Types of Arthritis
There are over 100 different types of arthritis. Osteoarthritis is undoubtedly the most common — 31 million Americans suffer from this type. Rheumatoid arthritis, psoriatic arthritis (PsA), fibromyalgia and gout are all common forms of arthritis.
Let's go over the most common types of arthritis.
Psoriatic arthritis is specific to people who have psoriasis. Psoriasis is a chronic skin condition that causes red patches topped with silvery scales. Though psoriasis is typically diagnosed first — most likely because it is visible — psoriatic arthritis can occur before psoriasis.
Psoriatic arthritis can occur in any joint, especially the hands, lower back and feet.
Like psoriasis, psoriatic arthritis symptoms can wax and wane; in fact, psoriatic arthritis can have periods of remission. However, there is no cure — symptoms must be managed in order to control damage to the joints.
Symptoms of psoriatic arthritis include:
- Swelling of the Fingers and the Toes: Swelling can occur even before having significant pain.
- Foot Pain: It is especially common to suffer from pain where the tendons and ligaments attach to the bone, causing Achilles tendinitis and plantar fasciitis.
- Lower Back Pain: Lower back pain that is caused by spondylitis, inflammation of the joints between the vertebrae and in between the spine and pelvis, is common with psoriatic arthritis.
Psoriatic arthritis is also an autoimmune disease. In the case of psoriatic arthritis and psoriasis, the body attacks the joints and the skin cells. There is no known cause, but genetics and environmental factors may be linked to the development of psoriatic arthritis.
Medications for Psoriatic Arthritis
There is currently no cure for psoriatic arthritis, but there are treatments that focus on controlling the inflammation in your affected joints to prevent joint pain and disabilities. Here are some medications that can help:
- NSAIDs: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help relieve pain and reduce inflammation. The ones available without prescription include ibuprofen and naproxen sodium (Aleve). If you're looking for something stronger, you'll require a prescription.
- Conventional DMARDs: This type of medication can slow the progression of psoriatic arthritis, saving joints and tissues from more severe damage. The most common one you'll find DMARD is methotrexate (Trexall, Otrexup, and others). Some of other types include leflunomide (Arava) and sulfasalazine (Azulfidine).
- Biologic Agents: This is also known as biologic response modifiers, targeting pathways in the immune system. Biologic agents include adalimumab (Humira), certolizumab (Cimzia), etanercept (Enbrel), golimumab (Simponi), infliximab (Remicade), ustekinumab (Stelara), secukinumab (Cosentyx), ixekizumab (Taltz), guselkumab (Tremfya) and abatacept (Orencia).
- Targeted Synthetic DMARDs: If other medications haven't been effective, Tofacitinib (Xeljanz) is a great option.
- Oral Medication: Apremilast (Otezla) decreases inflammation with the cells. Apremilast can be an option if other medications don't work.
When someone states that they have arthritis, it is typically osteoarthritis as it is the most common form. Osteoarthritis occurs when the protective cartilage at the ends of the bone begins to wear down. Eventually the cartilage wears down so much that bone begins to rub on bone, causing pain.
Eventually the bone on bone movement will cause changes to the bone, as well as deterioration of the connective tissues that hold the joint together.
Osteoarthritis is irreversible. Fortunately, it is manageable, and progression can be slowed through proper treatment and maintaining a healthy weight.
Osteoarthritis can occur in any joint, though it is most commonly noted in the knees, hips, spine and hands.
Symptoms of osteoarthritis include:
- Pain, especially during and after movement
- Swelling, which is typically caused by inflammation of the joint
- Tenderness when light pressure is applied
- Stiffness, especially upon waking or sitting for an extended period
- Reduced flexibility, which is often caused by inactivity
- A grating sensation that is felt during movement of the joint, as well as a popping and cracking sound
Osteoarthritis is considered a disease of overuse, though there may be other underlying causes, such as obesity, joint injuries and bone deformities.
Similar to osteoarthritis, rheumatoid arthritis (RA) causes pain and inflammation to various joints. It can affect any joint of the body, though it typically affects the joints of the hands and feet initially. Unlike osteoarthritis, RA can affect other organ systems.
RA is an autoimmune disease; this means that the immune system mistakes the body’s own tissues as foreign, attacking them. In the case of RA, the lining of the joints is attacked, causing swelling, erosion of the bone and bone deformities.
RA is inflammatory; this inflammation is what is believed to cause issues with various other organ systems.
Symptoms of RA include:
- Joints that are sore, swollen and warm to the touch
- Loss of appetite
- Joint stiffness, especially in the morning
As with many other autoimmune diseases, there is no known cause of RA. There does need to be a trigger to “turn on” the autoimmune process, which may be related to genetics. Smoking and exposure to certain environmental elements, such as asbestos and silica, also seem to increase the risk of developing RA.
Fibromyalgia is characterized by widespread musculoskeletal pain. Researchers are not certain about the pathophysiology of this condition, but one theory is that fibromyalgia amplifies pain by affecting the way the brain processes the signals.
There is typically a triggering event that causes fibromyalgia, such as surgery, infection or trauma. However, it can also develop slowly over time.
Symptoms of fibromyalgia include:
- Widespread Pain: Fibromyalgia is characterized by dull pain that lasts for at least three months. The pain must be present on both sides of the body and above and below the waist.
- Fatigue: It is common for those with fibromyalgia to be tired, even after excess sleep.
- Cognitive Difficulties: “Fibro fog” can make it difficult to concentrate and complete tasks.
There is still much that is unknown about fibromyalgia, including the cause. Doctors currently believe that genetics, infections, and physical and emotional trauma may all contribute to the development of fibromyalgia.
Gout is a type of arthritis that flares up periodically; symptoms typically come and go. Though gout can affect various joints, it occurs most commonly in the big toe.
Pain associated with gout is intense — it can wake the person suffering from sleep and feel as if the foot is on fire. Symptoms can come on very suddenly.
Symptoms of gout include:
- Intense Joint Pain: Joint pain is sudden and is most severe for the first four to 12 hours after onset. Joint pain typically affects the big toe, but can also occur in the wrists, fingers, elbow, ankles and knees.
- Pain That Lingers: Pain can last for several weeks.
- Inflammation: The affected joint is typically inflamed and red.
- Limited Range of Motion: It is not uncommon for range of motion to be limited as gout progresses.
Gout is caused by excess urate crystals that accumulate in the body. This accumulation causes inflammation, and eventually the crystals settle in the joints, causing pain.