Arthritis symptoms: When do achy joints become arthritis?

Creaky joints? Pain in your fingers? Got a swollen toe that looks suspiciously like gout? You’re probably wondering if they are arthritis symptoms Is the morning stiffness you feel in your neck lingering well after you’ve finished your breakfast? Are your painful knees making the stairs feel like a mountain? If your sore joints are becoming an uncomfortable part of your daily life, you might be wondering two things. Firstly, are these arthritis symptoms? And secondly, is this what living with arthritis feels like? “Arthritis is a term we use casually when talking about our creaky knees and achy fingers – especially as we get older,” says Holland & Barrett nutritionist, Emily Rollason. “But what you might not realise is there are several types of arthritis and related conditions.  And not all of them are limited to affecting the older generations.” So, what is arthritis? First of all, it’s not a single disease. It’s a term used to refer to a group of conditions that, in various ways, cause pain and inflammation in one or more joints. “Osteoarthritis and rheumatoid arthritis are by far the most common,” says Emily. “But there are many more forms of arthritis and related conditions that impact on joint health. Each has unique symptoms and causes. This makes getting an accurate diagnosis from a medical professional absolutely essential.” According to Versus Arthritis, about 18.8 million people in the UK suffer from musculoskeletal conditions. This includes everything from arthritis to more regular back pain. Arthritis makes up a large proportion of this figure. In fact, according to the NHS it affects more than 10 million people across the country¹. This includes people of all ages, including children. There are a whole range of treatments available to slow down the progression of a condition, or at least lessen some arthritis symptoms. In addition, there are various dietary and lifestyle changes that may offer benefits to joint health and help to prevent future flare ups. For example, some people feel that following an anti-inflammatory diet could be beneficial.

Common causes of arthritis

With so many different types of arthritis, the causes of these conditions vary considerably. One very broad reason for arthritis developing is inflammation around one or more joints. Inflammation is a response by your immune system to infection and injury. It’s an important part of healing and helps to protect your body from further damage. But inflammation becomes troublesome if it lasts for too long or if it’s happening in a place that doesn’t need it. This kind of chronic inflammation is the underlying cause of arthritis pain. But what’s causing it to happen? This is where things get less clear. There are lots of potential reasons for inflammation and some significant grey areas. However, what’s relatively consistent are the common risk factors that increase your likelihood of developing arthritic joints².

• Firstly, your age. For most types of arthritis, you’re more likely to be affected as you get older.
• Gender can also be an important factor with some arthritis conditions being more common in either men or women.
• A family history of the condition can make you more susceptible to inheriting arthritis symptoms.
• A previous injury to a joint also often has a big part to play in raising your risk of arthritis in that area.
• Obesity can put extra pressure on joints, exacerbating symptoms of arthritis.

Common symptoms of arthritis

What follows isn’t an exhaustive list of symptoms. But whether you have gout, psoriatic arthritis, osteoarthritis or rheumatoid arthritis, you’re likely to relate to at least one of these common signs of arthritis³. To provide a definitive list of arthritis symptoms is an impossible task. They vary from person to person and depend on the exact condition. This is why getting a professional and accurate diagnosis from a medical professional is crucial. The information on this page is not intended to encourage self-diagnosis. But we do hope it helps you to understand more about how arthritis affects the human body.

5 common arthritis symptoms

• Inflammation – we’re not talking acute inflammation (e.g. how your immune system responds immediately after an injury such a cut.) Arthritis is more persistent, chronic inflammation around a joint
• Pain ­– most sufferers complain of tenderness, discomfort and stiffness in a joint
• Restricted movement – certain actions can feel more difficult than they should
• Red skin over the joint – this is often accompanied by warmth in the area
• Weakness – loss of muscle mass and strength can impact of the operation of the joint

The basic anatomy of a joint

When you see some litter on the pavement, how does your mental decision to do the right thing lead to you bending your knees so you can reach down and pick it up? Before we talk about the various types of arthritis, let’s recap the basic anatomy of your joints.⁴ You’ll find joints located around your body in places where two or more bones meet. For example, hips, fingers, knees, toes and shoulders. But it takes a lot more than bones to make your body move. Every single one of your joints is made up of complex components. Here we highlight the main ones that come up when talking about arthritis:

What make your joints work?

• Tendons connect your bones to muscle
• Muscles provide support for the joint. They also receive the messages from your brain telling the tendons to pull on the bone to create movement
• Ligaments are stretchy bands of fibrous connective tissue, connecting bone to bone. They provide a joints stability and limit movement
• Around each joint is a capsule containing synovial fluid. This provides lubrication
• Cartilage covering the ends of your bones acts as a shock absorber. This allows bones to glide over each other smoothly

Inflammation upsets the delicate balance that enables your joint to operate in various ways. This causes the pain, restricted movement and stiffness that are common arthritis symptoms.

Osteoarthritis and rheumatoid arthritis – what’s the difference?

There are several types of arthritis, but two conditions stand out – osteoarthritis and rheumatoid arthritis. This is due to their prevalence. With an estimated 9 million people in the UK⁵ living with osteoarthritis, it’s by far the most common form of chronic joint pain. Rheumatoid arthritis follows, affecting approximately 400,000 people in the UK⁶. But, while they both cause pain, swelling and restricted movement, they are unique conditions. They affect people in very different ways. But the most significant distinction is what’s happening in your body to cause pain in the joints. Arthritis is sometimes crudely separated into two main forms – inflammatory and degenerative. These categories can help explain the core difference between the two most common types of arthritis. As an auto-immune condition, rheumatoid arthritis is an inflammatory arthritis type. This means your body’s own immune system attacks your joint tissue, causing the inflammation around your joints. In contrast, osteoarthritis is a degenerative form. It's caused by wear and tear over time breaking down the cartilage cushioning the joint.

9 types of arthritis

1. Osteoarthritis
2. Rheumatoid arthritis
3. Gout
4. Psoriatic arthritis
5. Enteropathic arthritis
6. Reactive arthritis
7. Secondary arthritis
8. Ankylosing spondylitis
9. Juvenile idiopathic arthritis

Osteoarthritis and rheumatoid arthritis are the main types of arthritis. But there is a myriad of other types of arthritis, all causing some level of pain and inflammation around one or more joints. But this will show up in different ways depending on the condition. For example, certain conditions only effect specific joints, while others show in many joints across the body. In addition, some types of arthritis impact on organs such as the heart, lungs, kidneys, eyes and skin, as well as joints. Here, we provide a brief overview of nine types of arthritis to show how differently it can show up in the body. Some of these are well-known and others may be less familiar.

1. Osteoarthritis

For most people, the low level of damage to joints caused by everyday living repairs itself without causing any pain or discomfort. Unfortunately, for those with osteoarthritis this isn't the case. Over time, the protective cartilage at the end of bones breaks down. This causes bones to rub together, leading to pain, swelling and restrictions when moving the joint. Osteoarthritis can start at any age (for example, as a result of an injury.) But the risk of this disease increases from your mid-forties. It’s also more common in women. It’s also more common in women. In terms of the joints affected, you’re most likely to experience osteoarthritis in knees, hips and small joints of the hands, but it can occur in any joint.

2. Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune disease. This means your usually helpful immune system for some reason gets things wrong. Instead of protecting you from infections and illness, it incorrectly attacks the healthy tissues around a joint. This triggers an inflammatory response, making the area swollen, stiff and painful. Rheumatoid arthritis can affect adults of any age and exist in many joints. But, it most commonly starts between the ages of 40 and 60 in hands, feet and wrists. Women are more likely to suffer from this condition than men.

3. Gout

The cause of Gout is a build-up of uric acid in the body. A certain amount of uric acid in the body is normal. But if it reaches a high level, it can form crystals that cluster around a joint. This causes the intense pain, redness and swelling that makes this condition so limiting. Gout is most prevalent in the big toe, but it can happen in any joint. Whilst it tends to affect men from their mid-20s, women are more likely to suffer with this form of arthritis after the menopause.

4. Psoriatic arthritis

Psoriatic arthritis is an auto-immune condition affecting some people with psoriasis⁷. In fact, almost 1 in 3 people with the skin condition also have psoriatic arthritis⁸. This type of arthritis causes the affected joints to become swollen, stiff and painful. It affects people of all ages but is more common in adulthood.

5. Enteropathic arthritis

Enteropathic arthritis describes a chronic inflammatory condition that affects those with an inflammatory bowel disease. The most common forms are ulcerative colitis or Crohn’s disease. Approximately 1 in 5 people with Crohn's disease or ulcerative colitis also develop enteropathic arthritis⁹. This type of arthritis is most commonly caused by inflammation in peripheral limb joints and the spine.

6. Reactive arthritis¹⁰

Most cases of reactive arthritis develop following an infection. For example, food poisoning and sexually transmitted infections are frequent triggers. It causes inflammation and redness in various joints, but most often the knees, toes, hips, feet and ankles. It can happen to men and women of any age. It’s usually short-lived and clears up within a few months, causing no long-term complications.

7. Secondary arthritis¹¹

Secondary arthritis is osteoarthritis that’s developed due to another disease or condition. This is usually quite specific. For example, injury or surgery to a joint can cause secondary arthritis (sometimes even years later.) Obesity and hormone disorders can also trigger it. The nature of secondary arthritis means it can develop at an earlier age than most other types of arthritis.

8. Ankylosing spondylitis¹²

Ankylosing spondylitis causes pain and swelling that’s usually focused around the joints of the spine. This inflammation triggers the body to create more of the mineral calcium. Calcium is normally used by the body to make bones strong. But in ankylosing spondylitis, the surplus calcium makes new bits of bone grow in the spine. This causes pain and stiffness. This type of arthritis is more common in men and usually develops between the ages of 20 and 30.

9. Juvenile idiopathic arthritis¹³

There are many different forms of this inflammatory form of arthritis. What is common across all is that it’s diagnosed before the age of sixteen. Fortunately, the symptoms of arthritis in people with JIA often improve as the child gets older.

A few things you think are true about arthritis (but aren’t)

Being such a common condition, it’s no surprise that there are many myths and misconceptions circulating about arthritis. So, we thought we’d highlight a few common myths about arthritis to set the record straight on a few fallacies.

Four top arthritis myths

1. It’s an old person’s disease
2. Live with it. There’s nothing you can do about it
3. Cracking your knuckles causes arthritis
4. Rheumatoid arthritis and osteoarthritis are the same thing

Myth #1: It’s an old person’s disease It’s true, your risk of getting some types of arthritis increases with age. For example, osteoarthritis and rheumatoid arthritis are significantly less frequently diagnosed before middle age. At the same time, there are about 15,000 children and young people in the UK living with arthritis¹⁴. In fact, Juvenile idiopathic arthritis (JIA) specifically occurs in pre-school age children or teenagers¹⁵. Also, simply because arthritis is more prevalent in those of more advanced years, don't dimiss it as ‘part of aging’. Regardless of age, there are lots of treatments and advice on living with arthritis. These can help decrease joint pain, prevent further damage and improve quality of life. Myth #2: Live with it. There’s nothing you can do about it There’s no cure for arthritis. However, there are things that can minimise joint inflammation and slow the progression of your condition. In addition to medication and physiotherapy, dietary and lifestyle changes can help to prevent flare-ups and help manage some arthritis symptoms. For example, research is emerging to suggest an anti-inflammatory diet may help to reduce some arthritis symptoms. Myth #3: Cracking your knuckles causes arthritis^16,17 Are you a knuckle-cracker? Then, you've likely heard the warning that your habit is a fast-track to arthritis in your fingers. But does cracking your knuckles actually cause arthritis? Cracking knuckles is a wince-inducing sound, but bar a few rogue studies, most research suggests little or no connection between knuckle-cracking and your likelihood of developing arthritis. Myth #4: Rheumatoid arthritis and osteoarthritis are the same thing It’s a common misconception that all types of arthritis are generally the same. In reality, osteoarthritis is very different from rheumatoid arthritis. And gout has unique arthritis symptoms to the psoriatic variety of the condition.

Summary: When do achy joints become arthritis symptoms?

But all I have are a few aches and pains, this can’t be arthritis, can it? For some people, arthritis symptoms only cause occasional discomfort. Others battle with the challenges they cause every single day. Sometimes it’s short and extremely painful attacks, and other times a more gradual deterioration over time. But regardless of how it affects you, arthritis is a serious, chronic health condition and should be treated in this way. An estimated 3 in 10 people across the UK live with musculoskeletal conditions¹⁸. This includes everything from arthritis to more regular back pain. This makes living with joint pain a reality for millions of people. So, if you’re struggling with the stairs or if you’re feeling twinges around an old sport injury, it’s worth getting a professional opinion to confirm whether they are arthritis symptoms. Because the honest answer is, only a health care professional can tell you for sure. Emily Rollason is a qualified Nutritional Therapist, achieving a Diploma from the Institute for Optimum Nutrition. Working with Holland & Barrett for six years, Emily has valuable experience working on a one-to-one basis with clients with a variety of health concerns such as endometriosis, adenomyosis and aiding those looking to support certain dietary requirements, such as a vegan or vegetarian diet. Emily has a long history of working with customers to guide them on what products are best suited to help them with their ailments. Her particular interests in nutrition and wellness focus around digestive health, female health and allergies/ intolerances. Last updated: 1 June 2020 Sources 1 https://www.nhs.uk/conditions/arthritis/ 2 https://www.arthritisaction.org.uk/living-with-arthritis/what-is-arthritis/ 3 As source 1 4 https://www.versusarthritis.org/about-arthritis/conditions/arthritis/ 5 As source 1 6 As source 1 7 https://www.nhs.uk/conditions/psoriasis/ 8 https://www.nhs.uk/conditions/psoriatic-arthritis/ 9 As source 1 10 https://www.nhs.uk/conditions/reactive-arthritis/ 11 As source 1 12 As source 1 13 As source 1 14 As source 1 15 https://www.versusarthritis.org/about-arthritis/conditions/juvenile-idiopathic-arthritis/ 16 https://www.jabfm.org/content/24/2/169.long  17 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1129752/ 18 https://www.versusarthritis.org/about-arthritis/data-and-statistics/state-of-musculoskeletal-health-2019/