Arthritis: symptoms, types, treatment and what causes it

The NHS says arthritis causes pain, swelling and stiffness in your joints, which can make the joint difficult to move. You can get arthritis in any joint, but the NHS lists commonly affected joints as those in the wrists, hands and fingers, the ankles, feet and toes, the back and spine, and the knees and hips.

Your symptoms may sometimes suddenly get worse. This is known as a flare-up and can last several days.

The pattern differs by type. For example, the NHS says osteoarthritis causes joint pain and stiffness and problems moving the joint, sometimes with swelling, tenderness and a grating or crackling sound. Gout usually causes sudden severe pain in a joint, most often the big toe. Psoriatic arthritis can also cause swollen fingers or toes, changes to the nails and feeling drained of energy.

The NHS says there are lots of types of arthritis and advises not to self-diagnose, but to see a GP if you are worried. It lists the following common types.

The NHS says there is currently no cure for arthritis, but treatments can help you manage your symptoms. Treatment depends on the type of arthritis and how it is affecting you, and you will be under the care of a healthcare professional while having treatment.

The NHS lists the following treatments for arthritis, and says a team of healthcare professionals will give you the help and support you need.

• Physiotherapy to help improve your strength and mobility.

• Occupational therapy to help with everyday tasks such as washing, dressing and cooking.

• Medicines to relieve symptoms such as pain, swelling and inflammation, or to reduce the activity of your immune system.

• Equipment to help with daily activities, such as walking aids, wheelchairs and mobility scooters.

• Complementary therapies, such as acupuncture, the Alexander technique and TENS.

• Surgery, if your symptoms are severe and other treatments have not helped.

Different types of arthritis are treated differently, so the NHS pages on each condition give more detail. In brief, the NHS describes the following approaches.

The cause depends on the type. The NHS says that in osteoarthritis the protective cartilage on the ends of the bones breaks down, causing pain, swelling and problems moving the joint. The exact cause is not known, but it lists several things thought to increase the risk.

In rheumatoid arthritis, the NHS says the immune system attacks the cells that line the joints by mistake, and it is not clear what triggers this. In gout the cause is too much uric acid in the blood, which can lead to crystals forming around the joints.

• Joint injury, including overusing a joint that has not had enough time to heal after an injury or operation.

• Other conditions, such as rheumatoid arthritis or gout, that have severely damaged a joint.

• Age, with risk increasing as you get older.

• Family history, although studies have not identified a single gene responsible.

• Obesity, which puts excess strain on weight-bearing joints such as the knees and hips.

• Being a woman, as the NHS says osteoarthritis is more common in women than men.

The NHS says a healthcare professional will ask about your symptoms and medical history and check your joints. You may be referred to a specialist (a rheumatologist) if they think you might have rheumatoid arthritis or gout.

Tests you may have include blood tests, an X-ray or ultrasound scan, and a sample of fluid taken from a joint with a thin needle, which helps to confirm gout. For osteoarthritis, the NHS says further tests such as X-rays or blood tests are not usually necessary but may be used to rule out other causes such as rheumatoid arthritis or a fracture.

The NHS says a GP may suspect osteoarthritis if you are 45 or older, your joint pain gets worse the more you use the joint, and morning stiffness is absent or lasts less than 30 minutes. It says prolonged joint stiffness in the morning can be a sign of rheumatoid arthritis.

The NHS lists things you can do to help ease arthritis symptoms. There is no single arthritis diet in the NHS guidance; the advice is to eat a healthy, balanced diet and keep to a healthy weight, as being overweight can put strain on your joints.

• Exercise regularly. The NHS says low-impact activities are best, such as swimming, walking, pilates and yoga.

• Eat a healthy, balanced diet.

• Keep to a healthy weight.

• Do not smoke, because it can make symptoms worse.

• Do not drink too much alcohol.

• For osteoarthritis prevention, the NHS suggests at least 150 minutes of moderate aerobic activity every week plus strength exercises on 2 or more days a week.

The NHS says juvenile idiopathic arthritis (JIA) affects children under the age of 16, and that there are several types of JIA, some milder than others. A GP is the first point of contact if a child has joint pain, swelling or stiffness that does not go away in a few days.

The urgent advice is the same for children and adults: ask for an urgent GP appointment or get help from NHS 111 for severe pain and swelling in just 1 joint that started suddenly, or if sore joints come with a high or low temperature.

The NHS says to see a GP if you have unexplained pain, swelling or stiffness in your joints that does not go away in a few days. In many areas you may be able to get help, such as physiotherapy, from NHS community musculoskeletal (MSK) services without a GP referral.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if any of the following apply.

• You have severe pain and swelling in just 1 joint that started suddenly.

• Your pain does not get better with painkillers such as paracetamol.

• The skin around the joint is red or hot (redness may be harder to see on brown and black skin).

• You have sore joints with a high or low temperature, or you feel hot, cold or shivery.

• You have sore joints and conjunctivitis, or sore eyes and problems with your vision.

• You have sore joints and pain when you pee, discharge from your penis or vagina, or a rash or sores on your genitals.

On the NHS, assessment usually starts with a GP or, in many areas, a self-referral to community MSK services. A GP can arrange blood tests and scans and refer you to a rheumatologist if rheumatoid arthritis, gout or another inflammatory type is suspected.

Some people choose to see a private rheumatologist or orthopaedic specialist for quicker access to review, imaging or surgery. In both settings the type of arthritis matters most, because it decides which treatments are appropriate, so ask for the specific diagnosis and keep your GP informed.