Arthritis and Joint Pain: What You Need to Know

Arthritis is not a single disease — it is an umbrella term covering more than 100 conditions that cause pain, stiffness, and swelling in the joints. It affects over 54 million adults in the United States, making it the leading cause of disability in the country. Yet many people accept joint pain as an inevitable part of ageing and delay seeking help, missing crucial opportunities to prevent joint damage and preserve function.

The two most common forms are osteoarthritis (OA) and rheumatoid arthritis (RA), and they are fundamentally different diseases requiring different treatment approaches. Osteoarthritis is a degenerative condition involving the breakdown of cartilage — the protective cushioning within joints — leading to bone-on-bone contact, inflammation, pain, and stiffness. It typically affects the knees, hips, hands, and spine, and is strongly associated with age, obesity, prior joint injury, and repetitive mechanical stress.

Rheumatoid arthritis is an autoimmune disease in which the immune system mistakenly attacks the lining of the joints, causing chronic inflammation that can destroy cartilage and bone over time. Unlike OA, RA is not caused by wear and tear — it can strike at any age and often affects multiple joints symmetrically, with prominent morning stiffness lasting more than one hour being a hallmark feature. Early and aggressive treatment with disease-modifying antirheumatic drugs (DMARDs) is essential to prevent irreversible joint damage.

Other notable forms include psoriatic arthritis, which affects up to 30% of people with psoriasis; gout, caused by uric acid crystal deposition in joints — most famously the big toe; ankylosing spondylitis, a form of inflammatory arthritis primarily affecting the spine; and juvenile idiopathic arthritis, which occurs in children and adolescents. Each has distinct characteristics, triggers, and treatment pathways that require specialist evaluation.

Diagnosis involves clinical examination, blood tests including inflammatory markers (ESR, CRP), rheumatoid factor, anti-CCP antibodies, and uric acid levels, alongside imaging studies such as X-ray, ultrasound, and MRI. X-rays reveal joint space narrowing, bone spurs, and erosions that confirm OA or RA changes. Ultrasound is particularly useful for detecting synovitis and guiding joint injections. MRI provides superior soft-tissue detail and can detect early inflammatory changes before plain radiographs become abnormal.

Treatment begins with conservative measures. Physiotherapy and targeted strengthening exercises are among the most evidence-based interventions available, reducing pain and improving joint stability and function. Weight management is critically important — every kilogram of body weight lost reduces the load on each knee by approximately four kilograms. Hot and cold therapy, topical anti-inflammatories, and activity modification provide additional symptom relief without systemic side effects.

For OA, oral analgesics, intra-articular corticosteroid injections, and hyaluronic acid viscosupplementation offer further relief. For RA and other inflammatory arthropathies, conventional DMARDs such as methotrexate remain the cornerstone, with biologic agents including TNF inhibitors and JAK inhibitors reserved for refractory cases. When conservative and medical management fails for OA, joint replacement surgery — particularly knee and hip arthroplasty — delivers transformative pain relief and functional restoration.

Living well with arthritis is entirely possible with the right management plan. Our orthopaedic and rheumatology teams work collaboratively to provide personalised care that prioritises keeping you active, independent, and pain-free. If joint pain is limiting your daily activities, we encourage you to seek an early assessment rather than waiting until the disease has progressed significantly.