3 most common forms of Arthritis

Arthritis – The 3 most common forms of Arthritis

Arthritis is often referred to as a single disease. In fact, it is an umbrella term for more than 100 medical conditions that affect the musculoskeletal system, specifically joints where two or more bones meet.

There are 3.9 million Australians with arthritis and this will grow to 5.4 million by 2030. Arthritis is a major cause of disability and early retirement due to ill-health. This costs the government $1.1 billion in extra welfare payments and lost taxation revenue and costs the economy $7.2 billion in lost GDP alone.

Arthritis-related problems include pain, stiffness, inflammation and damage to joint cartilage (the tissue that covers the ends of bones, enabling them to move against each another) and surrounding structures. This can result in joint weakness, instability and deformities that can interfere with the most basic daily tasks such as walking, driving a car and preparing food.

Research suggests that early intervention can delay the onset of the disease and may reduce the number of cases of osteoarthritis by about 500,000 within 15 years.

While there are about 100 forms of arthritis, the three most significant – osteoarthritis, rheumatoid arthritis and gout – account for more than 95% of cases in Australia.

Arthritis is not yet curable. While the condition is usually manageable, it invariably impacts on a patient’s quality of life and includes varying degrees of discomfort and pain.

The most common forms of arthritis are:

• Osteoarthritis
• Rheumatoid arthritis
• Gout
• Ankylosing spondylitis
• Juvenile arthritis
• Systemic lupus erythematosus (lupus)
• Scleroderma

In this article, we look at the 3 most common forms of arthritis in more detail, including numbers and data, symptoms and risk factors. You can also read our article on the 11 most common myths around arthritis – read article here.

Osteoarthritis

Osteoarthritis is a common chronic joint disease, causing large amounts of disability and pain in the Australian community. Is a degenerative condition that mostly affects the hands, spine and joints such as hips, knees and ankles, and usually gets worse over time. It is the predominant condition leading to knee and hip replacement surgery in Australia.

• 1 in 11 Australians (9%) have osteoarthritis based on self-reported data, approximately 2.1 million people in 2014–15
• 2 in 3 people who have osteoarthritis, based on self-reported data, are female
• 1 in 4 people with osteoarthritis self-reported fair or poor health (26%), compared to about 1 in 8 people (13%) without these conditions
• 29% rise in the rate of total knee replacements for osteoarthritis and a 31% rise in hip replacement from 2005–06 to 2014–15
• the hospitalisation rate was higher for males than females up to the age of 50–54, above which the rate was higher for females
• the hospitalisation rate increased with age until the age of 75–79, after which it fell
• people with osteoarthritis experience as much as 30% more falls and have a 20% greater risk of fracture than those without OA

Three key characteristics of osteoarthritis are:

• mild inflammation of the tissues in and around the joints
• damage to cartilage, the strong, smooth surface that lines the bones and allows joints to move easily and without friction
• bony growths that develop around the edge of the joints

Osteoarthritis mostly occurs in the knees, hips and small joints of the hands and base of the big toe. However, almost any joint can be affected.

The symptoms of osteoarthritis can vary from one person to the next. Symptoms of osteoarthritis vary, depending on which joints are affected and how severely they are affected.

However, the most common symptoms are pain and stiffness, particularly first thing in the morning or after resting. Affected joints may get swollen, especially after extended activity. These symptoms tend to build over time rather than show up suddenly.

Some of the more common symptoms include

• stiffness – especially when you haven’t moved your joints for a while, such as in the morning
• joint pain
• joint tenderness
• a grating or crackling sensation in your joints
• a limited range of movement / loss of flexibility of your joints
• muscle weakness
• clicking or cracking sound when a joint bends
• mild swelling around a joint
• pain that is worse after activity or toward the end of the day

Risk factors of osteoarthritis

Factors that may increase your risk of osteoarthritis include:

• Older age. The risk of osteoarthritis increases with age.
• Sex. Women are more likely to develop osteoarthritis, though it isn’t clear why.
• Obesity. Carrying extra body weight contributes to osteoarthritis in several ways, and the more you weigh, the greater your risk. Increased weight puts added stress on weight-bearing joints, such as your hips and knees. In addition, fat tissue produces proteins that may cause harmful inflammation in and around your joints.
• Joint injuries. Injuries, such as those that occur when playing sports or from an accident, may increase the risk of osteoarthritis. Even injuries that occurred many years ago and seemingly healed can increase your risk of osteoarthritis.
• Certain occupations. If your job includes tasks that place repetitive stress on a particular joint, that joint may eventually develop osteoarthritis.
• Genetics. Some people inherit a tendency to develop osteoarthritis.
• Bone deformities. Some people are born with malformed joints or defective cartilage, which can increase the risk of osteoarthritis.

Rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune disease that causes pain and swelling in the joints, where the body’s immune system attacks its own tissues. This happens because the immune system attacks the lining of the joints causing inflammation and joint damage.

RA usually affects the smaller joints, such as those in the hands, feet and wrists, although larger joints such as the hips and knees can also be affected.

Doctors still don’t know what causes RA, but it is more common in people who smoke or have a family history of this disease. It can also be difficult to diagnose because many conditions cause joint stiffness and inflammation.

Rheumatoid arthritis can affect anyone at any age, and may cause significant pain and disability.

• 2% of Australians reported having rheumatoid arthritis in 2014–15. That’s approximately 407,900 people
• 18% of people with rheumatoid arthritis self-reported poor health, compared to 3.9% of people without rheumatoid arthritis
• 59% rise in the rate of hospitalisation for people with rheumatoid arthritis, from 2005–06 to 2014–15—females accounted for most of this increase
• the hospitalisation rate for females (76 per 100,000 population) was 3 times that of males (25 per 100,000)
• the hospitalisation rate increased with age until the age of 70–74

The symptoms of rheumatoid arthritis (RA) usually develop gradually. The first symptoms are often felt in small joints, such as your fingers and toes, although shoulders and knees can be affected early, and muscle stiffness can be a prominent early feature.

The symptoms of RA vary from person to person. They can come and go, and they may change over time. You will experience flare-ups when, from time to time, your condition will worsen and your symptoms will be more intense and severe.

The symptoms of RA are outlined below.

• Pain. This is usually a throbbing and aching sort of pain. It is usually worse in the mornings and after you have been sitting still for a while. Pain is often felt while you are resting, not after activity.
• Stiffness. Joints affected by RA can feel stiff, especially in the morning. Morning stiffness associated with a kind of arthritis called ‘osteoarthritis’ usually wears off within 30 minutes of getting up in the morning. However, RA morning stiffness usually lasts longer than half an hour.
• Warmth and redness. The lining of the affected joint becomes inflamed, causing the joints to swell, become hot, tender to touch and painful.

RA can also cause inflammation around the joints, such as rheumatoid nodules, and in other parts of your body. The condition can also cause inflammation of your tear glands, salivary glands, the lining of your heart and lungs, and your blood vessels.

Additionally, about 40% of the people who have rheumatoid arthritis also experience signs and symptoms that don’t involve the joints. Rheumatoid arthritis can affect many non-joint structures, including:

• Skin
• Eyes
• Lungs
• Heart
• Kidneys
• Salivary glands
• Nerve tissue
• Bone marrow
• Blood vessels

Risk factors of rheumatoid arthritis

Factors that may increase your risk of rheumatoid arthritis include:

• Your sex. Women are more likely than men to develop rheumatoid arthritis.
• Age. Rheumatoid arthritis can occur at any age, but it most commonly begins between the ages of 40 and 60.
• Family history. If a member of your family has rheumatoid arthritis, you may have an increased risk of the disease.
• Smoking. Cigarette smoking increases your risk of developing rheumatoid arthritis, particularly if you have a genetic predisposition for developing the disease. Smoking also appears to be associated with greater disease severity.
• Environmental exposures. Although uncertain and poorly understood, some exposures such as asbestos or silica may increase the risk for developing rheumatoid arthritis. Emergency workers exposed to dust from the collapse of the World Trade Center are at higher risk of autoimmune diseases such as rheumatoid arthritis.
• Obesity. People who are overweight or obese appear to be at somewhat higher risk of developing rheumatoid arthritis, especially in women diagnosed with the disease when they were 55 or younger.

Rheumatoid arthritis can be difficult to diagnose in its early stages because the early signs and symptoms mimic those of many other diseases. There is no one blood test or physical finding to confirm the diagnosis.

Subscribe to our newsletter

Gout

Gout is a form of inflammatory arthritis that develops when an excess of uric acid in the blood leads to deposits of uric acid crystals in one or more joints, causing inflammation. Gout is associated with other serious health risks such as high blood pressure, diabetes, chronic kidney disease and cardiovascular disease.

• Australians had gout in 2014–15, based on self-reported survey data. That is approximately 192,000 people.
• 4x more men than women have gout —8 in 10 (81%) people with gout are men.
• 25% rise in the age-standardised rate of hospitalisation for people with gout, between 2005–06 and 2014–15. Males accounted for most of this increase.
• 80% of all hospitalisations for gout were for males (5,359 hospitalisations), compared to 20% for females (1,365 hospitalisations)
• hospitalisation rates increased with age and was highest for people aged 85 and over (237 per 100,000 population).

Symptoms of gout usually strike unexpectedly. They typically do not last more than a week, but may recur. Although, less commonly, some patients may have chronic pain due to gout. Symptoms of a gout attack may include:

• Warmth, pain, swelling, and extreme tenderness in a joint, typically the big toe or ankle, sometimes the knee, hand, or wrist
• Swelling, inflammation, and a feeling that the joint is very hot
• Extreme tenderness of the joint to even the lightest touch
• Red or purple skin around the joint
• In extreme cases, alternating chills and fever
• Limited movement in the affected joint

With recurring attacks, soft fleshy growths may appear; called tophi, they are accumulations of uric acid crystals. Over time, gout attacks may occur more frequently, involve more joints, have more severe symptoms, and last longer.

Gout Prevention

If gout runs in the family, men in particular should limit their intake of alcohol, fats, and foods that are more likely to increase uric acid level in the body — meat, sardines, bacon, mussels, and yeast. Alcohol, especially beer, can also bring on an attack of gout. Such men should watch their weight with extra care. Drinking plenty of liquids may help minimise the risk of kidney stones.

We strongly recommend making an appointment with your doctor if you have joint pain or stiffness that doesn’t go away.

To see the various types of Arthritis, visit www.arthritis.org/about-arthritis.

For more information on Arthritis – Arthritis Research UK provide a comprehensive guide to living with arthritis. You’ll find information on everything from types of arthritis and how to deal with them, lifestyle and living, to helpful hints and tips on dealing with arthritis day to day. Visit www.arthritisresearchuk.org/arthritis-information.

Read more on the importance of staying healthy over 60 in volume 2.
Volume two: Looking after your health and well-being after 60

Source:
– What is arthritis. Read article
– Arthritis Australia. Arthritis – Count the Costs and Bank the Savings. 30 May 2016. Read article
– Australian Institute of Health and Welfare. Read article
– Healthdirect. Osteoarthritis symptoms. Read article
– Arthritis Foundation. Osteoarthritis Symptoms. Read article
– Australian Institute of Health and Welfare. Read article
– WebMD, Understanding Gout – Prevention. 3 March 2015. Reviewed by Jennifer Robinson, MD. Read article
– WebMD, Understanding Gout – Symptoms. 3 March 2015. Reviewed by Jennifer Robinson, MD. Read article
– AIHW National Hospital Morbidity Database (NHMD). Read article
– Australian Institute of Health and Welfare. Read article
– Healthdirect. Rheumatoid symptoms. Read article
– Mayo Clinic. Rheumatoid arthritis, Symptoms and causes. By Mayo Clinic Staff. Read article

Subscribe to our newsletter