“Some dreams, live on in time forever. Those dreams, you want with all your heart.” Those were the words Gloria Estefan sang on 4 August 1996, at the closing ceremony of the Olympic Games in Atlanta, Georgia, United States, performing “Reach”, the event’s official theme song. For athletes who had spent years training, falling short, and getting back up, it captured what had brought them to that stadium: the choice to keep moving towards a goal that once seemed beyond them.
In the same year, on 12 October 1996, Arthritis and Rheumatism International (ARI) held the first World Arthritis Day (WAD) to raise awareness of rheumatic and musculoskeletal diseases (RMDs). So 1996 gave us two milestones with a common thread: a song about dreams, sung to a stadium of athletes whose lives revolved around movement, and a day for people whose movement can be limited by arthritis. How fitting then, that 30 years later, this year’s theme is “Achieve Your Dreams”. For someone living with arthritis, the dream isn’t usually a medal. More often, it’s about movement: a morning walk without stiffness, a return to the tennis court, or being able to carry your grandchild. Working towards that dream can start with understanding how arthritis might affect your joints, and the range of options available to help you stay active.
How Different Types of Arthritis Might Affect Your Joints
Understanding starts with the word itself. It combines the Greek arthron, meaning joint, with -itis, which in medicine signals inflammation. In practice, however, the term covers more than 100 conditions, which fall broadly into two groups: non-inflammatory and inflammatory. Both can cause pain and stiffness, but they affect the joint in different ways.
Non-inflammatory Arthritis
Osteoarthritis (OA) is the most common example of non-inflammatory arthritis, and it affects the whole joint. The cartilage cushioning the bone ends wears down, the bone beneath changes, and bony growths called osteophytes, or bone spurs, form at the joint’s edges. As a result, the joint can become painful and stiff, and pain tends to build with activity. It can develop in any joint, from the shoulder to the big toe. In the big toe, it’s known as hallux rigidus.
An injury can also set OA in motion. When this happens after a fracture, a dislocation, or a ligament or meniscus tear, it’s known as post-traumatic arthritis (PTA), and it can affect injured joints from the shoulder to the foot. In these cases, the injury might damage the cartilage or leave the joint less stable, changing how it carries load. Because this damage builds gradually, PTA might only appear years later. And as such injuries are common in sport, it tends to affect younger, active people, unlike most types of arthritis.
Inflammatory Arthritis
As its name implies, inflammatory arthritis is driven by inflammation, which can be triggered in different ways. Often, the immune system is responsible: in autoimmune forms, it mistakenly attacks the body’s own tissues instead of protecting them. In rheumatoid arthritis (RA), its target is the synovium, the thin lining of the joint, leaving the joint warm, swollen, and stiff. RA usually starts in the small joints of the hands and feet, on both sides of the body, and might later spread to larger joints such as the elbows and knees. Psoriatic arthritis (PsA), another autoimmune form, affects some people with the skin condition psoriasis and can make whole fingers and toes swell (dactylitis).
In other cases, the trigger is crystals. In gout, uric acid crystals set off sudden flares that leave a joint hot, red, and very tender, classically at the base of the big toe, where an attack is known as podagra. Calcium pyrophosphate deposition (CPPD) disease, whose attacks were once called pseudogout, causes similar flares, typically in the knee.
How to Protect Your Joints and Stay Active
Knowing which type of arthritis is involved also shapes how it’s managed. In inflammatory arthritis, controlling the inflammation is the priority, which is why medication comes first, and it must be prescribed and monitored by a doctor. OA and PTA on the other hand, can’t be reversed, and while medication can ease the pain, it doesn’t repair the joint. Rather than relying on medication alone, the aim is therefore to preserve the natural joint for as long as reasonably possible, usually starting with measures that ease the load on it and strengthen the muscles around it.
These non-surgical options include:
- Activity changes – Adjusting how a joint is used such as the reduction of high-impact activities can lower the stress placed on it.
- Weight management – Reaching a healthier weight eases the load on weight-bearing joints such as the hips, knees, and ankles. This helps reduce pain.
- Supportive devices – Braces, custom insoles, or changes in footwear can help stabilise a joint, redistribute the load on it, or take some weight off it.
- Strengthening exercises – A targeted programme strengthens the muscles around the joint and improves flexibility, helping to support and stabilise it.
When the above measures no longer keep symptoms under control, surgery might be recommended. Even then, preserving as much of the natural joint as possible remains the aim.
When Surgery Becomes Part of the Conversation
If surgery is recommended, the goal is to relieve pain and restore function. To achieve this, the choice of procedure depends on how much of the joint is damaged, where the damage sits, how stable the joint is, and the person’s age and activity level. And because the natural joint remains the priority, surgery aims to preserve its healthy parts wherever possible.
These surgical options include:
- Joint-preserving surgery – When the damage is still limited to one side, realigning the bone (osteotomy) can shift load onto the other. Where loose fragments or bone spurs restrict movement, keyhole surgery (arthroscopy) can also remove them.
- Joint fusion – When the damage is more advanced, the person’s own bones can be joined so they heal into one (arthrodesis), as in an ankle fusion. This can make the joint more stable and less painful, but it permanently removes movement at that joint.
- Joint replacement – Alternatively, the worn surfaces can be replaced with artificial parts (arthroplasty). Commonly done in the shoulder, hip, and knee, it can be total or, where suitable, cover only the damaged part, as in a partial knee replacement (PKR).
Each of these options comes with trade-offs, from recovery time and how much movement the joint keeps to how long an implant lasts. Balancing them against the condition of your joint and what you need it to do isn’t always simple, which is why an assessment by an orthopaedic specialist can help clarify which options might be suitable.
Unsure Whether Arthritis Is Behind Your Joint Pain?
Whether non-surgical or surgical, any treatment starts with knowing what’s causing the symptoms in the first place. This matters because joint pain, known medically as arthralgia, is a symptom rather than a diagnosis. Arthritis is one possible cause, but pain can also arise from the soft tissues around the joint or accompany hormonal changes. And if arthritis is found to be the cause, knowing which type matters, as conditions such as OA, RA, and gout can seem similar early on but are treated quite differently. For these reasons, persistent symptoms are worth assessing rather than attributing it to ageing.
At Oxford Orthopaedics, this assessment begins with a review of how your symptoms started, followed by a physical examination of how the joint moves and how stable it is. Where further investigation is indicated, imaging such as X-rays or an MRI scan can show changes in the bone, cartilage, and surrounding tissues, and if an inflammatory cause is suspected, blood tests might also be arranged. With a clearer diagnosis, our orthopaedic specialists can then advise on the approach best suited to your joint. So if pain or stiffness is still limiting your daily movement or the activities you’re working towards, please contact the clinic to book an appointment.
