Inflammatory Arthritis and Swollen Joints
Swollen joints happen when there's an increase of fluid in the tissues that surround the joints. Joint swelling is common with different types of arthritis, infections, and injuries. A swollen joint is a symptom of the following health conditions:
Osteoarthritis (OA). OA is the "wear-and-tear" arthritis that usually happens with aging or after injury. With OA, there's a wearing down of the cartilage that cushions the ends of the bones. OA may cause joint swelling in those joints that bear weight over a lifetime, such as knees, hips, feet, and spine. Except for the pain in the affected swollen joint, you usually do not feel sick or tired.
Rheumatoid arthritis (RA). RA is an inflammatory arthritis that can happen at any age -- even in young children. RA causes painful, stiff, and swollen joints. Usually, RA affects hands, feet, and knees, but it can also affect most joints and other parts of the body. RA symptoms can interfere with daily activities.
Gout. Gouty arthritis usually strikes suddenly, with severe joint pain, swelling, warmth, and redness, often in the big toe (about 50% of cases). Gout causes a painful, swollen joint that's so severe that the weight of bed sheets can cause distress. It usually involves one joint when it strikes, but occasionally gout can affect more than one joint.
With gout, uric acid -- a normal chemical in the body -- forms crystals that deposit in the joints, causing inflammation and pain. The crystals may also deposit in other areas to become nodules under the skin or stones in the kidney.
Ankylosing spondylitis. The key feature of this is the involvement of the joints at the base of the spine where the spine joins the pelvis, called the sacroiliac joints.
Psoriatic arthritis. Psoriatic arthritis is an inflammatory joint disease that's linked with psoriasis, a skin condition. Up to 30% of people with psoriasis will develop psoriatic arthritis.
Infectious arthritis. Infectious arthritis, or septic arthritis, is the result of a bacterial, viral, or fungal infection in the tissues and fluid of a joint. Joint infection usually occurs after a previous infection in the body. The infection travels to the joint via the bloodstream from another part of the body, such as a person's skin, nose, throat, ears, or an existing wound. Within hours to days, pain, inflammation, swollen joints, and fever develop. The joints most commonly affected with infectious arthritis are the knee, hip, shoulder, ankle, and wrists. Damaged joints are more vulnerable to infection.
Common bacterial causes of infectious arthritis include Neisseria gonorrhoeae and Staphylococcus aureus. Some joint infections may be caused by more than one organism.
Joint injuries. Joint injuries can result in painful, swollen joints and stiffness. Sometimes, joint pain can be caused by injured or torn muscles, tendons, and ligaments surrounding the joint, bursitis, tendinitis, dislocations, strains, sprains, and fractures.
What Is Joint Inflammation?
When you think of arthritis, you’re probably thinking of inflammation. Inflammation is a process in which your body's white blood cells and immune proteins help protect you from infection and things like bacteria and viruses.
In some diseases, your immune system triggers an inflammatory response when there isn’t anything to fight off. With these diseases, called autoimmune diseases, your body's immune system damages its own tissues. Your body responds as if normal tissues need to be fought off.
Symptoms of Joint Inflammation
Symptoms of swollen joints include:
- Deep, aching pain
- May feel warm to touch
- Inability to move them normally
Often, you’ll have only a few of these symptoms.
Inflammation may also have general flu-like symptoms including:
- Fatigue/loss of energy
- Loss of appetite
- Stiff muscles
Causes of Joint Inflammation
When you have inflammation, your body releases chemicals into your blood or affected tissues. These chemicals boost blood flow to an area of injury or infection and may cause redness and warmth. Some of the chemicals cause fluid to leak into your tissues, and that can bring on swelling. This process may trigger your nerves and cause pain.
Results of Joint Inflammation
More blood flow and the release of these chemicals attract white blood cells to the sites of inflammation. The higher number of cells and inflammatory chemicals in your joint can cause irritation, wearing down of cartilage (cushions at the end of bones), and swelling of your joint lining (synovium).
Diagnosing Joint Inflammation
Diagnosis of inflammatory joint diseases consists of all or some of these exams:
- Medical history and physical exam, focusing on which joints are involved
- Evaluation of other symptoms besides joint symptoms
- X-rays, blood tests, and other studies
Treating Joint Inflammation
Treatments for inflammatory joint diseases include medications, rest, exercise, and surgery to correct joint damage. Your treatment will depend on several things including the type of disease, your age, the type of medications you’re taking, your overall health, your medical history, and how severe your symptoms are.
The goals of treatment are to:
- Treat the disease that’s causing your inflammation
- Relieve pain with medication and by changing your activities
- Maintain joint movement, muscle strength, and overall function with physical therapy and exercise
- Lessen stress on your joints by using braces, splints, or canes as needed
Not all swollen joints are treated the same way. Treatment for swollen joints depends on the problem or diagnosis.
For example, steroid medications taken orally for a short period of time may be effective in reducing painful, swollen joints. Steroids block the production of inflammatory chemicals in the body.
Injecting an anti-inflammatory drug such as a steroid into a joint is another treatment method. The injection goes directly into the swollen joint -- the source of inflammation and pain. Injections usually give the patient temporary but rapid relief of joint swelling and pain. Fluid removal is part of this procedure in most circumstances.
For inflammatory types of arthritis such as RA, psoriatic arthritis, and ankylosing spondylitis, treatment may include NSAIDs, steroid medications, and the newer types of drugs that affect the immune system. These include the disease-modifying anti-rheumatic drugs (DMARDs), biologic agents such as tumor necrosis factor inhibitors, and enzyme inhibitors, which can block the proteins that cause inflammation.
Acute gout can be treated with a medicine called colchicine. This prescription drug eases swollen joints, pain, and inflammation caused by the crystal deposits in the joint. NSAIDs may also help decrease pain and swelling. Sometimes, stronger painkillers are needed.
Swollen joints and pain from infectious arthritis are treated with antibiotics to stop the infection. Sometimes, surgery may be needed to allow drainage of infected material.
Joint Inflammation Medication
Many drugs are available to ease joint pain, swelling, or inflammation and hopefully to keep your inflammatory disease from getting worse. These medications include:
- Anti-inflammatory pain relievers (NSAIDs such as aspirin, ibuprofen, or naproxen)
- Corticosteroids (such as prednisone)
- Other medications including chemotherapy drugs, disease-modifying treatments, biologic therapy, and narcotic pain relievers. Some of these medications treat other conditions, such as cancer and inflammatory bowel disease, or they prevent organ rejection after transplants. But your doctor can prescribe them to help treat your symptoms. Your dose or side effects may be different. But these are strong medications, and your doctor will want to keep a close eye on you while you take them.
If you’re taking any prescription drug, it’s important to meet with your doctor regularly so they can check how well it’s working and whether you have any side effects.
Can Inflammation Affect Internal Organs?
Inflammation can affect your organs as part of an autoimmune disorder. The symptoms depend on which organs are affected. For example:
- Inflammation of your heart (myocarditis) may cause chest pain or fluid retention.
- Inflammation of the small tubes that bring air to your lungs (bronchiolitis) may cause shortness of breath.
- Inflammation of your kidneys (nephritis) may cause high blood pressure or kidney failure.
- Inflammation of your eye (iritis or uveitis) may cause pain or vision problems.
- Inflammation of your muscles (polymyositis) may cause achiness or weakness.
- Inflammation of your blood vessels (vasculitis) may cause rash, headaches, or internal organ damage.
Pain may not be a main symptom because many organs don’t have nerves that sense pain.
Preventing Joint Inflammation
You can lower your risk of getting inflammation by making some changes in your daily life. These include:
- Keep a healthy weight.
- Exercise regularly.
- Don’t smoke.
- Eat a healthy diet with lots of fruits, vegetables, and omega-3 fatty acids.