Arthritis Screening

Arthritis is not a single disease — it is an umbrella term covering more than 100 different conditions that affect the joints, the tissues surrounding joints, and other connective tissue. It is the leading cause of work disability in the United States and affects people of all ages, races, and genders, though it becomes increasingly prevalent with age.

What Is Arthritis?

The two most common forms of arthritis are osteoarthritis (OA) and rheumatoid arthritis (RA), though there are many others including gout, psoriatic arthritis, lupus-related arthritis, and juvenile idiopathic arthritis.

Osteoarthritis is a degenerative joint disease caused by the breakdown of cartilage — the cushioning tissue that covers the ends of bones in a joint. As cartilage deteriorates, bones may rub against each other, causing pain, stiffness, swelling, and decreased range of motion. OA most commonly affects the knees, hips, hands, and spine. It is driven primarily by aging, mechanical stress, prior joint injury, and obesity. OA is the most common form of arthritis, affecting an estimated 32.5 million U.S. adults.

Rheumatoid arthritis is an autoimmune disease in which the immune system mistakenly attacks the synovial lining of joints, causing chronic inflammation that can erode bone and cartilage over time. Unlike OA, RA typically affects joints symmetrically (both hands, both knees), is associated with systemic symptoms (fatigue, fever, weight loss), and can involve organs beyond the joints including the lungs, heart, and eyes. RA affects about 1.5 million Americans, predominantly women.

Gout is caused by the accumulation of uric acid crystals in joints, producing sudden, severe attacks of joint pain, redness, warmth, and swelling — most famously in the big toe, but also in the ankle, knee, and wrist. Gout is closely linked to diet, obesity, kidney disease, and certain medications including diuretics and low-dose aspirin.

Risk Factors for Arthritis

While some risk factors for arthritis cannot be changed, others can be actively managed to reduce joint damage and disease progression:

Non-Modifiable Risk Factors

• Age: The risk of most types of arthritis — especially OA — increases substantially with age. The prevalence of arthritis among adults over 65 approaches 50%.
• Sex: Women are more likely than men to develop most types of arthritis, including OA (especially in the hands and knees) and RA. Gout, by contrast, is more common in men due to differences in uric acid metabolism.
• Genetics and family history: A family history of arthritis, particularly RA or OA, raises personal risk. Specific genetic markers (such as HLA-DRB1 for RA) are associated with susceptibility to inflammatory arthritis.
• Prior joint injury: A significant joint injury (fracture, torn ligament, dislocated joint) greatly increases the likelihood of OA in that joint — sometimes decades after the original injury. This is why athletes and military veterans carry elevated risk.

Modifiable Risk Factors

• Obesity: Excess body weight places enormous mechanical stress on weight-bearing joints, particularly the knees and hips. Every pound of excess weight adds roughly 4 pounds of pressure on the knees during walking. Obesity also promotes systemic inflammation, which can worsen inflammatory forms of arthritis. Weight loss is one of the most effective OA interventions available.
• Occupation and repetitive movements: Jobs or activities requiring repetitive bending, squatting, kneeling, or heavy lifting significantly accelerate joint wear. Construction workers, nurses, farmers, and assembly-line workers face particularly high rates of occupational arthritis.
• Physical inactivity: Inactivity weakens the muscles that support and protect joints, leaving them vulnerable to injury and accelerated wear. Low-impact exercise such as swimming, cycling, and walking is strongly recommended for arthritis prevention and management.
• Smoking: Smoking is a well-established risk factor for rheumatoid arthritis. The association is particularly strong in genetically susceptible individuals. Smokers with RA also tend to have more severe disease and respond less well to treatment.
• Diet: A diet high in purines (red meat, organ meat, shellfish) and fructose (sugary drinks) can elevate uric acid levels and trigger gout attacks. An anti-inflammatory dietary pattern (Mediterranean-style) may reduce RA disease activity.

Signs and Symptoms

While different types of arthritis have distinct features, hallmark symptoms across most forms include:

• Joint pain — ranging from mild aching to severe, disabling pain
• Joint stiffness — especially in the morning or after periods of inactivity
• Swelling around one or more joints
• Warmth or redness over a joint
• Decreased range of motion
• Fatigue (particularly prominent with inflammatory arthritis)
• Crepitus — a grinding, clicking, or crackling sensation in joints during movement

Morning stiffness lasting more than 30–60 minutes is a characteristic feature of inflammatory arthritis (RA, psoriatic arthritis) and helps distinguish it from the brief stiffness that typically accompanies OA. Sudden, excruciating pain in a single joint — especially the big toe or ankle — peaking within 12–24 hours is highly suggestive of a gout attack.

Prevention & Next Steps

While arthritis cannot always be prevented, you can take meaningful steps to reduce risk and slow progression:

• Maintain a healthy weight: For OA, weight management is the single most impactful modifiable intervention. Even a 10–15% reduction in body weight in overweight individuals significantly reduces knee pain and slows OA progression.
• Exercise regularly: Low-impact aerobic exercise and strength training protect joints by strengthening surrounding muscles, maintaining flexibility, and reducing inflammation. The CDC recommends 150 minutes of moderate aerobic activity per week for people with arthritis.
• Protect your joints: Use proper technique when lifting, wear supportive footwear, and modify activities that cause joint pain or impact.
• Seek early diagnosis and treatment: For inflammatory arthritis like RA, early and aggressive treatment with disease-modifying antirheumatic drugs (DMARDs) can prevent joint destruction and long-term disability. The therapeutic window is largest in the first 1–2 years of disease.
• Physical and occupational therapy: Targeted exercises, joint protection techniques, and assistive devices can dramatically improve function and reduce pain for people living with arthritis.
• Quit smoking: Especially important for reducing both RA risk and RA disease severity.
• Follow-up with a rheumatologist: If inflammatory arthritis is suspected, early referral to a rheumatologist is essential for proper diagnosis and treatment planning before irreversible joint damage occurs.