Arthritis can be a restrictive and painful condition that can affect a person’s mobility and day-to-day comfort. According to the World Health Organisation, over 528 million people are living with osteoarthritis, and 18 million live with rheumatoid arthritis, among 100+ other types of arthritis.
Arthritis isn’t a typical injury but a disease process that can create irreversible damage to the joints. With that said, there are several steps that can be taken to help alleviate the symptoms of arthritis, slow its progression, and enhance your overall comfort. Here’s a closer look at the four most common types of arthritis our physiotherapists see and help manage across our clinics in Hong Kong.
Osteoarthritis
You may know osteoarthritis as the “wear and tear” type of arthritis, often described as when the bone ends rub against each other and cause pain. While that description still has some truth, our understanding of osteoarthritis in the medical literature has grown. Osteoarthritis is now seen as a condition that affects the entire joint and all of its components, including your cartilage, ligaments, joint lining, and even the surrounding muscles. Some of the structural changes we see are not just a sign of the joint breaking down, but also of the body actively trying to repair damage. For example, new bone growths called osteophytes often form at the edges of the joint as part of this repair response.
Osteoarthritis can occur in any joint, but is especially common in the knees, hips, and feet. These joints take on the greatest loads during walking, standing, running, and other daily movements. Repeated stress, combined with age-related changes, makes them more vulnerable. The hands, spine, and shoulders can also be affected, though often in different ways and with slightly different patterns of change.
Osteoarthritis is the most widespread form of arthritis globally, and its prevalence grows as we get older, although younger people can develop it too, particularly after injury or repetitive joint strain. Factors such as genetics, body weight, occupation, activity levels, and even past trauma to the joint can all contribute to its development.
If you’re aged over 50, have ongoing joint pain and stiffness in one or more joints, and you have never been diagnosed with an inflammatory condition like rheumatoid arthritis, it’s a sign that you could benefit from an assessment to see if any osteoarthritis may have developed.
Rheumatoid Arthritis
Rheumatoid arthritis is an inflammatory joint disease where your body’s immune system mistakenly targets its own tissues - in this case, the synovial lining that surrounds the joints. The inflammation that follows is not part of a healthy repair process, but an abnormal response that causes pain, swelling, and stiffness. Over time, this persistent inflammation damages the cartilage, bone, and supporting structures, leading to permanent changes to the joint.
A key feature of rheumatoid arthritis is that it usually affects joints symmetrically. For example, both hands, both feet, or both knees may be involved at the same time. The symptoms often come in “flares”, where inflammation suddenly increases and the joints become painful, often hot, and swollen. These flares may settle down, but it’s the repeated episodes that contribute to the eventual structural damage of the joints.
While it can begin in almost any joint, rheumatoid arthritis often starts in the smaller joints of the hands and feet, and then progresses to larger joints. It can appear at any age, but it most commonly develops between the ages of 30 and 60, and it is more frequent in women. Genetic factors play a role in susceptibility, but environmental influences, lifestyle factors, and certain triggers are also thought to contribute.
Rheumatoid arthritis is a systemic condition, meaning it doesn’t just affect the joints. The same inflammatory process can sometimes involve other parts of the body, including the eyes, lungs, heart, and blood vessels. This makes it very different from more localised types of arthritis and highlights the importance of recognising it early.
If you notice that your joint pain is symmetrical, associated with prolonged stiffness in the morning, or occurs alongside general symptoms such as fatigue or weight loss, it may be worthwhile speaking to your doctor about the underlying cause and whether it could be related to rheumatoid arthritis.
Gout
Gout is an interesting form of arthritis caused by the build-up of uric acid within a joint, which then turns into tiny, needle-shaped crystals. Uric acid is a natural substance produced when the body breaks down purines, which are found in many foods and also occur naturally in our tissues. When uric acid levels rise above what the body can dissolve and excrete, the crystals deposit in and around joints, causing notable pain and discomfort.
A gout attack, often called a flare, occurs when the immune system reacts strongly to these crystals. This leads to sudden, intense pain, swelling, heat, and redness in the affected joint. Many people describe the pain as unbearable, to the point where even the weight of a bedsheet can feel excruciating when touching the affected joint. The most commonly affected joint is the big toe, but gout can also involve the midfoot, ankle, knee, and occasionally other joints.
Gout flares often come on very suddenly, sometimes overnight, and can last for days or even weeks. While the flare may resolve completely, repeated episodes can eventually cause more lasting changes to the joint, including chronic inflammation and stiffness. In severe cases, collections of urate crystals called tophi can form under the skin, appearing as firm lumps around the joints.
Gout is more common in men, particularly in middle age, although women can also develop it, often after menopause. A combination of factors influences risk, including genetics, diet, body weight, kidney function, alcohol intake, and other health conditions such as high blood pressure and diabetes. Because uric acid is managed through both production in the body and excretion by the kidneys, even small changes in either can tip the balance towards crystal build-up.
Arthritis In Kids - Juvenile Idiopathic Arthritis
Arthritis that develops in children and those under the age of 16 is usually referred to as juvenile idiopathic arthritis, unless another specific type of arthritis can be identified. The term “idiopathic” means that the exact cause is unknown. What is understood, however, is that juvenile idiopathic arthritis is an autoimmune condition. This means the immune system, which normally protects the body from infections, mistakenly attacks healthy tissue in the joints. The result is ongoing inflammation that can cause pain, stiffness, and swelling.
Juvenile idiopathic arthritis affects around one in 500 children, making it the most common type of arthritis seen in childhood. It can occur in any joint, but the knees, ankles, and feet are particularly likely to be affected, as well as the wrists and small joints of the hands. Because children are still growing, inflammation in the joints can interfere not only with comfort and mobility but also with bone growth and overall development. This is one of the key reasons why timely recognition is so important.
Symptoms may vary from child to child. Some children have only a few joints involved (oligoarticular JIA), while others have many joints affected (polyarticular JIA). There are also subtypes where the disease is accompanied by a fever, rash, or inflammation in other organs. A hallmark sign of JIA is morning stiffness, where joints feel particularly tight and difficult to move on waking, often easing as the day goes on.
Like adult forms of autoimmune arthritis, juvenile idiopathic arthritis can flare up, with periods of increased pain and swelling, and then settle down. As kids are in a critical stage of growth and development, these changes can have notable consequences for their mobility, alignment, and quality of life. If a child is struggling with unexplained joint pain, stiffness, or swelling that lasts for more than a few weeks, we recommend having your child assessed.
If you’re experiencing joint pain or have concerns about any changes you’re noticing, book in with one of our experienced physiotherapists here at PhysioCentral. Book your appointment online here.