Joint Pain and Swelling What Kind of Arthritis Is It

Most people have experienced mild joint pain from time to time. It’s common to have some stiffness in the morning that goes away as you go about your day, especially as you get older. 

But did you know that there are over 100 different causes of joint pain? Read on to learn more about some of the most common causes for achy joints, how to tell them apart, and how to take the next steps on getting the right diagnosis and treatment. 

What is arthritis?

Arthritis, or joint inflammation, is a general term that refers to swelling and pain in your joints. It’s a term that can refer to any medical condition that causes chronic (ongoing) or recurring joint pain, inflammation, or damage. It’s especially common in older adults, but it can also affect younger people — including children. 

Different types of arthritis can have different symptoms. These symptoms can be mild, moderate, or severe, and they can affect one joint, or many. People with arthritis usually have at least one of the following:

• Joint pain
• Joint stiffness
• Joint swelling 
• Joint redness
• Decreased movement in one or more joint(s)

How many types of arthritis are there?

There are over 100 types of arthritis, each with their own causes, symptoms, and treatments. Some of the most common types of arthritis are:

• Osteoarthritis (OA)
• Rheumatoid arthritis (RA)
• Psoriatic arthritis (PsA)
• Lupus
• Gout
• Fibromyalgia

Other examples of arthritis include:

• Juvenile idiopathic arthritis
• Reactive arthritis
• Ankylosing spondylitis
• Infectious (septic) arthritis
• Lyme disease arthritis

What are the differences between the most common types of arthritis?

Osteoarthritis

Osteoarthritis (OA) is the most common type of arthritis, caused by joint “wear and tear” over time. It starts by affecting your cartilage, the flexible connective tissue that cushions your joints. Normally, the cartilage allows the joints to glide over each other with ease. When cartilage starts to break down, it makes these movements less smooth. Pain, swelling, and stiffness can occur. 

Some of the hallmarks of OA are:

• It’s more common in older age, especially in women over age 50. 
• It starts gradually over months to years.
• It usually starts in one to two joints.
• Morning stiffness is present but goes away quickly (in less than 30 minutes).
• Joint pain is worse with activity, and better with rest.
• Joints crack, pop, or “give way” easily.
• Bony lumps (nodes) can form in your fingers, especially in the knuckles closest to your fingertips. 

Though osteoarthritis can affect any joint in the body, the most common joints are the: 

• Knees
• Hips
• Hands
• Spine

In some cases, the cartilage wears down completely and the bones of the joints can come into contact with each other. This can lead to increased pain and a limited range of motion of the joint.

Rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune disorder where your immune system begins damaging your body tissues. It results in stiffness and pain that can worsen over time. Smaller joints like the fingers and toes are usually affected first, but the symptoms can spread to the: 

• Wrists
• Elbows
• Shoulders
• Hips

Some of the hallmarks of RA are:

• It can begin at any age, but it most commonly begins in adults in their 60s.
• RA is 2 to 3 times more common in women than in men.
• It starts gradually over weeks to months.
• It usually starts in two or more small joints.
• It often affects the same joints on both sides of the body.
• Joints can look sore and inflamed.
• Morning stiffness is present and takes a long time to go away (longer than 30 minutes).
• Bony lumps (nodes) can appear in your fingers, especially in the knuckles in the middle or base of your fingers. 

Many people with RA will also have flu-like symptoms that come and go, like fever, weakness, and fatigue. And because RA is an autoimmune disease, it can also affect other body systems like your: 

• Skin
• Eyes
• Heart
• Blood vessels
• Lungs 

Gout

Gout is a type of arthritis that causes intense pain with redness, heat, and swelling — often in a single joint. It usually affects the big toes. It can also occur in other joints like the ankles, knees, hands, and elbows.

Some of the hallmarks of gout are:

• It’s most common in men over 40 and in women after menopause.
• Men are 3 times more likely to have gout than women.
• It often starts suddenly or overnight.
• It usually starts in the big toe.
• Joints can look sore and inflamed.
• Symptoms come and go over time.

Gout is unique because it is directly tied to your diet. It’s caused by a build-up of uric acid crystals in your blood — a substance that is made when your body breaks down purines, a chemical naturally found in foods. If your body makes too much uric acid, it can accumulate in the tissues, causing a “flare” of sudden intense pain. 

Psoriatic arthritis

Psoriasis is an immune system disease that causes body-wide inflammation. People with psoriasis often have a raised rash (plaques and scales) on their skin. About 30% of people with psoriasis will also have inflammation in their joints, called psoriatic arthritis (PsA). 

Some of the hallmarks of PsA are:

• It most commonly starts between ages 30 and 50, but it can happen at any age.
• PsA often starts about 10 years after psoriasis begins.
• Shallow or deep holes (pitting) can appear on your nails.
• It’s more likely to affect your spine than other types of autoimmune arthritis.
• Morning stiffness and fatigue are common.

Lupus

Lupus is an immune system disease that can affect almost any part of your body. Arthritis is the most common symptom seen in lupus. Because the whole body can be affected, people with lupus will usually have other symptoms as well, like: 

• Fever
• Rash
• Fatigue
• Sun sensitivity
• Chest pain

Some of the hallmarks of lupus arthritis are:

• It’s most common in women between ages 15 and 44, and in BIPOC.
• It usually affects the joints farthest away from your torso, like your fingers and wrists, and your knees, ankles, and toes.
• Morning stiffness is present, but it usually gets better as the day goes on.
• It usually affects multiple joints.
• Symptoms come and go over time.

Fibromyalgia

Fibromyalgia is a condition that causes widespread pain with no known cause. Though fibromyalgia doesn’t directly damage your joints like other types of arthritis, joint pain and stiffness are common symptoms. Fibromyalgia can also cause: 

• Difficulty sleeping
• Anxiety
• Depression
• Headaches
• Fatigue

Do all types of arthritis cause joint pain?

It depends. Though all types of arthritis can cause joint pain and inflammation, it’s possible to have arthritis without any pain. This especially true if it is mild, or if your healthcare provider catches it early. In some cases, arthritis may start out as stiffness or achiness, rather than pain. As arthritis progresses, the more inflamed (or damaged) the joint, the greater the chance of having pain.

Getting a diagnosis

If you have ongoing joint pain — or other symptoms — it can be helpful to talk to a healthcare provider about your experiences. Your provider can review your history and do a physical exam. 

In particular, your healthcare provider may want to talk with you about:

• When your symptoms started
• Which joints are affected
• Whether there are any times when your symptoms are better or worse
• Whether anyone else in your family has arthritis

Your provider may also suggest tests that can help with diagnosis:

• Laboratory tests: Testing is sometimes done on blood or urine, or on fluid found within the joint. Your provider can use this information to look for signs of body-wide inflammation, or other information that can confirm (or rule out) a diagnosis.
• X-rays and other imaging: Since changes in the joint are common in arthritis, an X-ray is often used to help with diagnosis. X-rays can show the condition of bone and cartilage. In early disease, there may not be any visible change, but as the condition progresses, joint damage may become apparent. Other types of imaging can also be used to look at the joint, like CT scans and MRIs.
• Arthroscopy: Arthroscopy involves making small incisions into the skin around the joint, then inserting a small camera to look at the area. This is a minimally invasive way to see the joint and its surrounding tissues.

How are different types of arthritis treated?

Regardless of the cause of arthritis, the main goals of treatment are the same:

• Relieve pain
• Decrease damage to the joints and surrounding tissues
• Improve your quality of life by making movements easier 

For autoimmune types of arthritis (like RA or lupus), treatments are also designed to help control the immune system and to decrease inflammation. 

Physical therapy and exercise

Physical therapy and exercise can help to reduce pain and stiffness, increase mobility, and bring blood and nutrients into your joints.

Examples of low-impact exercises that can keep joints strong and healthy are:

• Walking
• Water exercise
• Yoga
• Bike riding 

Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs)**

NSAIDs like ibuprofen or naproxen are usually the first choice for medication treatment. They help to reduce the pain and to decrease inflammation caused by many different types of arthritis. NSAIDs are available over-the-counter as pills, tablets, or ointments. Some types of NSAIDs are only available by prescription.

Pain medication

Just like NSAIDs, over-the-counter pain medications like acetaminophen (Tylenol) can help to ease joint pain in many different conditions. These medications do not reduce inflammation. For severe symptoms, prescription medications may be needed.

Disease-modifying anti-rheumatic drugs (DMARDs)

DMARDs are prescription medications used to treat inflammatory diseases like rheumatoid arthritis. They change how your immune system behaves, and keep it from attacking your joints.

Biologic response modifiers

Biologic response modifiers are prescription medications that are also used to treat autoimmune arthritis like RA. They are often used together with DMARDs to change how your immune system functions in your body. 

Injections

In some cases, a painful joint can be injected with medications like steroids or hyaluronic acid. Steroids (like prednisone) can help to reduce inflammation. Hyaluronic acid can help to stimulate the joint to produce more joint fluid, which can be decreased in some types of arthritis.

Surgery

In severe or advanced cases, surgery can sometimes be an option — like a joint repair, joint replacement, or joint fusion. Some procedures involve traditional surgery, while others can be done arthroscopically. Arthroscopic surgery involves making small incisions in the skin near the joint and inserting a camera and specialized tools to perform the procedure.

Is it possible to have multiple types of arthritis at the same time?

Yes. Since there are many causes of arthritis, it is possible to have more than one type at the same time — especially if they have different causes. For example, you could have osteoarthritis from joint “wear and tear” over your lifetime and also have a separate autoimmune condition like lupus. 

Can conditions other than arthritis cause joint pain?

Yes. There are many conditions that can cause joint pain. Examples include:

• Bursitis
• Sprains and strains
• Tendinitis

These conditions are often caused by injury or overuse, and they tend to resolve over time with rest and supportive care. Unlike arthritis, they do not typically cause long-term symptoms or require ongoing treatment.