Arthritis is a common condition that causes pain and inflammation within a joint.

In the UK, around 10 million people have arthritis. The condition affects people of all ages including children (see below).

There are many different types of arthritis that cause a wide range of symptoms. Two of the most common are osteoarthritis and rheumatoid arthritis. 

What is osteoarthritis?

Osteoarthritis is the most common form of arthritis in the UK, affecting an estimated 8.5 million people.

In people affected by osteoarthritis, the cartilage (connective tissue) between their bones gradually wastes away, leading to painful rubbing of bone on bone in the joints. The most frequently affected joints are in the hands, spine, knees and hips.

Osteoarthritis often develops in people who are over 50 years of age. However, it can develop at any age as a result of an injury or another joint-related condition.

Read more about osteoarthritis. 

What is rheumatoid arthritis?

Rheumatoid arthritis is a more severe, but less common, form of arthritis than osteoarthritis. It occurs when the body's immune system attacks and destroys the affected joints, causing pain and swelling to occur. This can lead to a reduction in movement and the breakdown of bone and cartilage.

In the UK, rheumatoid arthritis affects around 400,000 people, and  often starts in people between the ages of 40 and 50 years old. Women are three times more likely to be affected by the condition than men.

Read more about rheumatoid arthritis. 

Symptoms of arthritis

There are many different symptoms of arthritis and the symptoms you experience will vary depending on the type of arthritis you have. However, common arthritic symptoms include:

• joint pain, tenderness and stiffness
• inflammation in and around the joints
• restricted movement of the joints
• warmth and redness of the skin over the affected joint
• weakness and muscle wasting

Arthritis and children

Although arthritis is often associated with older people, it can sometimes also affect children. In the UK, about 12,000 children under 16 years of age have arthritis.

Most types of childhood arthritis are referred to as juvenile idiopathic arthritis (JIA). JIA causes pain and inflammation in one or more joints for at least six weeks.

Although the exact cause of JIA is unknown, the symptoms often improve as a child gets older, allowing them to lead a normal life.

The main types of JIA are discussed below.

Oligo-articular JIA

Oligo-articular JIA is the most common type of JIA. It affects four or less joints in the body, most commonly in the knees, ankles and wrists.

Oligo-articular JIA has good recovery rates and long-term effects are rare. However, there is a risk that children with the condition may develop eye problems, so it is recommended that they have regular eye checks with an ophthalmologist (an eye care specialist).

Polyarticular JIA (polyarthritis)

Polyarticular JIA, or polyarthritis, affects five or more joints. It can develop at any age during childhood.

The symptoms of polyarticular JIA are similar to those of adult rheumatoid arthritis. The condition is often accompanied by a rash and a high temperature (fever) of 38C (100.4F) or above.

Systemic onset JIA

Systemic onset JIA begins with symptoms such as a fever, rash, lethargy (lack of energy) and enlarged glands. Later on, joints can become swollen and inflamed.

Like polyarticular JIA, systemic onset JIA can affect children of any age.

Enthesitis-related arthritis

Enthesitis-related arthritis is a type of juvenile arthritis that affects older boys or teenagers. The condition can cause pain in the soles of the feet and around the knee and hip joints where the ligaments attach to the bone.

You can read more about arthritis in children on the Arthritis Care website.

Treating arthritis

There is no cure for arthritis but there are a number of treatments that can help slow down the condition’s progress.

Medication can help relieve the symptoms of arthritis. In severe cases, surgery may be recommended.

For osteoarthritis, analgesics (painkillers), non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids are often prescribed. In severe cases, surgery may be recommended such as:

• arthroplasty (joint replacement)
• arthodesis (joint fusion)
• osteotomy (where a bone is cut and re-aligned)

Read more about how osteoarthritis is treated.

The aim in treating rheumatoid arthritis is to slow down the progress of the condition and minimise joint damage. Recommended treatments may include:

• analgesics (painkillers)
• disease modifying anti-rheumatic drugs (DMARDs)
• physiotherapy 
• regular exercise 

Read more about how rheumatoid arthritis is treated.

Support groups

Support groups, such as Arthritis Research UK and Arthritis Care offer information, advice and support for people living with arthritis.

You can also use the post code search to find arthritis services in your area and hospitals for arthritis.

If you have arthritis, there are a number of things you can do to manage your symptoms and improve your quality of life.

For example, you can:

• control your weight to ease pressure on your joints
• avoid stress or injury to your joints to prevent or reduce the severity of osteoarthritis
• ensure good posture to strengthen healthy joint structure
• use physiotherapy and a walking stick or cane to help prevent your condition getting worse
• ensure that you regularly undertake weight-bearing exercise, such as walking, to help prevent osteoarthritis. This type of exercise will increase the strength of the muscles that support your joints

It is not true that avoiding exercise will help reduce joint problems occurring in later life.

Occupational therapy

Your GP can refer you to an occupational therapist who will be able to advise you about the equipment that you may need to assist your independent living.

They can also write supporting letters to your local social services department. If you need to adapt your home, a range of services and merchandise is available, so it is important to shop around.

Read more about occupational therapy.

Preventative measures

Arthritis can sometimes make you less flexible and less mobile. This can increase your risk of having an accident.

Listed below are a number of measures you can take to limit this risk.

• Eliminate home hazards - always keep your home well lit and remove all loose wires and cords that you may trip over. Make sure treads, rugs and carpets are secure. Keep rubber mats by the sink and in the bath to prevent slipping and always clean up spills immediately. Install grab rails in the bathroom and toilet to help you stand up without falling. Your GP or local authority may be able to provide support and advice about safety in the home.
• Improve your balance - exercise that helps improve your balance can prevent a fall. Being physically active can prevent up to 25% of falls. Ideal forms of exercise for improving balance include t'ai chi, yoga and dance.
• Exchange high heels for flats - high heels are bad for your posture and make you more prone to falling, so wear flat, comfortable footwear.
• Don’t drink too much alcohol - alcohol can affect your balance, making you more likely to take a knock or a fall. Keep within the government's recommended daily amounts of alcohol consumption (no more than 2-3 units for women and 3-4 units for men). A unit of alcohol is half a pint of normal strength lager or beer, one pub measure of spirit or one small glass of wine. Read more about alcohol units.
• Check your sight - as you get older, you will probably experience some deterioration in your eyesight. It is important to get your sight checked regularly by a qualified optician. Poor eyesight can increase your risk of accident and injury.
• Ask for help - if you know you have arthritis, avoid standing on chairs to reach high cupboards or change a light bulb. Also, try to avoid doing chores that you know will cause more pain. Write a list of the jobs that need to be done around the house and save it for the next time your friends or family visit.

The Royal Society for the Prevention of Accidents (RoSPA) provides more information about safety in the home.

Arthritis Care also has more information about living with arthritis.

There are many food myths surrounding arthritis, but some studies suggest certain foods may help to reduce pain and inflammation and slow the progression of arthritis.

Some people say dairy products cause arthritis and that cider vinegar and honey will cure it.

Others believe acidic fruits, such as lemons, oranges and grapefruit, and nightshade vegetables, such as potatoes, aubergines and peppers, can make symptoms worse.

Many people living with arthritis, particularly rheumatoid arthritis, also say there is a link between certain foods and the flare-ups they experience.

Healthy, balanced diet

Although there is little evidence to support these claims, some studies suggest certain foods may help reduce the pain and inflammation caused by arthritis and slow down the condition's progression.

These foods all contribute to a healthy, balanced diet, which will help with your arthritis and also reduce your risk of developing health complications, such as heart disease, osteoporosis (weak and brittle bones) and obesity.

If you are taking steroids over a long period of time you are more likely to develop osteoporosis. To reduce your risk, eat foods rich in calcium and vitamin D.

Calcium-rich foods include dairy products (milk, cheese and yoghurt), nuts, seeds and fish, such as sardines or whitebait (particularly if you eat the bones).

Sunlight is our main source of vitamin D but it can also be found in oily fish and fortified foods, such as cereals and margarines.

There is increasing evidence that the Mediterranean diet is good for arthritis as well as a number of other conditions. This diet includes plenty of fruit and vegetables, fish, grains and pulses and a moderate amount of red meat.

Foods rich in omega-3 are believed to have an anti-inflammatory effect, which may reduce the pain associated with inflamed joints. Omega-3 is found in oily fish, such as sardines, mackerel and salmon.

You should try to eat at least two portions of oily fish a week. Omega-3 is also found in nuts and seeds (particularly linseed or flax seed), and is regularly used to fortify margarines, cereals and bio-live yoghurt drinks.

Certain foods, such as patés, uncooked meats and unpasteurised dairy products can increase the risk of developing food poisoning. If you are taking immunosuppressant medication, you should avoid these foods.

For more dietary advice, see the Arthritis Care website information about eating well.

If you have arthritis, keeping active through regular exercise can help manage your condition. However, it is important you find the right type and level of exercise.

Regular exercise can help you maintain a healthy weight, improve your posture and reduce your chance of getting osteoporosis (weak and brittle bones).

In a survey carried out by Arthritis Care, 57% of people with arthritis said they found exercise to be an effective way of managing their symptoms.

Exercise programme

There are three types of exercise that combine to make up a good fitness programme. They are:

• range of movement - this helps improve strength and flexibility and promotes good posture; try swimming, t'ai chi and golf
• strengthening - this will help build the muscles, which in turn provide better support for your joints; try weight training. 
• aerobic - this raises your heartbeat, which helps to improve your level of fitness by strengthening your heart; some of the best forms of aerobic exercise are brisk walking, cycling and tennis.

Remaining physically active gives you the best possible chance of managing the symptoms of arthritis effectively. It is also essential for minimising your risk of developing a number of other health problems.

Finding the right level

Finding the right level of physical activity is very important if you are to gain the health benefits of exercise. Try to be realistic about the amount of exercise you are able to do and choose an activity you enjoy.

You may experience some pain when you first start a new exercise programme. This is often due to new muscles being used. However, if you feel pain for longer than two hours after exercising, or you have any pain in the joints, consult your GP or physiotherapist before doing the exercise again.

Exercising with osteoarthritis

Listed below are some tips for exercising with osteoarthritis.

• Regular exercise can be the best way to help reduce the symptoms of osteoarthritis. By keeping active you will strengthen the muscles surrounding your joints which will reduce further joint deterioration.
• Exercise will help you maintain a healthy weight which means you will put less strain on your joints.
• A moderate exercise programme is far more beneficial than a strenuous programme. Too much exercise can cause further pain and joint degeneration.
• Try to do small exercises every day to improve your range of movement. Arthritis Care provides a comprehensive list of exercises for you to try. 
• Never force a painful joint.

Exercising with rheumatoid arthritis

Listed below are some tips for exercising with rheumatoid arthritis.

• It is very important for people with rheumatoid arthritis to get the right balance between rest and activity.
• You can still exercise during a flare-up, but you should reduce the intensity of your workout.
• Exercise when you are least tired.
• Try to do small exercises every day that improve your range of movement.
• Exercising in the morning can help to reduce morning stiffness.
• Exercises that build and strengthen muscles can help protect and support your joints.
• Swimming, cycling and brisk walking are low impact exercises and particularly good for people with rheumatoid arthritis.
• Concentrate on maintaining good posture at all times.

Some people find complementary therapies can help ease the pain and discomfort of arthritis.

There are also complementary therapies that reportedly improve flexibility and mobility.

Most evidence regarding the benefits of complementary therapies for treating the symptoms of arthritis is anecdotal and has not been clinically proven to be effective.

However, if you are in pain and arthritis is having a detrimental effect on your life, trying complementary therapies is a positive way of taking control of your symptoms, and it may help you to manage your pain.

Your GP or consultant will be able to advise about different treatment options, including some complementary therapies.

Arthritis Care provides further information about complementary therapy for arthritis. Arthritis Research UK also produce a leaflet called Complementary and alternative medicine for arthritis (PDF).

Safety

The following checklist will help ensure that your treatment is safe and reliable.

• Ask how long the treatment is likely to last and how much it will cost.
• Find out if there is a governing body for the treatment you plan to receive and whether your chosen therapist is a member.
• Make sure your therapist has insurance cover.
• Ask about their training, how long they have practised and whether they have any particular areas of expertise.
• Tell them about any medication that you are taking.
• Do not stop taking any medication until you have discussed it with your GP or consultant.
• If you don’t trust a therapist, don’t use them.

Acupuncture

There is no clinical proof that acupuncture can help treat symptoms of arthritis or prevent the condition from progressing further.

However, some people have reported acupuncture has helped them manage the pain of arthritis. Speak to your GP if you are interested in trying acupuncture.

You can also use the post code search to find local complementary therapy services.

There are more than 5 million people in England who look after an ill or disabled partner, child, relative or friend. Caring for someone with arthritis can be a varied and demanding job. This is because of the broad range of medical, personal and emotional needs that a person with arthritis can have.

If you're caring for a family member, you may not consider yourself a carer because you're just doing what needs to be done. You might feel that you have no other options. This can be stressful and you may feel resentful towards the person you're caring for, which can also leave you feeling guilty. You may have been forced to leave your job, give up hobbies and stop socialising, which can be very isolating.

It's important to remember that you're not alone and that there is support available. By law you're entitled to a free health and social care assessment, which you can access through your local authority. The assessment will determine whether you can get practical and financial help. You can find out about assessments on Carers Direct.

Being a carer means that you may be entitled to certain financial benefits, especially if you have to give up work. Find out more about carers' benefits on Carers Direct. Carers can also get help with breaks from caring from local authorities or organisations such as Crossroads Care. You can find out about getting time off on Carers Direct.

Paul Casimir has been living with arthritis for half his life, but he doesn’t let it stop him from doing the things he enjoys. He tells his story.

Paul Casimir was diagnosed with rheumatoid arthritis at 20. He was a fast runner throughout his teens, but at 19 his body started to stiffen up.

“I had been feeling a little bit strange for about a year before I was diagnosed with arthritis,” says Paul. “I just seemed to move at the pace of a distracted goat. I didn’t really know what was going on. I was at drama school at the time and I kept getting cast as octogenarians.”

One day, after finishing a play, he collapsed into bed completely exhausted. When he woke up, his knees had swollen to the size of dumplings, and he was in bed for four days. His doctor was puzzled.

“It then went away for a while, but returned with a vengeance a couple of months later,” says Paul. "I was referred to a rheumatologist, who diagnosed rheumatoid arthritis. It was something I’d never heard of and I didn’t know why it was happening to me. I had tears in my eyes when she told me.”   

Paul managed his condition with painkillers and anti-inflammatory medication for the next few years. It was difficult for him to move properly. "Dancing was what got me through the roughest times," he says. "Even when I could barely move, I could still dance. Standing still was excruciating, but transferring my weight from one leg to the other was bearable."

One day, he decided to see how he would get on without medication. He has never looked back.

“I didn’t really notice much of a difference with the medication,” he says. “People diagnosed now would be offered different kinds of medication, such as disease-modifying medication, but I guess that wasn’t around when I was diagnosed.

“After a while it became really important to me to start challenging the condition, to take back control of my life.”

He started swimming and going out dancing, and stopped worrying about what other people thought. It's been five years since the last big flare-up.

“I just learnt to get on with life," he says."It’s easy to dwell on the pain and misfortune and to think ‘why me’. But, in the end, that's really quite futile. What’s important is to focus on all the things you enjoy. I swim regularly and enjoy a ramble in the woods, whereas 20 years ago I'd have thought 'Let's go for a walk' was the most ridiculous suggestion someone could make! The richer your experiences in life, the more you're distracted from the pain.

"And I still look good on the dancefloor, dancing like a robot from 1984!” 

Jo has been living with osteoarthritis for 15 years. When she felt her independence slipping away, she knew she had to take stock of her life.

“I broke my ankle in 1990 and was warned by an orthopedic surgeon to expect the onset of osteoarthritis. What I didn’t anticipate was that within five years, not only both my ankle joints, but also my knees and hips would be affected. I currently live with a dull constant pain, which will continue for the rest of my life.

"I was lucky to be diagnosed by my GP on the second visit. My doctor was very thorough and sent me to a rheumatology clinic for tests to be certain that the condition I had was osteoarthritis.

“Osteoarthritis affects almost every part of my life. My favourite pastime is making wooden toys. Unfortunately, I now also experience pain in my finger joints. My aim now is to keep my hands moving and try to lessen the damage so I can continue to enjoy my hobbies for as long as possible.

“I have now been living, struggling and sometimes laughing with and at osteoarthritis for the last 15 years. In the last two years, my osteoarthritis has worsened significantly. My knees are beginning to give way, my left calf muscle has become wasted and my feet are ‘turning over’. I enjoy walking, as I'm a country girl at heart, but it's increasingly becoming agony even to pop along to the supermarket in the next street.

“In the past, my ‘disability’ went seemingly unnoticed by others. I was pushed out of the way and ranted at on buses for asking for a seat. I began to fear that I was losing control of my independence. I had to take stock of my life and my future.

"At this time, a good friend gave me a walking stick. It stayed consigned to the corner for several months because I wasn't prepared to carry a symbol of my increasing disability. One day I was unable to stand up and needed friends to help me to my feet. The shock and the embarrassment were what I needed to shake me out of my pride and into the stark reality of my situation.

"I started to use the stick to come in to work. I immediately noticed that with a visible sign of my problems, people were more patient, the pushing stopped and I got offered a seat on the bus. The stick has given me back my confidence for walking. Although other people notice it, I'm gradually becoming less aware of my constant companion and friend. Everyone needs a friend they can lean on!

“I feel passionately about the need for good quality care for patients with osteoarthritis across the country. It's important to me that everyone gets the same sort of attention and treatment from the NHS that I have had. Early diagnosis is crucial, but so is swift access to the right treatment, information and programmes.”

When we think of arthritis, we normally think of old age. But the disease can strike young people too. Kate Llewelyn, 34, first noticed her symptoms when she was just 13.

“The soles of my feet became very painful,” she recalls. “I went to the doctor. He wasn’t my usual GP and he just told me to buy new shoes! I did, but they didn’t help. A month later two of my fingers swelled up and became very painful. I went back and saw my regular doctor, who diagnosed rheumatoid arthritis.”

Kate was put on to anti-inflammatory drugs and also had to take 12 soluble aspirins a day. “I still hate the taste!” she says. She had hydrotherapy sessions three times a week, which helped her pain. However, at 14, she had to take a year off school as her pain got worse.

“Every joint in my body would ache, apart from my hips, which luckily have never been affected,” she says. “It was difficult as I felt quite isolated. I had home tuition, but I lost contact with lots of friends.”

However, Kate refused to let the disease beat her. She gained good GCSEs and A-levels, then went to university. “All my tutors were very supportive,” she says. “Of course, the arthritis did affect my social life. I couldn’t be spontaneous as I always had to plan how I’d get home from somewhere, as I couldn’t walk very far.” Following university, she got a job with Arthritis Care and now edits the charity’s magazine.

Kate has a very aggressive form of rheumatoid arthritis and so far has had an elbow and a knee replacement. In the past, she’s tried several drugs, including methotrexate and gold injections. She's currently on anti-TNF, a new arthritis drug designed to stop the disease progressing, which she says is working well.

She’s under no illusions about the severity of her illness. “Sometimes, when the pain is bad, I think: 'is this the next stage?' I know I’ll need more operations in the future but I try to stay positive. It can be hard. It’s not obvious that I’ve got arthritis and I’ve been shouted at for parking in disabled spaces! But I try not to get angry because I know people are just ignorant."

Kate has learned to live with the disease. “I have to watch my energy levels. If I know that, for example, I’m going to a wedding, I’ll do absolutely nothing the day before because I know it will wipe me out and I’ll be fit for nothing the day after. I also have to be ruthlessly practical in every aspect of my life, for example, if I have a work meeting I always try and get people to come to me.”

She urges anyone with arthritis to learn about their condition. “Get in touch with Arthritis Care and you’ll get all the information you need,” she says. “You’ll also find support and help with what can be a very isolating condition.”

Paul Casimir was diagnosed with rheumatoid arthritis more than 20 years ago. He tells of his experience of living with the disease

“The year is 1984 and Frankie Say Relax, but my Walkman only seems to play Heaven Knows I'm Miserable Now. At 15, I was a champion sprinter, but now aged 20 I can only move at the pace of a distracted goat. Though the youngest in my year at drama school, I find I'm only cast as octogenarians.

“On completing a run of The Crucible (I played an 83-year-old) I collapse into bed for days. My doctor diagnoses glandular fever. The next morning I wake up to find my knees have swollen to the size of dumplings. The doctor is completely flummoxed. ‘Anything can happen with glandular fever,’ he adds helpfully. Gradually I recover and the inflammation subsides. But it returns with a vengeance two months later. I'm referred to a rheumatologist who diagnoses rheumatoid arthritis. I feel the hot pinpricks of tears as she informs me.
 
“Twenty-three years later I've had help from more positive health professionals, various meds, support from family and friends. But what got me through the roughest times was this: Last Night a DJ Saved My Life. Not literally, but near enough. Even on the days and nights I could barely move, I could still dance. Standing still was excruciating, but transferring my weight from one leg to the other was bearable. Only when I'm dancing do I feel this free.
 
“It's five years since my last big flare-up. My lifestyle could be healthier. I drink too much red wine, eat too much red meat and have never properly quit smoking. But I also swim regularly and enjoy a ramble in the woods, whereas 25 years ago I thought, ‘let's go for a walk’ was the most ridiculous sentence in the English language. And I still look good on the dance floor, dancing like a robot from 1984!”

The list below is a combination of the and brand names of medicines available in the UK. Each name provides a link to a separate website (Medicine Guides) where you can find detailed information about the medicine. The information is provided as part of an on-going medicine information project between NHS Direct, Datapharm Communications Ltd and other organisations.

The medicines listed below hold a UK licence to allow their use in the treatment of this condition. medicines are not included.

The list is continually reviewed and updated but it may not be complete as the project is still in progress and guides for new medicines may still be in development.

If you are taking one of these medicines for a different condition, or your medicine for this condition is not mentioned here at all, speak to your prescriber, GP or pharmacist, or contact NHS Direct on 0845 46 47.

Information about the symptoms of the two main types of arthritis: osteoarthritis and rheumatoid arthritis.

Symptoms of osteoarthritis

The main symptoms of osteoarthritis are:

• pain, especially when doing load-bearing activities, such as walking
• short-lived stiffness in the morning, which improves in 30 minutes or less when you start to move
• difficulty moving your affected joints or doing certain activities 

However, in some cases of osteoarthritis, you may not have any symptoms at all, as the pain can come in episodes. Often, you will only experience symptoms in one joint or a few joints at any one time. Your symptoms may also develop slowly.

Other features you or your doctor may notice include:

• joint tenderness
• increased pain and stiffness when you have not moved your joints for a while
• joints appearing slightly larger or more 'knobbly' than usual
• a grating or crackling sound or sensation in your joints
• limited range of movement in your joints
• weakness and muscle wasting (loss of muscle bulk)

You are most likely to develop osteoarthritis in the joints of your knees, hips or hands.

For more information about how osteoarthritis can affect the knees, hips and hands, see Osteoarthritis - Symptoms 

Symptoms of rheumatoid arthritis

The symptoms of rheumatoid arthritis usually develop gradually. The first symptoms are often felt in small joints, such as your fingers and toes, although shoulders and knees can be affected early, and muscle stiffness can be a prominent early feature.

The symptoms of rheumatoid arthritis vary from person to person, but are usually:

• pain and stiffness in the joints
• warmth and redness
• inflammation around the joints and in other areas

These symptoms can come and go, and they may change over time. You will experience flare-ups when from time to time, your condition will worsen and your symptoms will be more intense and severe.

You can experience a flare-up at any time of the day or night. However, it is likely that your symptoms will be more painful in the morning, when you first wake up. Usually, your symptoms will begin to ease as the day progresses and you start using and flexing your joints.

For more information, see Rheumatoid arthritis - Symptoms