Arthritis and Joint Pain: What You Need to Know

Arthritis is not a single disease — it is an umbrella term for over 100 conditions causing joint pain, stiffness, and swelling. It affects 58.5 million Americans, making it the leading cause of disability in the country. The two most common forms are osteoarthritis and rheumatoid arthritis.

Osteoarthritis (OA): The wear-and-tear form of arthritis, OA develops when cartilage — the protective cushion between bones — breaks down over time. It most commonly affects knees, hips, hands, and spine. Risk factors include age over 50, obesity (each pound of body weight places 4 pounds of stress on the knee), prior joint injury, and family history.

Rheumatoid arthritis (RA): An autoimmune disease in which the immune system attacks the joints, causing inflammatory synovitis. RA typically affects the small joints of the hands and feet symmetrically and can cause systemic inflammation affecting the heart, lungs, and eyes. Early aggressive treatment with disease-modifying drugs (DMARDs) prevents joint destruction.

Distinguishing OA from RA: OA is characterized by pain that worsens with activity and improves with rest, minimal morning stiffness (less than 30 minutes), and absence of systemic symptoms. RA causes significant morning stiffness lasting more than 60 minutes, joint swelling and warmth, fatigue, and elevated inflammatory blood markers (CRP, ESR, RF, anti-CCP).

Non-surgical management: For OA, first-line treatment includes low-impact exercise (swimming, cycling, walking), physical therapy to strengthen muscles around the joint, weight loss, acetaminophen or topical NSAIDs for pain, and intra-articular corticosteroid or hyaluronic acid injections. For RA, methotrexate is the cornerstone DMARD, escalated to biologic agents (TNF inhibitors, JAK inhibitors) for inadequate response.

When to consider joint replacement: Knee and hip replacement are among the most successful surgical procedures in medicine — with patient satisfaction rates above 90%. The timing is right when joint pain is severely limiting daily activities, sleep is disrupted by pain, and 3–6 months of conservative treatment has not provided sufficient relief.

Dr. Lisa Mitchell specializes in sports medicine and non-surgical arthritis management at SilverOak Trauma Center, Denver. Dr. Steven Campbell performs robotic-assisted joint replacement at SilverOak Medical Center, Chicago. Consultations available in-person and via video.