Arthritis

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Arthritis is a painful condition that affects one or more joints in the body. Hallmark symptoms are pain and stiffness that worsens with age. The two most common types are osteoarthritis and rheumatoid arthritis. Osteoarthritis breaks down the cartilage — the strong, flexible connective tissue that protects the ends of bones where they form a joint. Rheumatoid arthritis is an autoimmune disease in which the body attacks the joints. Arthritis is especially common in adults over age 50. Research suggests that about 30% of American adults have some degree of arthritis. 

Your joints naturally wear out as you age. Sometimes, arthritis occurs in joints that have been affected by injury or infection. Different types of arthritis include gout, psoriatic arthritis and reactive arthritis. Infections or underlying health conditions, such as psoriasis or lupus, can cause other types of arthritis.

Treatments vary depending on the type of arthritis. The main goals of arthritis treatment is to reduce symptoms, decrease pain, increase joint function and improve quality of life.

Signs and Symptoms

Arthritis can occur in any joint, but most commonly it occurs in:

  • Hand and wrist
  • Ankle and foot
  • Knee
  • Hip
  • Shoulder
  • Lower spine 

Your symptoms of arthritis depend on what type of arthritis you have and where the affected joint or joints are in the body. Some symptoms may occur in waves (called flare-ups). Some may occur after activity. Symptoms include:

  • Joint pain
  • Inflammation (swelling)
  • Stiffness
  • Reduced range of motion (how far you can move the joint, with or without pain)
  • Discoloration of the skin
  • Tenderness or sensitivity to touch or pressure around the joint
  • A feeling of warmth around the joint

See a doctor about joint pain if:

  • Your symptoms last more than three days.
  • Symptoms are present in more than one joint.
  • You have several flare-ups of joint pain in one month.
  • The joint is very warm and uncomfortable.
  • The pain, stiffness, or loss of joint function is affecting your daily life.

Causes

Osteoarthritis is caused by normal wear on the joints and gradual wearing down of the cartilage. 

Gout is a specific type of arthritis caused by a buildup of urate crystals in your blood. Your body produces uric acid naturally when it breaks down some of the food you eat, including many seafoods, red meat and alcohol. It can occur in any joint, but most commonly it occurs in the big toe. Pain is sudden and very intense.

Autoimmune disorders, such as rheumatoid arthritis, can cause your body to attack your joints.

Viral arthritis can be triggered by viruses, including coronavirus, hepatitis B and C, mumps, and Epstein-Barr (the virus that causes mononucleosis). 

Diagnosis and Treatment

Diagnosis begins with a physical examination and a thorough health history, as well as questions about your overall current health, lifestyle, diet, medications and any illnesses or conditions. Your provider will check any affected joint for  damage, pain and inflammation. They will check your range of motion and joint function, and will ask about pain and stiffness. Based on the results of this physical exam, your provider may recommend a blood test or diagnostic scans.

Tests

Bloodwork
Analyzing certain substances in your blood can help your health care provider correctly diagnose arthritis. Blood, urine and joint fluids commonly are tested for this condition. If joint fluid is needed for testing, your provider will numb the area around the affected joint and withdraw fluid with a needle. 

Scans

These tests give slightly different pictures of your joints and may be used separately or together to help diagnose your issue. These tests include:

  • X-rays use low levels of radiation to visualize bone and show cartilage loss, bone damage and bone spurs. X-rays may not show early arthritic damage, but they often are used to track progression of the disease.
  • CT scans take X-rays from many different angles. The images are combined to show a cross-sectional view of the area. CTs can show both bone and the surrounding soft tissues.
  • MRI uses radio waves and a strong magnetic field to show more detailed cross-sectional images of soft tissues, including cartilage, tendons and ligaments.
  • Ultrasound uses high-frequency sound waves to image soft tissues, cartilage and fluid-containing structures (bursae) near the joints. Ultrasound also may be used to guide needle placement for drawing joint fluid or injecting medications into the joint.

Arthritis Treatment 

The main goal of arthritis treatment is to reduce pain, increase mobility and improve quality of life. Your health care provider will talk with you about treatment options based on your specific type of arthritis, the severity of symptoms and other important factors. Effectiveness and side effects vary among treatments and arthritis patients. 

Medications

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) relieve pain and reduce inflammation. These drugs include ibuprofen (Advil) and naproxen sodium (Aleve). Side effects of oral (pill form) NSAIDs include stomach irritation and may increase your risk of heart attack or stroke. NSAIDs also can be available as creams or gels, which can be rubbed into the skin around the affected joint.
  • Counterirritant creams or ointments are made of capsaicin, the substance that makes peppers spicy. Applying these to the skin around the joint may disrupt pain signals from the joint and bring some pain relief. 
  • Corticosteroids, including prednisone, reduce pain and inflammation as well as slow joint damage. These drugs can be given as a pill (orally) or as an injection. Side effects include weight gain, diabetes and thinning bones.
  • Disease-modifying antirheumatic drugs (DMARDs), such as methotrexate, slow the progression of rheumatoid arthritis. DMARDs protect the joints and surrounding tissue from permanent damage.

Lifestyle Changes for Arthritis Treatment

With or without medication, lifestyle changes can make a positive impact. These changes include:

  • Adopting an anti-inflammatory diet, including fruits, vegetables and fatty fish such as salmon
  • Using a medical device such as a cane or a walker
  • Wearing comfortable clothing with no zippers, buttons, or snaps
  • Practicing mindful meditation or yoga, which can increase and preserve flexibilty
  • Getting some physical activity such as walking, swimming and exercises that strengthen the joints and preserve function and mobility 
  • Stopping smoking

Physical Therapy

Physical therapy for arthritis can be beneficial in reducing pain, increasing flexibility, strengthening joints and muscles, and protecting joint function and mobility. 

Arthritis Surgery

If your symptoms are not effectively managed with medication, lifestyle adjustments or physical therapy, your medical professional may talk to you about surgical options. Some procedures include:

  • Arthroscopy: This minimally invasive procedure uses a tiny camera and special tools to repair tears and soft tissue, remove damaged cartilage and ligaments, and extract small pieces of cartilage that may be floating in the joint fluid, causing pain. 
  • Joint resurfacing: This procedure replaces the damaged part of the joint with a synthetic implant. This minimally invasive surgery is an alternative to total joint replacement.
  • Osteotomy: For this procedure, the surgeon removes or adds a small piece of bone near the damaged joint to reduce pain or correct misalignment in the joint. This surgery can stop damage to the joint and delay total joint replacement.
  • Synovectomy: The lining of the joints is called the synovium. A surgeon removes inflamed or damaged synovium to reduce pain or improve range of motion.

Risk Factors

Anyone can develop arthritis, but some factors may increase your likelihood of certain types of arthritis. Some risk factors for arthritis can be controlled, but others cannot. In general, risk factors for arthritis include:

  • Age: Your joints naturally degrade over time. Arthritis is common in adults ages 50 and older.
  • Gender: Women are more likely to develop osteoarthritis than men. 
  • Genetics: Some types of arthritis are passed through genes, so you may be more likely to develop this condition if people in your family have it.
  • Weight: Obesity can put added stress on joints, especially the hip, knee and ankle joints. 
  • Smoking: This habit can make arthritis worse, and it can make it difficult to manage with exercise and activity.
  • Infections: Some infections can trigger arthritis, such as Lyme disease and COVID-19.
  • Injury: Damage or trauma can cause arthritis to develop in the joint.

Complications

Because arthritis causes pain and a loss of joint function and mobility, you may not be able to complete tasks for daily living such as bathing, dressing or preparing food. Lack of activity can lead to weight gain or to mental health issues such as depression. 

Prevention

If you are at a higher risk for arthritis, there are some steps you can take to delay onset, keep symptoms from getting worse or reduce your risk, including:

  • Eating a healthy diet, including anti-inflammatory foods
  • Stopping smoking
  • Maintaining a healthy weight 
  • Getting physical activity
  • Wearing appropriate clothing, footwear and protective gear for activities
  • Annual checkups with your primary care provider

Support

Norton Healthcare provides free educational programs for arthritis patients. 

Next Steps

If joint or bone pain is affecting you or a loved one, make an appointment today.
 
Schedule now — no referral necessary:
(502) 559-5500

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Why Choose Norton Orthopedic Institute

More patients choose Norton Orthopedic Institute for hip or knee replacements and other orthopedic procedures than any other health care provider in Louisville or Southern Indiana.

  • About 50 providers, including board-certified and fellowship-trained orthopedic surgeons, offer care at twelve locations in Louisville and Southern Indiana.
  • Same-day appointments often are available.
  • Norton Healthcare is the first health system in the nation to be recognized as an Advanced Orthopedic & Spine Center of Excellence by DNV.
  • Our hip replacement specialists are pioneers in minimally invasive surgeries focused on minimizing pain and recovery time.
  • Robotic-assisted surgical techniques improve precision for a more natural-feeling knee replacement to get you moving again.
  • Educational programs help patients prepare for joint replacement surgery and recovery.
  • Medicare, Medicaid and most major commercial insurance plans are accepted.
  • Your free Norton MyChart account allows you to communicate with your provider, manage appointments, get alerted if an earlier appointment becomes available, refill prescriptions and more from a mobile device or computer.
  • KORT Physical Therapy offers a variety of services, in partnership with Norton Healthcare, at convenient locations throughout Louisville and Southern Indiana. Find a location near you or request an appointment today.

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