Arthritis is a condition in which one or more of your joints are inflamed. This results in stiffness, soreness, and swelling. While there are different types, arthritis can be broadly split into two categories: inflammatory arthritis and noninflammatory arthritis.
Generally speaking, the inflammation in inflammatory arthritis is caused when the immune system attacks the connective tissues in the body. Some examples of common types of inflammatory arthritis are rheumatoid arthritis and psoriatic arthritis.
Noninflammatory arthritis, such as osteoarthritis (OA), can also cause inflammation. However, this inflammation typically results from normal wear and tear to the joints. Over time, the cartilage in your joints can become worn down, causing the bones within a joint to rub together, which is the source of pain and stiffness.
This article breaks down some of the most common types of inflammatory arthritis, discusses what causes them, what their symptoms are, and how they’re diagnosed and treated.
Some of the common types of inflammatory arthritis are:
- Rheumatoid arthritis (RA): RA is an autoimmune condition. In RA, your immune system mistakenly attacks the lining of your joints.
- Psoriatic arthritis (PsA): PsA is a type of arthritis that impacts individuals with the skin condition psoriasis. It’s an autoimmune condition in which the immune system attacks healthy joint and skin tissue.
- Axial spondyloarthritis: Axial spondyloarthritis is a type of inflammatory arthritis that mainly impacts the spine and sacroiliac (SI) joints. The SI joints are the joints that connect your hipbone to your spine.
- Lupus arthritis: Like RA and PsA, lupus is an autoimmune condition. Many people with lupus have musculoskeletal involvement, which can lead to joint pain and swelling.
- Juvenile idiopathic arthritis (JIA): JIA is a type of inflammatory arthritis that affects children and adolescents. It’s an autoimmune condition in which the immune system mistakenly attacks healthy joint tissues.
- Gout: Gout is an inflammatory condition that can cause joints to swell and become sensitive and painful. It’s triggered by the presence of uric acid crystals in the joints.
Generally speaking, all types of inflammatory arthritis involve the following symptoms in the joints:
- tenderness or pain
- swelling
- stiffness
- redness
However, each type of inflammatory arthritis can also have unique symptoms or impact a specific area of the body. Let’s explore this now.
Rheumatoid arthritis
RA most often impacts the small joints of the body, such as those in the hands, feet, and wrists. Typically, more than one joint is affected. Additionally, more often than not, the same joints on both sides of the body are involved. This is called symmetric arthritis.
Other symptoms of RA include:
- morning joint stiffness that can last for 30 minutes to hours
- decreased range of motion
- joint deformities
- fatigue
- low-grade fever
In some instances, RA symptoms can get worse over a period of time. This is often referred to as a flare.
Psoriatic arthritis
PsA can affect a variety of different joints in the body. In fact, there are several types of PsA, which are classified by their severity and the area of the body that they affect.
Additional symptoms of PsA include:
- warmth in the joints
- nail changes, such as pitting, cracking, or separation from the nail bed (onycholysis)
- swelling of the fingers or toes (dactylitis)
- swelling where ligaments or tendons connect to bone (enthesitis)
- psoriasis
- fatigue
- low-grade fever
As in RA, people with PsA can also experience flares. There are many things that can bring on a PsA flare.
Axial spondyloarthritis
The main symptoms of axial spondyloarthritis are chronic lower back pain and inflammation of the SI joints. This can lead to:
- pain that:
- is often worse at night
- improves with activity
- worsens with rest
- stiffness, particularly in the morning
- fusion of bones in the spine (bamboo spine)
Those with axial spondyloarthritis typically have two or more other disease features, which can
- back pain due to inflammation
- arthritis
- swelling where ligaments or tendons connect to bone (enthesitis)
- swelling of the fingers or toes (dactylitis)
- eye pain and inflammation (uveitis)
- psoriasis
- Crohn’s disease
- symptoms that respond well to nonsteroidal anti-inflammatory drugs (NSAIDs)
- high levels of C-reactive protein
- a family history of the condition
- certain genetic markers
Lupus arthritis
Lupus can impact many organs and tissues. In addition to joint pain and inflammation, a person with lupus may experience:
- fatigue
- low-grade fever
- body aches and pains
- headaches
- skin rashes, which can include a butterfly-shaped rash across the cheeks and nose
- chest pain
- shortness of breath
- sensitivity to sunlight
- mouth sores, which are typically painless
- hair loss
- dry eyes and mouth
- Raynaud’s syndrome, which makes the fingers and toes turn white or blue in the cold
Juvenile idiopathic arthritis
While JIA can affect any joint in the body, it most often impacts the:
- hands
- wrists
- elbows
- knees
- ankles
There are several types of JIA and specific symptoms can vary. In addition to general symptoms of inflammatory arthritis, an individual with JIA can also have:
- warmth in the joints
- fatigue
- rash
- decreased appetite
- dry eyes
- blurry vision
- fever
Gout
Gout is characterized by sudden, painful joint swelling. During this time, the affected joint becomes very sensitive and even the slightest bit of pressure can cause serious pain. The joint may also appear red and feel warm.
Initially, gout affects only one joint, which is typically the big toe. However, it’s possible for other joints to be impacted as well, such as the:
There are a variety of potential causes of inflammatory arthritis.
Rheumatoid arthritis
RA is an autoimmune condition. This means the body’s immune system attacks healthy tissues. In the case of RA, the immune system attacks the synovium, which is the lining around the joint that facilitates smooth joint movement.
The exact cause of RA still remains a mystery. It’s believed things like genetics, infections, and external or environmental factors may potentially contribute.
Those assigned female at birth are more likely to develop RA than those assigned male at birth. The condition typically develops in middle age.
Psoriatic arthritis
PsA is also an autoimmune condition. Similar to RA, it’s unknown what exactly causes the immune system to attack healthy skin and joint tissue in PsA. It’s believed that a complex combination of both genetic and environmental factors contributes to the development of PsA.
PsA is estimated to affect between
Axial spondyloarthritis
Similar to the other autoimmune arthritis types, the exact cause of axial spondyloarthritis is unknown. It’s possible that genetics play an important role in the development of the condition.
The estimated prevalence of axial spondyloarthritis in the United States is between
Lupus arthritis
The specific cause of lupus is unknown. It’s believed that certain individuals are at a genetic predisposition for the condition and that lupus can be triggered by factors like certain infections, stress, or environmental exposures.
Lupus most often impacts those assigned female at birth during childbearing age. Additionally, rates of lupus are
Juvenile idiopathic arthritis
It’s unknown what causes JIA. In fact, the word idiopathic indicates that a condition has no identifiable cause. It’s possible a combination of genetic and environmental factors contributes to the development of JIA.
In JIA, the onset of symptoms occurs prior to age 16. Additionally, a child can have symptoms of one type of JIA but can develop symptoms of another type later on.
Gout
Gout is caused by a buildup of uric acid in the body. However, it’s estimated that only about
When uric acid levels are high, it can form crystals that can build up in the joints. This is what causes a gout attack.
A variety of factors can contribute to increased uric acid levels and gout attacks:
- underlying health conditions, such as dehydration and diabetes
- certain types of medications, such as aspirin and diuretics
- certain foods, such as seafood and meat
- sugary drinks and other foods sweetened with high fructose corn syrup (which raise uric acid when the fructose breaks down)
- alcohol consumption
- having obesity
After your doctor takes your medical history and performs a physical examination of your joints, they may order additional tests. These most often include blood tests and imaging tests.
A variety of blood tests can help to diagnose inflammatory arthritis. These include tests for:
- complete blood count, which measures the levels of different blood cells
- rheumatoid factor, which is often present in RA
- C-reactive protein and erythrocyte sedimentation rate, which can indicate inflammation
- uric acid test, which assesses increased uric acid in the blood that can indicate gout
- genetic tests, which can help to identify genetic markers associated with some types of arthritis, such as axial spondyloarthritis and JIA
Imaging tests can help your doctor visualize the affected joints and look for signs of inflammation and damage. Some examples of imaging technology that may help diagnose inflammatory arthritis include:
The treatment of inflammatory arthritis has several goals. These include:
- lowering inflammation levels
- easing symptoms
- stopping the progression of the condition
- reducing the risk of joint damage or other complications
- improving joint function
- boosting quality of life
Inflammatory arthritis may be treated differently depending on the type, but there are some general treatments.
Medications
Medications are often used to treat the different types of inflammatory arthritis. Depending on the type of inflammatory arthritis and its severity, different medications may be recommended.
Your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) or naproxen (Aleve), in situations where inflammatory arthritis is mild to moderate.
Corticosteroids, which can be taken orally or by injection, can also reduce inflammation in the joints. However, these are often used on a short-term basis due to the potential side effects that they can cause.
Some types of drugs can target the body’s immune response, helping to block it and slow down the progression of inflammatory arthritis. These drugs are called disease-modifying antirheumatic drugs (DMARDs) and may be used to treat conditions like:
- RA
- PsA
- axial spondyloarthritis
- lupus arthritis
- JIA
Additionally, DMARDs can be further broken down into traditional DMARDs and biologics. Some examples of traditional DMARDs that can be used to treat inflammatory arthritis include:
Biologics are a newer type of DMARD. Biologics target a very specific part of the immune response instead of blocking larger parts of the immune system like traditional DMARDs. Some examples of biologics that are used for inflammatory arthritis are:
- adalimumab (Humira)
- etanercept (Enbrel)
- infliximab (Remicade)
- golimumab (Simponi)
- certolizumab (Cimzia)
- tocilizumab (Actemra)
- abatacept (Orencia)
- tofacitinib (Xeljanz)
- rituximab (Rituxan)
Physical therapy and assistive devices
Physical therapy can help improve muscle strength, flexibility, and range of motion. Stronger muscles can better support a joint, possibly easing pain during movement.
Assistive devices, like canes, raised toilet seats, or equipment to help you drive a car and open jar lids, are available to help you maintain independence and daily function.
Surgery
Doctors don’t typically recommend surgery for inflammatory arthritis. However, it may be an option if damage to the affected joint is severe. In this situation, your doctor might recommend surgery to repair or replace the joint.
Living with inflammatory arthritis can be a challenge. However, various lifestyle measures can help you manage the condition.
For instance, regular exercise and managing your weight can help reduce the burden on your joints. Exercise not only contributes to weight management, but it can also help support joints by strengthening the surrounding muscles.
Eating a balanced diet that includes lots of fruits, vegetables, low fat proteins, and whole grains can also help ease inflammation and prevent weight gain. Additionally, managing your diet can help to prevent gout attacks.
Being sure to get enough sleep is also important. Being well-rested is a good way to reduce fatigue, lower stress, and decrease levels of inflammation.
Stress can also contribute to flares of autoimmune conditions like RA and PsA. Because of this, it’s important to explore ways to reduce stress in your daily life. Some examples of activities that can help with stress are:
- yoga
- meditation
- breathing exercises
- hobbies
- going for a walk outside
- listening to soothing music
Inflammatory arthritis is treatable. As with most health conditions, getting an early diagnosis and a head start on treatment often results in the best outcomes.
Don’t assume all joint stiffness is another unavoidable sign of aging. If there’s swelling, pain, or stiffness, it’s a good idea to make an appointment with your doctor, especially if these symptoms interfere with your daily activities.
Aggressive treatment and a better understanding of your specific condition may help keep you more active and more comfortable in the years ahead.