals that irritate nearby nerves
Fluid buildup inside the joint can cause pressure, stiffness, and irritation
Muscle weakness can put more stress on the joints and the inflammation may damage the ligaments that support the joint
The fusion of joints (most often in the spine) can happen in certain types of inflammatory arthritis
Chronic pain and long standing pain can become what is called centralized after which the body’s perception of pain can become heightened
Some of the more common types of inflammatory arthritis include the following:
Rheumatoid arthritis: small bones of the hands and feet are most commonly affected. More common in women than men and onset is often between 30 and 50 years of age. It is the most common type of autoimmune arthritis.
Psoriatic arthritis: Occurs in people who have psoriasis of the skin. Most often occurs years after skin symptoms present but sometimes can occur beforehand. Can affect any joint and range from mild to severe. Like psoriasis it may have active periods and periods of remission.
Systemic Lupus Erythematosus (SLE): This autoimmune condition can be life threatening. Not only does the inflammation cause joint damage but it can cause damage to many of the other organs such as the skin, kidneys, lungs and brain and affect blood vessels.
Ankylosing spondylitis: Inflammation targets the joints and ligaments of the spine leading to stiffness and sometimes over time fusion of the vertebrae and sacrum. Back pain and stiffness may be mild and episodic or severe and chronic. This type of arthritis can affect areas outside of the spine as well such as the hips, ribs, shoulder, feet, and ankles.
Infectious (septic) arthritis: this type of arthritis is caused by infection-causing germs entering a joint space. These germs may enter the body through a wound, a surgery, or an injection and may travel a ways before settling into one (or rarely two) joint. The onset is usually rapid and damage can be severe and permanent if not addressed quickly. Bacteria are the most common cause of septic arthritis and the bacteria Staphylococcus Aureus is the most common perpetrator. Viruses and fungi can also cause septic arthritis.
Unlike other types of arthritis the onset is typically very quick and pain is accompanied by swelling, warmth, redness, fever and chills. The knee is most commonly affected but hips, ankles, and wrists may also be affected. Treatment of this condition typically requires antibiotics, antivirals or antifungals and often fluid needs to be drained from the affected joint.
Metabolic Arthritis: Imbalances in the metabolism of the body can lead to arthritis. The primary example of metabolic arthritis is gout. Gout is also considered to be an inflammatory arthritis but since it is not caused by an autoimmune response it was not included in the list above.
Gout is a complex form of arthritis characterized by sudden, severe bouts of joint swelling, pain, warmth, redness, and tenderness. Accumulation of needle-like urate crystals in the joint causes the inflammation and pain characteristic of gout. Gout attacks are most common in the joint at the base of the big toe but can actually occur in any joint. Ankles, knees, fingers, wrists and elbows may be affected by gout as well. An attack of gout typically occurs suddenly but recurrent bouts can cause lasting joint damage.
WHAT TO DO ABOUT ARTHRITIS?
As you can see, there are many types of arthritis and the treatment of arthritis will vary based on its cause. For example, the treatment for an autoimmune mediated arthritis will differ from the treatment for an arthritis caused by an acute infection or even from gradual wear and tear. One thing we do know is that physical activity and physical therapy can be effective tools in managing the symptoms of arthritis and improving mobility and function. If you’d like to know more about how physical therapy can help your arthritis symptoms, schedule an evaluation with a therapist at Evolve and we will be happy to share more about our treatment approach.
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