Arthritis

Arthritis is a broad word for pain, stiffness, swelling and reduced movement of joints. It is not a single disease — it covers more than 100 conditions. In India, the three commonest forms are osteoarthritis (wear and tear), rheumatoid arthritis (autoimmune), and gout (crystal disease). Each has different treatment, so the label "arthritis" alone isn't enough — the type matters.

Main types — broad picture

• Osteoarthritis (OA) — most common; joint cartilage wears down; knees, hips, fingers, spine. Worse with use, better with rest; stiffness eases quickly after getting going.
• Rheumatoid arthritis (RA) — autoimmune; attacks the joint lining (small joints of hands/feet, then larger). Prolonged morning stiffness (hours); symmetrical.
• Gout — crystal deposits in a joint; sudden, severe, usually the big toe.
• Psoriatic arthritis — with psoriasis skin changes.
• Ankylosing spondylitis — inflammatory back pain in young adults.
• Reactive arthritis — after an infection (gut, urinary).
• Infectious (septic) arthritis — a bacterial joint infection; medical emergency.
• Juvenile idiopathic arthritis — in children.

Red flags — see a Health Expert urgently

• Single hot, very painful, swollen joint with fever — rule out septic arthritis immediately.
• Severe joint pain with rash, high fever, unwell.
• Progressive weakness, numbness, or trouble walking.
• TB of a joint is a real Indian differential — a chronic swollen joint with low-grade fever and weight loss deserves a tuberculosis work-up.
• Sudden inability to use a joint after injury.

Evaluation

• Detailed history (pattern, timing, stiffness, symmetry, triggers).
• Examination of all joints and skin.
• Blood tests — CBC, inflammation markers (ESR, CRP), rheumatoid factor, anti-CCP, uric acid, HLA-B27 in some.
• X-rays for longer-standing disease; ultrasound/MRI for earlier detection; joint fluid aspiration for suspected crystals or infection.

What helps across most types

• Healthy weight — every kg makes a big difference, especially for knee arthritis.
• Regular low-impact exercise — walking, cycling, swimming, yoga, tai chi. Strengthening the muscles around the joint reduces pain more than rest.
• Physiotherapy — often transformative; under-used.
• Pain relief — NSAIDs as needed; topical gels; simple pain relievers; short courses where possible.
• Joint-specific treatment — disease-modifying drugs for RA and other inflammatory types; urate-lowering drugs for gout; knee/hip replacement for severe OA.
• Don't self-prescribe unregulated ayurvedic or herbal arthritis medicines — many have been shown to contain hidden steroids or NSAIDs. Unusually fast relief from an unbranded product is a warning sign.