Photo by Margo Giannaklis
Everyone's experience of arthritis will be different, but some symptoms commonly occur
There are many different types of arthritis, all with varying symptoms, and each type will affect people in different ways. There are some symptoms, however, that occur pretty often across the family of arthritis conditions, such as pain, stiffness and extreme tiredness (see list below).
Arthritis symptoms can vary from day to day, week to week, or month to month, depending on whether your arthritis is active, where joints are inflamed, swollen, warm and painful, or whether it’s inactive, where symptoms have settled.
Scientists are positively working towards finding the cause of arthritis, so in time they may find a cure. The good news for now is that arthritis symptoms can settle, sometimes for years at a time. The key is for you to work with your rheumatology team to find which combination of medication works most effectively for you. It is helpful to remember that what works for you may not work for someone else, even if you are members of the same family.
If you think you might have arthritis it is advisable to see your GP. It may help to take our Early Diagnosis Checklist with you, perhaps on your mobile, to help you have the conversation about your symptoms. In addition, making a short diary of what symptoms you have experienced, when and for how long, and even taking photos on your phone of swollen joints or rashes, can be a real help for your GP.
Scientists believe that the earlier you are diagnosed and treated the better your outcome in the long-run. But the key, regardless of when you were diagnosed, is for you and your doctor to work as a team. Together you want to identify an achievable treatment plan, one that you feel positive about and feel you can stick to. One helpful thing to remember is that your treatment will be a journey, it may take time, and you may need to try a few different paths before you find the one that will lead to the best possible outcome.
There is much excitement amongst scientists and medical professionals about the real advances in knowledge, treatments and medicines for arthritis in recent years, all complemented by a growing range of technological tools that can help improve your arthritis experience.
The most common symptoms of arthritis are:
Juvenile idiopathic arthritis and rheumatoid arthritis are just two types of inflammatory arthritis, but there are others. This means that the lining of the joints, called the synovium, can become inflamed.
Normally, inflammation will happen when the body is trying to fight off something that is potentially harmful, such as germs, allergens or a foreign body, such as a splinter. But with inflammatory arthritis the inflammation occurs for unknown reasons.
Arthritis can affect any joint, but some more commonly than others, such as knees, shoulders and hands. When a joint becomes inflamed it can cause pain, stiffness and swelling. If a joint remains inflamed for a long period of time it can become damaged, which in turn can cause further pain.
But it isn’t always joints that are tender. Some people with arthritis may get other aches and pains from muscles, such as the sides of your neck, or across your shoulders. If you have problems with your neck it may be possible that you also notice pins and needles, and tingling in your fingers, dizziness and muscle spasms.
It’s important to remember that a symptom you experience may not necessarily be related to your arthritis, so it is essential to discuss your symptoms with your doctor. Keeping a diary, and even photos on your mobile, can be hugely beneficial for both you and your doctors and specialist nurses.
People with arthritis commonly experience stiffness in the joints, and may find it difficult to stay mobile and flexible.
The joints might be especially stiff in the mornings or after a period of sitting still, and it may or may not feel painful. Morning stiffness can vary from lasting minutes to an hour or more, though once you get moving the stiffness can ease. A warm shower can help.
Doctors aren’t sure what makes the joints feel stiff. One explanation is that the cartilage, the material covering the ends of your bones on your joints, becomes rough and makes the joint harder to move.
When a joint is stiff you will notice that it is more difficult to move it through its normal range of movements. Exercise that you enjoy or physiotherapy can help maintain flexibility, and regular is the key, little and often within your limits.
In nearly all cases it is advisable that you try, at least once a day, to move your joint through its range of motion to help prevent further stiffening. This can be a formal exercise taught by your physiotherapist, or swimming, dancing, walking, anything that gets those muscles and joints moving.
Severe stiffness is often the first sign of arthritis. It is very useful to keep a diary of your symptoms as, along with other tests, it can help your doctor to judge which type of arthritis you have and how it is progressing. Take note of when symptoms come and go, how severe they are and how long they last for.
The lining of your joints is called the synovium, and to help your joints move smoothly there is a natural lubrication inside called the synovial fluid. When there is active inflammation in a joint, the linings start to produce too much of the synovial fluid and this leads to the joint swelling and looking puffy.
If you are unsure if a joint is swollen it can sometimes be helpful to ask someone you trust to check whether your joints look the same on both sides of your body, or if one joint looks bigger than the same joint on the opposite side.
A swollen joint may feel hot to the touch and possibly look slightly red, though not always. It is valuable to know that heat and redness, especially if you have a temperature and feel unwell, can also be a sign of infection, related or unrelated to your condition, so it always advisable to speak to your doctor.
It’s common for people with arthritis to get problems with fatigue – that’s extreme physical or mental tiredness, or both.
It can affect people with any sort of arthritis, but it’s more common with the inflammatory types, such as rheumatoid, psoriatic and ankylosing spondylitis. But is can also be a symptom of other conditions; autoimmune diseases such as lupus, or a condition called fibromyalgia, which may be associated with chronic pain.
If you are suffering from fatigue you should ask for advice from your hospital team – your rheumatology nurse, occupational therapist and physiotherapist – about how you can pace yourself and plan, so you can make the most of your energy, maintain physical activity and learn to deal with stress or anxiety.
A flare is when the symptoms of arthritis get worse for a period of time. Flares are recognised to happen after illnesses, stress, child birth or changes in medication.
Some people say that damp or cold weather triggers their arthritis, but this is not yet proven. Scientists at the University of Manchester are currently conducting a study to see if there is a link between the weather and symptoms, by inviting anyone with arthritis or a chronic pain condition to download an app and record their symptoms daily for six months. The app will link this with the weather each day. The intended outcome is to collect a large sample of data and to identify patterns that link pain and weather together. Find out more at Cloudywithachanceofpain.com.
Flu-like symptoms, including a fever or a rash, can accompany the onset of arthritis or a flare-up. A temperature of 38ºC or over may also be an indication of an infection.
Some people with arthritis can be at increased risk of infection, because of their disease and because their medication may suppress their immune system.
You should always check with your doctor if you experience a rash or fever.
Some people with juvenile idiopathic arthritis (JIA) can get uveitis, which is inflammation of the eye.
It’s really important that you tell your doctor or rheumatology nurse about any changes you notice in your eyes, because if it inflammation continues it can cause blurred vision or even loss of vision.
With some types of arthritis, such as psoriatic or juvenile idiopathic arthritis, it is possible to get symptoms to the joint in your jaw, making eating and brushing your teeth difficult at times. It is helpful to let your dentist know about your condition, and important to get regular check-ups. It may also be helpful to get further professional advice; your rheumatologist may refer you to an orthodontist, for more specialist guidance.
Some people may also be affected by mouth ulcers, as a possible side-effect from some medicines. Others may get mouth ulcers due to other inflammatory conditions. The important message here is don’t suffer in silence – a sore mouth can lead to a low appetite, which in turn can lead to weight loss and fatigue. There are solutions. Let your GP or hospital specialist know if you suffer from mouth ulcers so they can offer advice and treatment to help.
