Common questions about joints, arthritis and osteoporosis

It depends on the type. The most common type, osteoarthritis, does not usually threaten life but can limit movement, and exercise often helps ease it. Inflammatory types such as rheumatoid arthritis are long-term, and if they are not treated they can damage the joints, cause inflammation in the lungs, heart or eyes, and raise the risk of heart attack and stroke. Early diagnosis and the right treatment from a rheumatologist help reduce these risks, and physiotherapy helps keep you moving. Any hot, swollen joint with a fever needs the emergency department straight away (911 in Jordan or 122 in Iraq and Kurdistan).

Read more: Knee osteoarthritis · Source: NHS — Rheumatoid arthritis · NHS — Arthritis

Not always. Rheumatism is a popular word for many kinds of joint and muscle pain, while rheumatoid arthritis is one specific autoimmune disease, in which the immune system attacks the lining of the joints by mistake, making them swollen, stiff and painful, often in the hands, feet and wrists. Psoriatic arthritis is also immune-related, but osteoarthritis is not. What people call rheumatism in the blood is usually a test result, which can be positive in people without the disease and negative in some who have it, so the doctor interprets it together with an examination; on its own it is not enough for a diagnosis.

Source: NHS — Rheumatoid arthritis · NHS — Rheumatoid arthritis: diagnosis

Usually not life-threatening, but they need follow-up. Psoriatic arthritis is a long-term condition in which the immune system attacks healthy tissue; it can affect people with psoriasis and causes joint pain, swelling and stiffness, swollen fingers or toes and nail changes. It is treated with medicines decided by a rheumatologist, and a physiotherapist teaches exercises to strengthen and protect the joints. Reactive arthritis appears after an infection, such as food poisoning or some genital infections, and usually goes within six months, though it can last longer or come back. See a doctor if joint pain and swelling keep coming back, even without psoriasis.

Source: NHS — Psoriatic arthritis · NHS — Reactive arthritis

The main symptoms are pain, swelling and stiffness in the joints, often starting in the small joints of the hands and feet and usually on both sides of the body. The pain and stiffness are often worse in the morning and after inactivity, and morning stiffness often lasts longer than half an hour, unlike in osteoarthritis. The joints may become warm and tender, sometimes with tiredness, a poor appetite or weight loss. Symptoms usually develop over weeks and may come in flares. A doctor diagnoses it with an examination, blood tests and sometimes scans such as X-rays, and early referral to a rheumatologist matters, because early treatment protects the joints.

Source: NHS — Rheumatoid arthritis: symptoms · NHS — Rheumatoid arthritis: diagnosis

It is not contagious: rheumatoid arthritis is not an infection and does not pass from person to person. It is an autoimmune condition, in which the immune system attacks the lining of the joints by mistake, and it is not yet known what triggers this. Genes can make it more likely if a close relative has it, but they are thought to play only a small role, so having an affected relative does not mean you will get it. It is also more common in women and in people who smoke.

Source: NHS — Rheumatoid arthritis: causes · Johns Hopkins Arthritis Center — Ask the expert: Is RA a communicable disease? (2007)

There is no permanent fix for rheumatoid arthritis yet, but modern treatment can help control it: the aim is remission or the lowest possible disease activity, and many people have months or even years between flares and keep working. This relies on long-term medicines decided by a rheumatologist and on starting early, with physiotherapy and occupational therapy helping with movement and daily tasks. Be wary of products that promise to make it disappear for good, and never stop a medicine without talking to your doctor.

Source: NHS — Rheumatoid arthritis · NICE NG100 — Rheumatoid arthritis in adults: management (2018, updated 2020)

Guidelines recommend physical activity as a core part of care for inflammatory arthritis, such as rheumatoid arthritis, and for osteoarthritis, because it is effective and safe when it is adapted to you. A physiotherapist helps improve your fitness, flexibility and muscle strength with a graded programme that suits your condition. As for natural treatment in the sense of herbs and home remedies, NICE says complementary therapies have little or no evidence of long-term benefit and should not replace your doctor's treatment. At Revibe we start with an assessment and build the plan alongside your rheumatologist's plan.

Read more: Your first session · Source: Rausch Osthoff AK et al. (2018). 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Ann Rheum Dis 77(9):1251–1260 · NICE NG100 — Rheumatoid arthritis in adults: management (2018, updated 2020)

It can be serious because of fractures, not because of the thinning itself. It weakens bones slowly over years so they break more easily, and it is often only found after a broken wrist, hip or spinal bone from a minor fall. Broken spinal bones can cause long-term pain and a stooped back. But it is a long-term condition that can be managed: bone-strengthening medicines decided by your doctor, strength and balance exercise, and preventing falls at home.

Read more: Home physiotherapy · Source: NHS — Osteoporosis · Brooke-Wavell K et al. (2022). Strong, steady and straight: UK consensus statement on physical activity and exercise for osteoporosis. Br J Sports Med 56(15):837–846

Yes, it can be treated even if it does not disappear completely: depending on your fracture risk, your doctor decides on bone-strengthening medicines and the right amount of calcium and vitamin D. A UK expert consensus recommends resistance and impact exercise to strengthen bones, strength and balance training to prevent falls, and back-extension exercise to improve posture, while avoiding deep forward bending. People with a previous spinal fracture usually keep impact no higher than brisk walking. Calcium-rich food and stopping smoking also help. At Revibe we build a safe, graded programme after an assessment, and home visits are available for people who need them.

Read more: Home physiotherapy · Source: Brooke-Wavell K et al. (2022). Strong, steady and straight: UK consensus statement on physical activity and exercise for osteoporosis. Br J Sports Med 56(15):837–846 · NHS — Osteoporosis

Usually not until a bone breaks. A fracture in one of the spinal bones can cause sudden back pain and, over time, a stooped, bent-forward posture, so new back pain in someone with osteoporosis needs a doctor the same day. Widespread body aches are not usually from osteoporosis itself, so ask your doctor to look for the cause. Osteoporosis is found with a bone density scan, a short, painless test your doctor may request based on your age and risk factors, sometimes together with a tool that estimates your risk of a fracture. An ordinary X-ray shows fractures, but osteoporosis is diagnosed with the bone density scan.

Read more: Back pain · Source: NHS — Osteoporosis

Genes play a part: a family history of osteoporosis, especially a parent who broke a hip, raises the risk, but it is not the only factor. Others include getting older, the menopause, especially if it comes early, which is why women are more at risk, taking steroid tablets for a long time, low body weight, little exercise, smoking and heavy drinking. To prevent it: regular weight-bearing and resistance exercise, food rich in calcium and vitamin D with a little sunlight, and stopping smoking. If you have risk factors, ask your doctor about a bone density scan.

Source: NHS — Osteoporosis · NHS — Osteoporosis: prevention

Osteoarthritis, sometimes called degenerative arthritis, is the most common type of arthritis. It affects the whole joint, causing pain, stiffness and sometimes a grating or crackling feeling, most often in the knees, hips and hands, and it can affect the spine. It is different from osteoporosis, which weakens the bones without pain until a fracture, although the two can occur together. Osteoarthritis is long-term but does not necessarily get worse and can improve; NICE guidance puts exercise, weight loss if needed and understanding the condition at the core of treatment, with manual therapy added to exercise rather than replacing it. Injections and surgery are your doctor's decision.

Read more: Knee osteoarthritis, Hip osteoarthritis · Source: NICE NG226 — Osteoarthritis in over 16s: diagnosis and management (2022) · NHS — Osteoarthritis

Sometimes. An inflamed joint can feel warm to the touch, and inflammatory types such as rheumatoid arthritis can cause tiredness and sometimes a high temperature. But a high temperature with a hot, swollen, red joint and sudden severe pain that makes it hard to move the joint or put weight on it may mean an infection inside the joint, which is more likely in people with rheumatoid arthritis. This is serious and needs fast treatment, usually in hospital, so do not wait or start physiotherapy: go to the emergency department straight away (911 in Jordan or 122 in Iraq and Kurdistan).

Source: NHS — Septic arthritis · NHS — Rheumatoid arthritis: symptoms