Living With Arthritis
This resource guide can help give you ideas on how to live an active, happy and productive lifestyle despite your arthritis. Learn how arthritis may affect your life and what you can do to prepare and adjust.
The term "arthritis" encompasses more than one condition, but it's usually used in reference to osteoarthritis, a disease in which cartilage breaks down, causing the ends of the bones to grind against each other. Rheumatoid arthritis and gout are also common forms of arthritis. Rheumatoid arthritis develops when the immune system attacks the membrane covering a joint, while gout occurs when uric acid crystals build up in the joints.
All three conditions can greatly affect your day-to-day life, but there are many things you can do to control the symptoms, preserve mobility and find ways to do the things you love.
Osteoarthritis affects more than 32 million adults in the United States, making it the most common form of arthritis. Although anyone can get arthritis, you have an elevated risk of developing it if you have any of the following risk factors:
- You're a woman.
- You're an older adult.
- Someone in your immediate family, such as a parent, has osteoarthritis.
- You're overweight or obese.
- You have a history of joint injury.
You're also more likely to get arthritis if you regularly perform repetitive motions with the same joint. For example, someone who bends their knees frequently may develop osteoarthritis in the knee joints.
The most common signs of arthritis are pain, stiffness and swelling in the affected joint, along with decreased flexibility. If you have these symptoms, your doctor may order X-rays or blood tests and perform a physical examination to determine if they're caused by arthritis.
Although RA causes some of the same symptoms as osteoarthritis, it doesn't have the same cause. Your immune system is responsible for fighting off bacteria, viruses and other harmful organisms. In some people, the immune system can't distinguish between harmful organisms and healthy cells, causing it to attack those healthy cells. This is known as an autoimmune disorder. If you have RA, your immune system attacks the joints, causing pain, tenderness, stiffness and swelling. RA may also cause fatigue, fevers, weakness or weight loss. Approximately 0.6% of the U.S. population has been diagnosed with RA.
Scientists don't know what causes autoimmune disorders, but you have an increased risk of RA if any of the following apply to you:
- You're a woman.
- You have a certain variation in the HLA-DRB1 gene, which tells your body how to make a protein involved in immune function.
- You're an older adult.
- You've never given birth.
- You smoke cigarettes.
- You were exposed to tobacco smoke or other pollutants as a child.
- You're obese.
If you have any symptoms of RA, discuss them with your doctor. You'll need a physical examination, lab tests and X-rays for a diagnosis to be made. After you're diagnosed with RA, you should see a rheumatologist, which is a doctor who specializes in treating arthritis and autoimmune disorders. RA requires specialized treatment, so it's important to seek care from an expert. Early treatment may prevent the disease from getting worse as you age.
Some of the foods you eat contain purines, which break down into uric acid during the process of metabolism. In some people, uric acid crystals build up in the joints, causing a painful condition known as gout. The main symptom of gout is severe joint pain, especially in the big toe. As the amount of uric acid in the affected joint decreases, the severe pain typically gives way to lingering discomfort. Gout also causes inflammation and redness of the affected area, along with reduced motion.
Your risk of gout increases if any of the following apply:
- You regularly consume shellfish, red meat and/or beverages sweetened with fructose, all of which contain purines that can break down into uric acid.
- You drink beer or other types of alcoholic beverages.
- Someone in your family has had gout.
- You're a man.
- You've had surgery recently.
- You're overweight.
- You take low-dose aspirin or certain types of medication used to reduce blood pressure.
- You have diabetes, kidney disease, heart disease, metabolic syndrome, obesity or untreated hypertension.
Several types of medication are available to treat the symptoms of all three main types of arthritis. These medications can improve your quality of life by reducing pain and other symptoms, but they may have undesirable side effects.
Acetaminophen is typically used to treat the pain caused by osteoarthritis and RA. It causes relatively few side effects, but you do need to watch for symptoms of an allergic reaction. Seek medical attention right away if you experience any of the following:
- Peeling skin
- Redness of the skin
- Blistering skin
- Difficulty swallowing
- Difficulty breathing
- Swelling of the extremities or any part of the face
Too much acetaminophen can cause liver damage, so don't use it for longer than recommended.
Nonsteroidal Anti-inflammatory Drugs
Nonsteroidal anti-inflammatory drugs reduce inflammation by inhibiting certain enzymes. Ibuprofen and naproxen are available over the counter; other NSAIDs are by prescription only. Although NSAIDs are helpful for treating arthritis pain, they can also cause serious side effects, especially if you have a chronic health condition.
In some people, NSAIDs cause gastrointestinal bleeding. You shouldn't take NSAIDs if you have kidney disease, as they can cause acute kidney dysfunction and problems with fluid and electrolyte balance. NSAIDs aren't advised for people with heart disease or a history of heart attack, either, because they can cause strokes, heart attacks and abnormal heart rhythms. Other possible side effects include headaches, dizziness, drowsiness and diarrhea.
Topical analgesics are creams or gels that can be applied directly to the affected area. The medication is absorbed by your skin, providing quick relief from osteoarthritis pain. Many of these products have a strong odor, so you may want to use them only when you know you won't have to leave the house for a few hours. The most common side effects of topical analgesics are irritation, stinging or burning at the application site.
Corticosteroids are used to treat rheumatoid arthritis and gout. They work by reducing inflammation in the affected joints, relieving pain and other symptoms. Some of the most common side effects of corticosteroids are increased blood pressure, changes in appetite, mood swings and elevated blood glucose levels. In some people, corticosteroids also cause puffiness of the face.
Disease-modifying Antirheumatic Drugs
Disease-modifying antirheumatic drugs suppress the immune system, preventing it from attacking the joints. This prevents additional joint damage, which can slow down the progression of RA and help relieve some of your symptoms. Cyclosporine, cyclophosphamide, hydroxychloroquine and methotrexate are examples of DMARDs used to treat RA and other autoimmune disorders.
Because they suppress the immune system, DMARDs increase your risk of infections. Headache and nausea are some of the most common side effects of these medications; if you receive your medication via injection or infusion, you may also have an injection site reaction or an infusion reaction. You may need to stop an infusion if you experience any of the following:
- Chest pain
- Elevated blood pressure
- Signs of anaphylaxis
- Low blood pressure
Biologics are a subset of DMARDs that are prescribed when conventional DMARDs aren't working. Four types of biologics are used to treat RA: B-cell inhibitors, selective co-stimulation modulators, interleukin inhibitors and tumor necrosis factor-alpha inhibitors. Like conventional DMARDs, biologics can cause headaches, nausea, infusion reactions or injection site reactions. Easy bruising and bleeding, fatigue, dizziness, vision problems and stomach pain are also potential side effects of biologics.
Colchicine is an anti-inflammatory that reduces the pain caused by gout. It does this by reducing the amount of uric acid buildup in the joints. Possible side effects of this medication include vomiting, diarrhea and nausea.
Medical and Surgical Procedures
Cortisone injections reduce inflammation in the affected joint, relieving arthritis symptoms. Too many of these injections can cause additional joint damage, so your doctor may only administer three or four per year. In addition to joint damage, cortisone shots can cause nerve damage, joint infections, weakening of the tendons, facial flushing and temporary increases in blood sugar.
Hyaluronic Acid Injections
Hyaluronic acid is chemically similar to a natural fluid that lubricates your joints. If you have osteoarthritis, hyaluronic acid injections can relieve symptoms by protecting your joints from friction. After an injection, you may experience some pain or swelling around the affected joint. Muscle pain, muscle stiffness and difficulty moving the joint are also common side effects.
Several surgical procedures, including osteotomy, joint replacement, joint fusion and synovectomy, are used to treat arthritis that hasn't responded to other treatments. After these procedures, you can expect to experience pain, stiffness and limited mobility at the surgical site. You'll also need to do physical therapy to strengthen the muscles around the joint. Like any surgical procedure, arthritis surgery can lead to infections, blood clots or other complications.
Some people with arthritis report that their symptoms make it a little more difficult to perform certain parenting activities, such as carrying tired kids or running around the playground. You can still be a wonderful mother or father with arthritis, but you may need to use an assistive device or make other accommodations when engaging in physical activity with your children.
Arthritis sometimes affects relationships with friends, spouses, siblings and other loved ones. If your arthritis affects your mobility, you may have to explain to friends that you can't do the same activities you used to enjoy together. You may also have to educate your loved ones about arthritis, especially if you develop it at a young age. Not everyone knows what causes arthritis or what should be done to manage it, causing them to give "helpful" advice that isn't helpful at all.
If you have arthritis, it may change your financial outlook, especially if you have rheumatoid arthritis and need infusions to treat the symptoms. In 2017, a study published in Clinical Therapeutics indicated that the overall cost of infusions exceeded $36,000 per patient per year. Even if your insurance company covers the cost of infusions and other treatments, you may have to pay a large deductible before your coverage kicks in. Your plan may also include cost-sharing provisions that require you to pay for a certain percentage of every infusion.
Severe arthritis symptoms may cause you to change jobs at some point because you can no longer do physical labor. For example, someone who works on their feet all day may have to switch to something involving seated work to accommodate their arthritis symptoms. In some cases, changing jobs results in a loss of income or employee benefits. The emotional cost of changing careers can also be high, especially if you are leaving behind a job you loved to start over at another company.
Arthritis causes a variety of symptoms, but you don't have to let the disease control your life. Follow the tips below to relieve arthritis symptoms, improve your quality of life and continue doing as many of the things you love as possible.
Exercise to Relieve Arthritis Symptoms
When you're in pain, it's natural to want to take it easy, but it's important to exercise your arthritic joints as much as you can. The American College of Rheumatology reports that people with arthritis sleep better, have less pain and have more energy when they exercise regularly.
If you have limited mobility due to your arthritis, you may have to start out with therapeutic exercise, or exercise prescribed by a health professional. This type of exercise usually focuses on a specific joint, such as the knee, and is monitored by a physical therapist or some other health professional. Your PT may have you engage in a combination of aerobic exercises and strengthening exercises to improve your endurance, strengthen the muscles around your joints and prevent joint stiffness. Using a recumbent bike is an example of aerobic exercise, while lifting weights is an example of a strengthening exercise.
Once your arthritic joints are stable, you can engage in recreational exercise. Walking, riding a bicycle, swimming and golfing are all great ways to maintain your range of motion and prevent joint stiffness. Before you start any exercise plan, consult with your doctor to find out if there are any activities you should avoid or modify to accommodate your arthritis symptoms. In general, you should choose low-impact activities that give you the benefits of exercise without the extra stress on your joints.
Diet for Arthritis
No diet, no matter how low in calories or rich in nutrients, can cure arthritis; however, certain foods help reduce inflammation in the body, which may help relieve some of your arthritis symptoms. The Arthritis Foundation recommends a Mediterranean-style diet, which focuses on fruits, vegetables and the healthy fats found in nuts, seeds and certain types of fish.
If your doctor agrees that a Mediterranean diet would be beneficial, try eating the following foods:
- Nuts (1.5 ounces per day): Nuts have a lot of calories, but you shouldn't avoid them completely if you're looking to reduce inflammation. They contain high levels of monounsaturated fats, which are known to fight inflammation in the human body. Nuts also contain protein and fiber to keep you feeling full so you don't snack as much between meals.
- Olive oil (2 to 3 tablespoons daily): Olive oil contains compounds that have some of the same properties as the NSAIDs used to treat arthritis. They also contain fats that are good for your cardiovascular health.
- Fruits and vegetables (nine servings daily): Fruits and vegetables contain antioxidants, which are compounds that prevent cell damage. Vitamin C, found in citrus fruits, also keeps the joints healthy and prevents inflammatory arthritis in some people.
- Whole grains (6 ounces per day): If you're overweight, eating foods high in fiber — like whole grains — can help you lose weight and take some of the stress off your joints.
- Beans (1 cup twice per week): Beans contain phytonutrients, which contain anti-inflammatory compounds, fiber and antioxidants. Beans are also a good non-meat source of protein.
Traveling with Arthritis
Traveling with arthritis can be difficult, especially if you like to go to theme parks or other destinations that typically require several hours of walking each day. Fortunately, you don't have to give up travel, even if your symptoms worsen over time. Implement some of the following tips to ensure you can continue to explore the world.
Before you book a trip, contact the airline, bus company or railroad service to determine what type of assistance is available for passengers with mobility problems. In the United States, airlines are required to assist passengers with disabilities by providing wheelchairs and other assistive devices, having employees escort passengers through the airport and making seating accommodations when necessary. On its Accessible Travel Services page, Amtrak has information on station accessibility, traveling with a wheelchair and what you need to do if you have a service animal or need assistance from a companion while you travel.
In 2010, new standards went into effect for hotels and other lodging facilities. The standards apply to new construction as well as existing facilities undergoing renovations. Under the new guidelines, places of lodging must make their premises more accessible to people with disabilities. For example, bathrooms must be large enough to accommodate wheelchair transfers, and hotels with pools must provide lifts or sloped pool entries. Before you make a reservation, contact the lodging facility and ask to speak with someone who is knowledgeable about the property's layout and accessibility features. Depending on the severity of your arthritis, you may need to ask about wheelchair accessibility, the availability of assistive devices and other accommodations to make your trip a success.
If you have any specific attractions in mind, such as zoos, theme parks, sports stadiums or national parks, do your research before you go on vacation. Many venues have accessibility information on their websites; if you can't find the information you need, don't be afraid to call and talk to an agent to find out what you can expect in terms of accessibility.
If you have limited mobility, ask if any assistive devices are available for free or for a small rental fee. Walt Disney World and Disneyland have electric conveyance vehicles available for guests who have trouble walking long distances. Other attractions may have similar accommodations available. In many cases, assistive devices are available on a first-come, first-served basis. To ensure you get the device you need, arrive at your destination early and ask an employee where to go to get a wheelchair, walker, electric conveyance vehicle or other assistive device.
When you're stressed, your body releases chemicals that contribute to inflammation, making your arthritis symptoms worse. Therefore, managing stress is an important part of managing arthritis. Exercise is a great way to relieve stress, but there are other things you can do if you don't feel well enough to engage in physical activity:
- Meditate: Meditation helps you focus your attention on the present, taking attention away from the stress in your life. It involves sitting in a quiet area, focusing on your breathing and directing your thoughts away from the things that cause you stress.
- Plan to take breaks: If your schedule is always packed, you probably don't have much time to relax. Next time you write down your schedule for the week, try building in several short breaks each day. Taking just five or 10 minutes away from work, school and parenting activities can help you stay grounded and avoid high stress levels.
See a professional: If arthritis is interfering with your relationships or causing you stress at work or school, it can be helpful to meet with a trained therapist to get an unbiased opinion on how you should handle the situation. A good therapist can help you identify negative thought patterns and replace them with behaviors that help you reduce stress and improve your quality of life.
- American Academy of Orthopaedic Surgeons: After Your Joint Replacement Surgery
- American Occupational Therapy Association: Managing Arthritis
- Arthritis Foundation: 36 Tips for an Arthritis-Friendly Diet
- Arthritis Foundation: Arthritis by the Numbers
- Arthritis in America
- Strength Training for Older Adults
- Palomar Health: Joint Replacement Surgery Patient Guide
- University of Texas: No-Equipment Home Workouts
- U.S. Department of Health: Physical Activity Guidelines for Americans
- Versus Arthritis: Diet and Arthritis