Arthritis

Last updated 01 July 2016 — Last reviewed 15 December 2013

Arthritis mostly affects joints, yet many people think of it as a bone condition. Find out how the treatments of osteoarthritis, rheumatoid arthritis and gout might increase your risk of osteoporosis and what you can do if you are worried about this.

Arthritis literally means ‘inflammation of the joint’. It most often affects cartilage (flexible tissue) at the joints rather than bones but people often think of it as a bone condition.

The most common symptoms are:

  • pain 
  • swelling and stiffness in one or more joints 
  • fatigue

Woman with joint pain

There are many treatments available for arthritis that can help to ease pain, maintain flexibility and slow further development. It is important to determine the type of arthritis, so the correct treatment can be used. While there are many conditions that can be classified as arthritis, three of the most common are osteoarthritis, rheumatoid arthritis and gout.

Osteoarthritis

Osteoarthritis is the most common type of arthritis. It occurs when a joint between two bones becomes worn because the cartilage is damaged.

Causes

Age causes degeneration of the cartilage so most people over 45 may have symptoms of osteoarthritis. However, it more often affects women and manual labourers. Osteoarthritis can also run in families. Being overweight or having a joint injury increases the risk of osteoarthritis developing.

Signs & symptoms

Osteoarthritis usually occurs in fingers and large weight-bearing joints such as the hips, knees, ankles and lower spine.

Joints may appear enlarged. Pain from these joints is often worse in the morning or after resting and improves with use.

Diagnosis

Osteoarthritis tends to develop slowly over several years. X-rays may not always show early arthritis but will show severe arthritis.

Managing & treating

Some joint pain may be improved with exercise (and weight loss if needed). Exercise will also help improve joint flexibility and strengthen the muscles around the joints. Some types of exercise may be harmful to inflamed joints, so it is best to discuss the types of exercise that are best for you with your health practitioner or physiotherapist.

Pain relief may be important to assist with movement and this should be discussed with your health practitioner. In some cases a regular dose of pain relief medication may be advised rather than taking medications as required.

Link with bone health

Osteoarthritis does not appear to cause osteoporosis (thinning of the bones such that they are at increased risk of fracture).

Rheumatoid arthritis

Rheumatoid arthritis is a much less common disease and causes inflammation around joints and organs.

Causes

This is an 'auto immune disease' and occurs when the body’s immune system attacks its own tissues. When this happens, the tissue surrounding a joint (the ‘synovial membrane’) becomes thickened and inflamed, producing fluid that causes joint swelling.

Rheumatoid arthritis is most common between the ages of 25 to 50 and women are three times as likely as men to develop it.

Signs & symptoms

The joints become painful and swollen over a short period of time, and the disease can make you feel generally unwell.

Managing & treating

Medical advice from your doctor should be sought early to get proper treatment which will prevent further joint damage. Some medications aim to reduce pain, and some aim to slow the progress of the disease, so often a combination of medications will be advised. A rheumatologist (medical specialist in the area of joints and bones) will often need to be consulted in order to thoroughly assess you and advise you about medications and other management strategies.

Link with bone health

Rheumatoid arthritis is a risk factor for osteoporosis and the medications used to treat rheumatoid arthritis can weaken bones. Regular bone density checks are important if you have rheumatoid arthritis.

Gout

Gout is one of the most painful forms of arthritis.

Causes

Gout occurs when there are increased levels of uric acid in the blood, which the body cannot excrete, causing tiny crystals of uric acid to crystallise in the joints.

Signs & symptoms

This causes irritation, extreme pain and tissue inflammation. It usually affects one joint at a time, commonly beginning with the joint of the big toe; although it can go on to affect the ankles, knees and hands.

It is more common in men, particularly between the ages of 40 to 50. If women develop gout it tends to be after menopause. Some medications can also increase the chance of developing gout.

Managing & treating

Gout usually responds well to treatment for acute joint inflammation, but if recurrent gout occurs preventive treatment may be required such as changes to diet and cutting down on red meat and alcohol (if needed). Sometimes medications need to be adjusted or new medications introduced to prevent further 'attacks', so your doctor is the best person to advise you about this.

Link with bone health

While gout does not cause osteoporosis, some treatments for gout such as corticosteroids (prednisolone and similar medications) do impact on bone strength and density and so can increase the risk of osteoporosis.

Ways to help manage arthritic conditions

There are many ways to help manage arthritic conditions including:

  • Exercise such as stretching and/or strength work, walking, swimming or cycling
  • Physiotherapy, osteopathy and massage to assist with flexibility and muscle relaxation
  • Healthy eating
  • Relaxation or meditation to help with pain management
  • Medicines such as non-steroidal anti-inflammatories and paracetamol
  • Alternative therapies such as glucosamine and fish oil

Discuss the best options for you with your doctor.

This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at December 2013.

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