Nearly 40 million Americans have arthritis, which causes joints to become inflamed or swollen. There are more than 100 types of arthritis that affect the joints and connective tissues (tendons and ligaments) of the body.

Arthritis sets off a painful, destructive cycle in which inflammation - part of the body\\'s natural defense system - causes tissue damage that the body tries to deal with by creating more inflammation. The inflammation causes swelling, pain, redness and a loss of motion in the joint. Ultimately, it can change the bones and connective tissues, reducing their ability to function.


Symptoms

Each type of arthritis has different symptoms and patterns. Each requires different treatments. Common symptoms include:
Pain or tenderness in the joints
Swelling in one or more joints
Warmth and redness in a joint
Stiffness or difficulty using or moving the joint

Severe rheumatoid arthritis (shown above right) can destroy the joints and deform the wrist, finger and knuckle joints. In the case of rheumatoid arthritis, symptoms include fatigue, weaknesses, loss of appetite, fever and anemia. When a person gets up after sleeping, joints are usually stiff, swollen and tender.

Some forms of arthritis go through cycles of getting better and worse. A flare-up means the disease is more active. During this time, there is increased morning stiffness, more pain and swelling in the joints, involvement of new joints, and increased tiredness and fatigue. Flare-ups can occur after eating a specific food. Milk is the most common offender. Other foods are shrimp, wheat products, and certain meats.


Causes and Risk Factors

It is not yet known what causes arthritis. Inflammation occurs in a damaged area of a joint. Damage can be caused by injury, infection, neurogenic disturbances, metabolic disturbances, among others.

New research indicates that people with certain gene types seem to be more likely to get certain kinds of arthritis. There are also signs that microorganisms may trigger its start.

Diagnosis

To find out whether you have arthritis, a doctor may take your medical history and do a physical examination. He or she may also have X-rays or other imaging procedures done along with blood and lab tests.

Lab tests may include:
Antinuclear antibody (ANA) test to check levels of antibodies in the blood
Sampling the synovial fluid, which surrounds and lubricates the joints, to see if it has crystals, bacteria or viruses
Complete blood counts to see if white blood cell, red blood cell and platelet levels are normal
Creatinine to monitor for underlying kidney disease
Erythrocyte sedimentation rate to detect inflammation
Rheumatoid factor test to determine if rheumatoid factor is present in the blood
Urinalysis to determine levels of protein, red blood cells, white blood cells, and casts

The photo below on the left shows advanced rheumatoid arthritis that has caused swelling in all of the joints of the hand and wrist. The photo on the right shows an unusual form of arthritis caused by a crystal material containing calcium. It causes premature osteoarthritis in many joints.

The most common forms of arthritis are:
Osteoarthritis
Rheumatoid arthritis, a progressive form of arthritis that causes pain and joint deformity
Spinal arthritis
Gout
Lupus
Scleroderma
Juvenile arthritis

Treatments

There is no cure for arthritis yet. But most people with the condition can do normal activities of daily living.

Some of the ways in which arthritis is treated include:
Drugs, such as pain relievers, nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids and cortisone injections
Rest. Being tired and feeling pain are signs of arthritis and show that it may be time to rest joints and muscles
Exercise, when balanced with rest, can help reduce pain and stiffness, making muscles stronger and joints more flexible. Consult your doctor first, however, before beginning an exercise program.
Maintaining proper body weight and eating a well-balanced diet. Extra weight increases pressure on the joints and can make some types of arthritis worse.
Using devices such as splints, braces, canes or shoe inserts to protect joints from the stresses of daily activities and relieve symptoms.
Heat and cold therapies. Heat therapy (paraffin wax, ultrasound or moist heat) increases blood flow and flexibility in the joint. Cold therapy (cold packs, cold-water soaks, over-the-counter sprays and ointments) numbs the nerves and relieves inflammation.
Surgery to repair or remove a diseased or damaged joint, fuse the bones in a joint or replace joints with artificial ones.