What is arthritis?

What is arthritis information booklet

Contents
What is arthritis? 4
What is a joint and how does it work? 5
The main types of arthritis 6
Osteoarthritis 6
Gout and calcium crystal diseases 8
Rheumatoid arthritis 11
Spondyloarthritis 14
Ankylosing spondylitis 14
Psoriatic arthritis 16
Juvenile idiopathic arthritis (JIA) 17
When should I see a doctor 18
Persistence of symptoms 18
Swelling of joints 18
Effects on daily life 19
Other conditions that have similar symptoms to arthritis 20
We’re the 10 million people living with arthritis. We’re the carers, Lupus 20
researchers, health professionals, friends and parents all united in Fibromyalgia 21
our ambition to ensure that one day, no one will have to live with Polymyalgia rheumatica 21
the pain, fatigue and isolation that arthritis causes. Back pain 22
We understand that every day is different. We know that what works Tendinopathy 23
for one person may not help someone else. Our information is a
How can I help myself if I have arthritis? 24
collaboration of experiences, research and facts. We aim to give you
What type of exercise should I do? 25
everything you need to know about your condition, the treatments
Understanding your condition 27
available and the many options you can try, so you can make the
best and most informed choices for your lifestyle. What will the future hold for me? 28
We’re always happy to hear from you whether it’s with feedback on our Where can I find out more? 30
information, to share your story, or just to find out more about the work
of Versus Arthritis. Contact us at [email protected] Talk to us 31

Registered office: Versus Arthritis, Copeman House, St Mary’s Gate, Chesterfield S41 7TD
Registered Charity England and Wales No. 207711, Scotland No. SC041156.

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What is arthritis information booklet

What is arthritis? What is a joint and how does it work?

The word arthritis is used to describe pain, swelling and stiffness in A joint is where two or more bones meet, such as in the fingers,
a joint or joints. Arthritis isn’t a single condition and there are several knees, and shoulders. Joints hold bones in place and allow them to
different types. move freely within limits.
Around 10 million people in the UK are thought to have arthritis. Most of the joints in our body are surrounded by a strong capsule.
It can affect people of all ages – even children and teenagers. The capsule is filled with a thick fluid that helps to lubricate the joint.
Some forms of arthritis are more common in older people. These capsules hold our bones in place. They do this with the help of
ligaments. These are a bit like very strong elastic bands.
If you have pain in or around a joint or joints that doesn’t go away
after a few days, you should see a doctor. Finding out what’s causing The ends of the bones within a joint are lined with cartilage. This is a
your pain is key to finding the right treatment and self-help options. smooth but tough layer of tissue that allows bones to glide over one
another as you move.
Although there’s no cure for arthritis, treatments have improved
greatly in recent years and, for many types of arthritis, particularly If we want to move a bone, our brain gives a signal to the muscle,
inflammatory arthritis, there’s a clear benefit in starting treatment which then pulls a tendon, and this is attached to the bone. Muscles
at an early stage. therefore have an important role in supporting a joint.
It may be difficult to say what has caused your arthritis. There are
A healthy joint
several factors that can increase the risk of each type of arthritis.
It could be that the genes you inherited from your parents or
grandparents made you more likely to get arthritis. Muscle
Bone
Arthritis can make life tough by causing pain and making it harder
to get about. The symptoms of arthritis can vary from week to week,
and even from day to day. Many types, such as osteoarthritis and Tendon
rheumatoid arthritis, are long-term conditions. Joint capsule
However, with the right treatment and approach you can manage Cartilage
your symptoms. Capsule lining
(Synovium)
Whatever condition you have, remaining physically active will help
you stay mobile and will be good for your general health. Synovial fluid

Bone

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What is arthritis information booklet

The main types of arthritis A joint affected by osteoarthritis

Because there are several types of arthritis, it’s important to know

which one you have. There are some similarities between these
conditions, but there are also some key differences. Thickened,
stretched
Osteoarthritis capsule
The most common type of arthritis is osteoarthritis. It is estimated Bony spurs
that around 8.75 million people in the UK have seen a doctor about (osteophytes)
osteoarthritis. Roughened
thinning Thickened,
Osteoarthritis starts with the roughening of cartilage. cartilage inflamed
synovium
If this happens, the body can put in place a repair process to try to
make up for the loss of this important substance. The following can
then happen:
• Tiny bits of extra bone, called osteophytes, can grow at the ends
of a bone within a joint.
• There can be an increase in the amount of thick fluid inside the joint.
• The joint capsule can stretch, and the joint may lose its shape. Being overweight can make you more likely to get osteoarthritis
and can make it worse.
Sometimes, the early stages of osteoarthritis can happen without
causing much pain or trouble. However, it can lead to damage inside Taking painkillers, such as paracetamol and non-steroidal anti-
a joint, as well as pain and stiffness. inflammatory drugs (NSAIDs), such as ibuprofen can help reduce
your symptoms and allow you to stay active. Keeping active will also
Osteoarthritis is more common in women and usually affects people
reduce pain, stiffness and swelling.
from the age of 45 onwards. The parts of the body most commonly
affected are the knees, hands, hips, and back. There are NSAID creams that you can rub into the affected area.
It might be an idea to try these first.
Keeping active will help you maintain a healthy weight, and this will
reduce the pressure on your joints. Doing regular exercise will keep There is a range of pain relief options available. If you’re finding
muscles around a joint strong, and this will help to support and the pain of osteoarthritis difficult to cope with, a doctor or
stabilise a joint affected by osteoarthritis. physiotherapist would be able to give you specific advice.

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What is arthritis information booklet

If your osteoarthritis becomes severe, particularly in your knees and

hips, your doctor might discuss with you the possibility of surgery.
This is usually considered only after you’ve tried all the other
treatment options.
Joint replacements are now very sophisticated and successful.

To find out more about osteoarthritis visit:

www.versusarthritis.org

Gout and calcium crystal diseases

Gout is a type of inflammatory arthritis that can cause painful
swelling in joints. It typically affects the big toe, but it can also affect
other joints in the body.
Joints affected by gout can become red and hot. The skin may also
look shiny and can peel.
It’s caused by having too much urate, otherwise known as uric acid,
in the body. We all have a certain amount of urate in our body.
However, being overweight or eating and drinking too much of certain
types of food and alcoholic drinks can cause some people to have
more urate in their bodies. The genes you inherit can make you more
likely to develop gout.
If it reaches a high level, urate can form into crystals that remain in
and around the joint. They can be there for a while without causing
any problems and even without the person realising they are there.

The genes you inherit can make you

more likely to develop gout.

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What is arthritis information booklet

A knock to a part of the body or having a fever can lead to the crystals Rheumatoid arthritis
falling into the soft part of the joint. This will cause pain and swelling. Rheumatoid arthritis is a type of inflammatory arthritis. It is what is
There are drugs that can reduce the amount of urate in the body known as an auto-immune condition.
and prevent gout attacks, the most commonly used are allopurinol The immune system is the body’s natural self-defence system, and it
and febuxostat. If you’re having a gout attack, you’ll also need short- protects us from infections and illness. When someone has an auto-
term pain relief. Non-steroidal anti-inflammatory drugs (NSAIDs) as immune condition, the body’s immune system mistakenly attacks the
well as paracetamol can be good drugs to try first. body’s healthy tissues, such as the joints, causing inflammation.
Men can get gout from their mid-20s, and in women it’s more common Inflammation is normally an important tool in the immune system.
after the menopause. Taking water tablets can increase the risk of gout. It occurs when the body sends extra blood and fluid to an area to
There are also conditions that cause calcium crystals to form in and fight an infection. This is what is happening for example if you have
around joints. a cut that gets infected, and the skin around it becomes swollen and
a different colour.
We all need calcium to make bones and teeth strong. However, some
people can have too much calcium in their bodies, which can then
form as crystals around joints. This can lead to painful swelling. A joint affected by rheumatoid arthritis

Calcium crystal diseases tend to clear up on their own. Taking

painkillers and NSAIDs, and applying an ice pack wrapped in a damp Muscle
Bone
towel, can soothe the pain and swelling. Capsule
(ligaments)
Erosion into
To find out more about gout and calcium crystal corner of bone
Inflamed
diseases visit: www.versusarthritis.org synovium
spreading
Thinning across joint
of cartilage surface

Synovial fluid
Although there’s no cure for arthritis,
treatments have improved greatly in Tendon
recent years.

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 What is arthritis information booklet

However, in rheumatoid arthritis the inflammation and extra fluid in

a joint can cause the following problems:
• It can make moving the joint difficult and painful.
• Chemicals in the fluid can damage the bone and joint.
• The extra fluid can stretch the joint capsule. Whenever a joint
capsule is stretched, it never quite returns to its original position.
• Chemicals in the fluid can irritate nerve endings, which can
be painful.
• As well as causing pain and stiffness, inflammation can cause
permanent damage to a joint. Starting effective treatment early
on can help to minimise damage.
Symptoms of rheumatoid arthritis can include:
• swollen and tender joints
• swelling and stiffness in joints in the morning that lasts for longer
than half an hour
• severe tiredness, also called fatigue
• a general feeling of being unwell.
Rheumatoid arthritis often starts in the small joints of the hands and
feet, and it can affect the same joints on both sides of the body at
the same time. It can start quite slowly and then gradually get worse,
or it can start more aggressively.
Rheumatoid arthritis can affect adults of any age. It most commonly
starts among people between the ages of 40 and 60. It’s more
common in women than men.
There are drugs that can slow down an over-active immune system
and therefore reduce the pain and swelling in joints. These are called
disease-modifying anti-rheumatic drugs (DMARDs) and include
biological therapies.

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What is arthritis information booklet

If you have rheumatoid arthritis, treatment will start with conventional

DMARDs. These can have the overall effect of reducing the activity
of your immune system, which is overactive and causing damage to
your body.
If these drugs have been tried and don’t work, doctors will look at the
possibility of trying the newer biological therapies. Biological
therapies have a more targeted effect on the immune system.

To find out more about rheumatoid arthritis visit:

www.versusarthritis.org

Spondyloarthritis
Spondyloarthritis is a word used to describe a number of conditions
that cause pain and swelling, mainly around the joints of the spine.
In these conditions there is inflammation of small pieces of connective
tissues, called entheses. These are tough little cords that join either
ligaments or tendons to bones.

Ankylosing spondylitis
Ankylosing spondylitis is a type of spondyloarthritis and it causes
pain and swelling, mainly around the joints of the spine.
There are drugs that can slow this process down. Keeping active
In this condition, in response to inflammation around the spine, the
will help to minimise stiffening of the spine, while maintaining a good
body can create more of the mineral calcium. This mineral is normally
posture will help prevent increased curving of the spine.
used by the body to make bones strong. However, in ankylosing
spondylitis the extra calcium can make new bits of bone grow in the Ankylosing spondylitis usually occurs between the ages of 20 and 30.
spine, and this will cause pain and stiffness. It is more common among men.
This condition typically causes pain in the second half of the night,
and swelling of your back in the morning that lasts for more than To find out more about ankylosing spondylitis and
half an hour. related conditions visit: www.versusarthritis.org

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 What is arthritis information booklet

Juvenile idiopathic arthritis (JIA)

If someone is diagnosed with inflammatory arthritis before their
sixteenth birthday, it’s called juvenile idiopathic arthritis, or JIA.
There are different types of JIA. They are auto-immune conditions,
and the immune system can cause pain and swelling in joints.
The earlier someone is diagnosed with JIA, the better. This is so that
effective treatment can be started and limit any damage to the body.
There are drugs that can treat the symptoms, such as painkillers and
non-steroidal anti-inflammatory drugs (NSAIDs). Disease-modifying
anti-rheumatic drugs (DMARDs) and biological therapies can slow
down or stop the arthritis causing the swelling inside the body.
Psoriatic arthritis There are about 12,000 young people in the UK who have JIA.
Psoriatic arthritis is an auto-immune condition. It is also a type
of spondyloarthritis.
To find out more about juvenile idioapthic arthritis visit:
The body’s immune system can cause painful swelling and stiffness www.versusarthritis.org
within and around joints, as well as a red scaly skin rash called
psoriasis. The rash can affect several places in the body, including
the elbows, knees, back, buttocks and scalp.
It is also common to have severe tiredness, otherwise known as fatigue.
Disease modifying anti-rheumatic drugs (DMARDs) and biological
therapies can treat the cause of the inflammation in joints. There is also
a variety of treatments, such as creams and medications, for psoriasis.
Psoriatic arthritis usually affects people who already have psoriasis.
However, some people develop the arthritis before the psoriasis.
It’s possible to have the arthritis but no psoriasis at all.
This condition can affect people of any age, but tends to affect adults.

To find out more about psoriatic arthritis visit:

www.versusarthritis.org

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What is arthritis information booklet

When should I see a doctor?

It’s common to have aches and pains in your muscles and joints from
time to time. This may especially be true if you take part in unusual
or strenuous physical activities.
So, how can you tell the difference between the early signs of
arthritis and normal pain and stiffness? And, how do you know when
you should see a doctor about your symptoms?
If you have swelling or stiffness that you can’t explain and that
doesn’t go away in a few days, or if it becomes painful to touch your
joints, you should see a doctor. The earlier you get a diagnosis and
start the right type of treatment, the better the outcome will be.
Here are some other things to think about that might help you
decide whether you need to see a doctor:

Persistence of symptoms
• How and when did the pain start?
Effects on your daily life
• If the pain came on after unusual exercise or activity you may have
• See a doctor or other relevant healthcare professional if you’re
just overdone it a bit, and the pain should ease within a few days.
unable to do everyday tasks due to joint or muscle pain.
• See a doctor if the pain isn’t linked to an injury or if the pain
• If you’ve lifted something heavy and hurt your back, for example,
won’t go away.
take some painkillers, apply some heat and try to stay active. If the
pain doesn’t ease after a couple of weeks or so, see a doctor.
Swelling of joints
• If a joint becomes swollen, and isn’t linked to an injury, you should It’s important to see a doctor if you get any new symptoms or if you
see a doctor. have any trouble with drugs you’re taking.
• This is especially important if you’re also unwell or have a fever, If you have an appointment with a doctor, to help make sure you get
or if the joint is red and warm. the most out of it, you could take a list of questions with you and tick
them off as they are discussed.
If you’re ever struggling with any aspects You could also keep a symptoms diary with details of how you’re
feeling in between appointments. Some people find that taking a
of managing your arthritis, or notice new friend or relative with them to an appointment can provide support
symptoms, you should see a GP. and ensure that all important points are discussed.

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What is arthritis information booklet

Other conditions that have similar Fibromyalgia

symptoms to arthritis Fibromyalgia is a long-term condition that can cause pain and
tenderness all over the body.
There are a number of other conditions that can cause pain and
possibly swelling in and around joints. Symptoms can be similar to arthritis. However, the symptoms are
mainly in the muscles rather than the joints.
Lupus The most common symptoms of fibromyalgia are:
Lupus is an auto-immune condition. The immune system mistakenly • widespread pain
attacks the body’s own healthy tissues.
• trouble sleeping
There can be many symptoms of lupus. It’s possible for the heart,
• when you do get sleep, it can be unrefreshing
lungs and other organs of the body to be affected.
• fatigue
Joint pain and swelling is common in lupus, particularly in the small
joints of the hands and feet. Joint pain in lupus can move around • headaches
from one joint to another. • difficulty concentrating
Lupus can be difficult to diagnose, as it can cause many different • a poor memory.
symptoms which often appear like other conditions. If you have fibromyalgia, you’re probably very sensitive to pain or
physical pressure.
To find out more about lupus visit:
www.versusarthritis.org To find out more about fibromyalgia visit:
www.versusarthritis.org

Polymyalgia rheumatica (PMR)

Polymyalgia rheumatica (PMR) is a condition involving painful and
stiff muscles. The hips, shoulders and thighs are commonly affected.
Lifting both arms above your head can be painful and difficult. The
pain and stiffness are often worse in mornings. Other symptoms
include a general feeling of being unwell and fatigue.
It mainly affects people over the age of 70.

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What is arthritis information booklet

Some people who have polymyalgia rheumatica develop a condition

called giant cell arteritis (GCA). This affects the blood vessels in the
head and can lead to symptoms of pain and tenderness around the
side of the head.
Giant cell arteritis can also cause pain in the tongue or jaw when
chewing, and in rare cases problems with vision or even loss of
vision. If you get any of these symptoms, it’s important to see a
doctor urgently. If left untreated, giant cell arteritis can lead to
permanent damage to eyesight, even blindness.
Both polymyalgia rheumatica and giant cell arteritis can be treated
effectively with steroids, normally tablets.

To find out more about polymyalgia rheumatica visit:

www.versusarthritis.org

Back pain
Back pain is a common problem that affects many of us. It’s usually Tendinopathy
caused by a simple muscle or ligament strain and not usually by a Tendinopathy is a condition in which tendons, the strong cords that
serious problem. There might not even be a specific cause. attach muscles to bones, are painful.
Back pain will usually clear away in a couple of weeks. The affected part of the body may be hot, swollen and red. This can
Remaining active while taking painkillers is often the best thing make moving that part of the body difficult. You might also feel a
you can do. grating sensation.
This can be caused by over-use of that part of the body. Stopping
To find out more about back pain rheumatica visit: or altering the activity that caused the problem may be the first step
www.versusarthritis.org to recovery.
Remaining generally active and taking painkillers can also help.
Applying an ice pack, such as a bag of frozen peas wrapped in a tea
towel, can also reduce pain and swelling.

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What is arthritis information booklet

How can I help myself if I have arthritis?

As well as medical treatments, there are many things you can do
to help yourself manage your arthritis.
You might not always feel like exercising if you have arthritis. And
you might be worried that exercising will make your pain or your
condition worse.
However, exercise can make symptoms such as pain and swelling
better. There are several reasons why this is the case:
• Your muscles will become stronger. This will provide better
support to the joint.
• Your joints will become supple and less likely to become stiff.
• Your joints will be able to maintain their range of movement.
• Exercise improves your overall health and fitness and can help
you maintain a healthy weight.
• Exercise leads to the release of chemicals in the body called
endorphins. These are painkillers produced naturally by the body. What type of exercise should I do?
Releasing them into the blood through exercise can make you People usually find that low-impact exercise is best. Swimming,
feel good. cycling, brisk walking, yoga, t’ai chi, and Pilates are all examples of
• Exercising regularly can help you get good sleep, which can help exercises that have helped people with arthritis. It’s good to find
the body repair itself. something you enjoy so that you keep doing it.
You may feel some discomfort and sometimes pain when you
exercise. This feeling is normal and should calm down a few minutes
after you finish. It’s not a sign that you are hurting yourself. Exercise
will help reduce pain and can help you manage your arthritis better.
Remaining physically active will help you While you can push yourself and do strenuous exercise, it’s
stay mobile and will be good for your important not to overdo it. If you are in pain that you can’t cope with
during or after your activity, you will need to see a doctor. The key is
general health. to start off gently and to gradually increase the amount you do.

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What is arthritis information booklet

Regular exercise is also an important part of maintaining a healthy Understanding your condition
weight. This will improve your symptoms as it will take pressure
Having a good understanding of your condition will help you know
off joints. Being overweight can make someone more likely to have
about your treatment options and why exercise and other self-
inflammation in their body.
management methods are important. It will also mean you’re in
The best way to lose weight is to have a healthy, low-fat, low-sugar and a good position to get the most out of your appointments with
balanced diet. Make sure you have plenty of fresh fruit and vegetables, healthcare professionals.
drink plenty of water, and exercise regularly. If you burn off more
If you’re ever struggling with any aspects of managing your arthritis,
calories than you consume on a daily basis, you will lose weight.
or notice new symptoms, you should see a GP. They could also refer
If you are ever struggling and need support or motivation to keep you to another relevant healthcare professional.
active, see a GP or physiotherapist.
This could include a physiotherapist, who is trained to help you with
If you can afford it, another option would be to have regular sessions exercise and help you maintain movement and function of any part
with a personal fitness trainer at a gym. If you are able to find of your body affected by arthritis.
someone who is trained to personal trainer level two or above, they
Alternatively, you might benefit from seeing an occupational
will be able to give you advice on the best exercises for you and can
therapist. These are professionals who could help you overcome
monitor your progress. Make sure you tell them about your condition.
the difficulties that your condition might cause, by providing
practical solutions.
You can be referred to physiotherapists and occupational therapists
on the NHS through your GP. If you are struggling with every-day
tasks at home, you may be able to get access to an occupational
therapist through your local social services department.

To find an occupational therapist near you, visit:

www.rcotss-ip.org.uk/find
To find an physiotherapist near you, visit:
www.csp.org.uk/public-patient/find-physiotherapist/

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What is arthritis information booklet

What will the future hold for me? how it affects you, and how your employer might be able to help
you is a useful first step to unlock the rights and support you’re
It’s difficult to say for certain how arthritis will affect you over time. In entitled to by law.
some types of arthritis symptoms can come and go.
Being in pain from arthritis can often lead to anxiety and depression.
Most people with arthritis don’t have major mobility problems, and It’s important to tackle feelings like this, because they can affect how
effective treatment will help reduce the risk of joint damage, even in well you manage your condition.
more severe cases.
Talking to your partner, relative, friend, or a doctor can really help.
There is plenty you can do to remain positive and proactive in all You might find it helpful to try something like cognitive behavioural
aspects of managing your arthritis and your overall health. therapy, or mindfulness. These are talking therapies that have helped
If you’re worried about what impact arthritis will have on your people cope better with the effects of arthritis.
working life, it’s important to know that you have rights and options. If you have arthritis it does have the potential to have an impact
If you work your arthritis might mean that you need to change on your quality of life. However, with the right treatment, support,
aspects of your job or even train for a different role. knowledge and approach, you will be able to live a fulfilling, happy
Your employer has a duty to make sure that your arthritis doesn’t and successful life.
make it difficult for you to do your job, and that you’re comfortable The more physically and socially active you are, the more control you’ll
at work. Having a chat with your manager about your condition, have over your life, and the less control arthritis will have over you.

The more physically and socially

active you are, the more control you’ll
have over your life, and the less
control arthritis will have over you.
What is arthritis information booklet

Where can I find out more? Talk to us

If you’ve found this information useful, you might be interested in
other titles from our range. You can download all of our booklets
from our website www.versusarthritis.org or order them by
Helpline
contacting our Helpline. If you wish to order by post, our address You don’t need to face arthritis alone. Our advisors aim
can be found on the back of this booklet. to bring all of the information and advice about arthritis
into one place to provide tailored support for you.
Bulk orders
For bulk orders, please contact our warehouse, APS, directly to
Helpline: 0800 5200 520
place an order: Email: [email protected]
Phone: 0800 515 209
Email: [email protected] Our offices
We have offices in each country of the UK. Please get in touch
Tell us what you think to find out what services and support we offer in your area:
All of our information is created with you in mind. And we want
to know if we are getting it right. If you have any thoughts or England
suggestions on how we could improve our information, we would Tel: 0300 790 0400
love to hear from you. Email: [email protected]
Please send your views to [email protected] Scotland
or write to us at: Versus Arthritis, Copeman House, St Mary’s Tel: 0141 954 7776
Court, St Mary’s Gate, Chesterfield, Derbyshire S41 7TD. Email: [email protected]

Thank you! Northern Ireland

A team of people helped us create this booklet. We would like to Tel: 028 9078 2940
thank Dr David Walker, Dr John Jackman and Professor Ian Giles Email: [email protected]
for helping us review this booklet.
Wales
We would also like to give a special thank you to the people Tel: 0800 756 3970
who shared their opinions and thoughts on the booklet. Your Email: [email protected]
contributions make sure the information we provide is relevant
and suitable for everyone.

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What is arthritis?
Arthritis is a general term to mean painful, stiff and swollen joints.
In this booklet, we talk about the most common types of arthritis,
their treatment options and what you can do to help yourself.

For information please visit our website:

versusarthritis.org
0300 790 0400
/VersusArthritis
@VersusArthritis
@VersusArthritis

© Versus Arthritis 2020

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