What to Do for Arthritis: A Guide to Symptoms, Causes, and Care

As one of the most common diseases in this country, arthritis affects millions of adults worldwide, according to the Global Rheumatoid Arthritis (RA) Network. Senile arthritis types include osteoarthritis, rheumatoid arthritis, and gout, and they are most common in older people.

Read our arthritis guide for help identifying these common forms of senile arthritis and to learn about care and treatment options.

By simple definition, arthritis is inflammation of one or more joints that is recurrent or chronic. The inflammation can negatively affect all parts of the joint, including the ligaments, cartilage, synovial fluid, and bone. The most common symptoms are pain and stiffness, but the severity and symptoms can vary across each type of arthritis. For some, pain is chronic and constant, while for others, it comes and goes.

The age when arthritis starts is variable. There are over 100 forms of arthritis, with the most common being osteoarthritis and rheumatoid arthritis. So, what type of arthritis is most common in the elderly? It’s osteoarthritis – affecting approximately 50% of people aged 65 and over in the U.S., according to the Centers for Disease Control (CDC).

Osteoarthritis (OA), also known as degenerative joint disease, is the most common type of arthritis among the general population, affecting over 32.5 million U.S. adults, per the CDC. OA starts when the cartilage within a joint begins to break down, causing deterioration of tendons and ligaments and changes in the underlying bone, according to the Cleveland Clinic.

At OA’s worst, all of the cartilage in a joint wears away, leaving bones to rub against each other. OA most commonly affects hands, knees, hips, neck, and lower back, according to theinformation on osteoarthritis provided by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a specialized branch of the National Institutes of Health (NIH).

Also known as wear-and-tear arthritis, OA symptoms can range from occasional stiffness and mild pain to severe joint pain that persists even when you rest or try to sleep. Osteoarthritis can lead to bone spurs, mobility issues, and sometimes disability if your lower back, knees, or hips are affected.

What causes osteoarthritis?

Osteoarthritis is a complex disease and is still the focus of much research. Approximately 80% of adults aged 55 and over show evidence of OA on their X-rays, according to the Cleveland Clinic. Evidence is growing for the role of systemic factors, such as genetics, diet, hormones, and bone density as well as more acute factors like obesity, muscle weakness, and overuse of joints.

Scientists believe the cause of OA can also depend on which part of the body is involved. For example, OA in the hands or hips may be due to genetic factors. OA in the knees can be linked with being overweight or having past injuries. Overuse can also cause OA in joints, especially in the case of long-term occupations which require repetitive movements.

Rheumatoid arthritis (RA) is an autoimmune and inflammatory disease where the immune system attacks healthy cells in the body by mistake, causing chronic inflammation. Since it is systemic, RA typically affects multiple joints at once. RA tends to come and go, with long-lasting inflammation and symptoms known as flares, which can last for days or months at a time.

RA affects more than the joints. In fact, approximately 40% of people with RA experience signs and symptoms that don’t involve the joints. People with RA frequently feel general fatigue and can even experience a low-grade fever. Affected areas can include skin, eyes, lungs, heart, kidneys, salivary glands, nerve tissue, bone marrow, or blood vessels, according to the Mayo Clinic. And, tissue damage done by RA could potentially cause long-lasting or chronic pain, lack of balance, and deformity, according to research by the CDC.

In the early stages of RA, people may not see redness or swelling, but they may experience tenderness and pain, according to a rheumatoid arthritis articleby theArthritis Foundation. Pain, tenderness, swelling, or stiffness that lasts for six weeks or longer could be an early sign of RA. Here are some other early symptoms of RA to watch out for:

• Morning stiffness that lasts for 30 minutes or longer
• Multiple joints affected at once
• The same joints affected on both sides of the body

What causes rheumatoid arthritis?

Doctors can’t pinpoint the exact cause of RA. Like OA, RA seems to be due to a combination of environment and predisposition. However, scientists have certainly been able to identify some risk factors. RA most often begins between the ages of 30 and 50, according to the American College of Rheumatology.

A study done by the Department of Public Health and Department of Medicine Medical College of Ohio showed a clear connection between exposure to environmental toxins and an increased risk of RA. The allergenic environment can confuse the body’s immune system, causing an overreaction of the autoimmune system.

And, women show an increased vulnerability. Rheumatoid arthritis is almost three times more likely to appear in women than men, according to a study published by Women’s Health. Other risk factors include genetics, obesity, and smoking, according to the CDC.

If you can’t control the environment you live or work in, you or your loved one can still lower the chances of developing rheumatoid arthritis by quitting smoking, leading a healthy lifestyle, and taking care of your gums, as periodontal disease can also increase risk, according to the NIAMS.

Gout is a complex yet common form of inflammatory arthritis and one of the most painful. It typically affects one joint at a time, often the big toe joint, according to the CDC. It is common for those with gout to experience a combination of flares and remissions. Affected areas with gout can include the following:

• Joints
• Bursae (cushion-like sacs between tissues)
• Tendon sheaths (membranes surrounding tendons)
• Kidneys

Gout is most often detected in the big toe but also commonly affects the lesser toe joints, ankle, and knee, according to the CDC. A tell-tale sign of gout is a dark red or purple joint that is swollen and very tender. Your doctor might suggest blood tests and X-rays or may want to draw a sample of fluid from your joint while you are having an attack.

What causes gout?

Gout is caused by hyperuricemia, a condition where too much uric acid accumulates in the body, causing crystals of uric acid to form in the connective tissue and joint spaces. These deposits cause swelling, redness, heat, pain, and stiffness in the joint. Gout attacks often follow eating purine-rich foods, like red meat, organ meat, and some kinds of seafood, such as anchovies and sardines, according to the CDC.

Being male, overweight, and having certain health conditions like hypertension, kidney disease, or diabetes are known to increase chances of gout, according to the Mayo Clinic. Drinking alcohol and certain medications can also make gout worse. In older adults, some blood pressure medicines, like diuretics, can also increase the chances of gout, per the CDC.

As mentioned previously, there are many forms of arthritis. Some less common forms of arthritis include psoriatic arthritis, ankylosing spondylitis, and reactive arthritis.

• Psoriatic arthritis. People with psoriasis (inflammation of the skin) can also develop arthritis. Typically, they experience swollen fingers and toes, nail changes, lower back pain, eye inflammation, and inflammation of joints, according to a psoriatic arthritis overview by the NIAMS.
• Ankylosing spondylitis. Mainly affecting the spine, ankylosing spondylitis can cause some of the bones in the spine to fuse over time, according to clinical manifestation research published by UpToDate. Early signs include pain and stiffness in the lower back and hips, especially in the morning or after periods of inactivity.
• Reactive arthritis. Triggered by other infections in the body, reactive arthritis typically targets the knees, ankle, and feet. Signs and symptoms come and go, usually clearing up within a few weeks or months, according to a reactive arthritis overview published by the NIAMS.

Although it’s not a type of arthritis, lupus is known as an arthritic condition because of the chronic inflammation associated with it. Approximately 95% of lupus patients experience arthritis at some point, according to the John Hopkins Lupus Center. If you or your loved one has lupus, be sure to check for symptoms of arthritis as well.

Arthritis can go undetected for years. It’s important to look out for the effects of arthritis on the elderly so that proper treatment and pain-management measures can be undertaken.

Here is a list of common arthritis symptoms, according to the Arthritis Foundation:

• Lasting or recurring joint pain
• Joint swelling
• Joint stiffness
• Tenderness or pain when touching a joint
• Problems using or moving a joint normally
• Warmth and redness in a joint

If you or your loved one experience any of these symptoms for longer than two weeks, consider seeing a doctor or rheumatologist. To make an accurate diagnosis, health care providers may review medical history, examine joints, or order laboratory tests or imaging.

Let our care assessment guide you

Doctors may even perform arthrocentesis, otherwise known as joint aspiration, which is the procedure of removing fluid from a joint. The joint fluid is then used to properly diagnose arthritis and can be used to ease swelling and joint pressure, according to the Cleveland Clinic.

Each kind of arthritis is handled a little differently, but there are some common treatments. Medications are often used for elderly arthritis pain relief.

Although there’s no cure for arthritis, there are many medicines commonly used to treat arthritis pain, per the Arthritis Foundation:

• Topical pain relievers. Medications like capsaicin and lidocaine can be found over the counter to help provide relief for acute arthritis in the elderly, according to a pain management overview by the Arthritis Foundation.
• Acetaminophen. Short-term use of acetaminophen can help alleviate acute symptoms or flares. Be careful to not exceed recommended dosages.
• Antidepressants. Some doctors prescribe antidepressants due to their ability to help curb arthritic pain.
• Opioids. Opioid painkillers are used to treat more severe pain and must be closely monitored by a doctor.
• Steroids. Steroids, such as hydrocortisone or triamcinolone, are often injected into affected joints to provide pain relief.
• Non-steroidal anti-inflammatory drugs (NSAIDs). Short-term use can help alleviate acute symptoms or flares, but those with intestinal complications should be sure to use with caution, according to a study published on NSAIDs and gastrointestinal problems in the scientific journal Current Gastroenterology Reports.
• Disease-modifying antirheumatic drugs (DMARDs). DMARDs may alter the course of some forms of inflammatory arthritis, such as RA. They suppress the immune system to prevent it from attacking the joints.

Some NSAIDs, like ibuprofen and naproxen, are sold without a prescription, while other NSAIDs must be prescribed by a doctor. But, be wary about the side effects of NSAIDs, which can range from nausea and heartburn to dizziness and bloody stools, according to the Cleveland Clinic.

You should always read the warnings on the package or insert that comes with the medicine. Before taking any NSAIDs or acetaminophen for arthritis pain, make sure to consult with your doctor on if and how you should use them.

A doctor may suggest surgery when damage to joints becomes disabling or when other treatments do not help. Surgeons can repair or replace some joints with artificial ones. There are several surgery options, including arthroscopy, joint resurfacing, total joint replacement, and more, according to the Arthritis Foundation. Be sure to discuss all of the available options with a doctor when considering surgery for arthritis.

Learning how to protect and treat your joints is key to natural arthritis care. For example, the right shoes and a cane can help with any worsening pain in the feet, knees, and hips. There is also a market for specially designed gadgets that help seniors open jars and bottles or turn doorknobs with ease. The following lifestyle habits are also key to caring for arthritis:

• Getting plenty of rest
• Exercising
• Eating a healthy, well-balanced diet
• Controlling weight

There are many natural remedies for arthritic pain. Comfort can even be found by applying heat or cold, soaking in a warm saltwater bath, or swimming in a heated pool. Treatments like acupuncture, massage, or meditation have also proven to alleviate some pain and symptoms related to arthritis, according to the Arthritis Foundation.

How dietary changes can help

Diet can either be a protective factor or a risk factor when it comes to arthritis, according to a study published on dietary habits and arthritisin the scientific journal Nutrients. Certain foods are pro-inflammatory and should be limited to once or twice a month, while some foods are anti-inflammatory and should be consumed daily.

Foods to avoid or reduce include the following:

• Red meats
• Sugar
• Alcohol
• Coffee

Foods to consume or increase include the following:

• Fatty fishes (salmon, sardines, trout, etc.)
• Extra-virgin olive oil (daily)
• Whole grains
• Legumes
• Fruits and vegetables (5+ servings daily)
• Dark, leafy greens

How exercise can help

Exercise is a great way to keep the body strong enough to control arthritis symptoms. Daily exercise, as simple as walking or swimming, helps keep the joints moving and lubricated, decreases pain, improves balance, and makes muscles around the joints stronger, according to research on how to ease arthritis pain conducted by the Mayo Clinic.

The Arthritis Foundation also recommends theseforms of exercise to ease arthritic pain:

• Aerobic exercises. Usually done in chest-deep water, water aerobics lessen the impact on joints compared to traditional aerobics.
• Cardio. Cycling or walking can work the muscles in the lower body to help relieve arthritis pain.
• Range-of-motion exercises. Tai chi and yoga both improve flexibility, strengthen muscles, and reduce arthritis stress.
• Strengthening exercises.Weight training will keep or build muscle strength. Strong muscles can help support and protect your joints.

Before trying any methods to ease arthritic pain, always talk to a doctor to help ensure proper care and treatment.

As a caregiver to a senior with arthritis, one of the most important things to remember is to be empathetic and to listen. Make sure your loved one’s concerns are heard and that you help communicate them to a health care provider so arthritis is properly diagnosed and treated.

During the early stages of senior arthritis, it’s important to track symptoms, medications, dietary habits, and physical activity. This information can be used by a doctor to identify patterns of your loved one that may need adjusting.

Other ways to help a senior with arthritis include the following:

• Encourage physical activity. Depending on their capabilities, you could sign them up for exercise classes or simply go on daily walks with them.
• Keep track of their medications and treatment. Help ensure proper care while avoiding the dangers of an overdose. It can also help you see changes in symptoms to identify what works for them.
• Help them eat a well-balanced diet. Incorporate arthritis-friendly, anti-inflammatory foods into their meals, while limiting inflammatory foods that worsen the effects of arthritis.
• Create an arthritis-friendly home environment. Install grab bars and toilet seat risers in the bathroom. Use Velcro instead of buttons. Get them shoehorns to make putting on shoes easier.

If your loved one is experiencing extreme symptoms and can no longer live independently, it may be time to consider other options. If they are still okay to remain in their home but require some day-to-day assistance, home care may be the ideal option for them. In-home caregivers can assist with challenging daily tasks, meal preparation, light housekeeping, medication management, and more. If they can no longer live in their home, an assisted living facility might be the right route for them.

No matter the path you and your loved one choose to take, it’s important to work closely with them and their primary care provider to ensure their arthritis is properly managed.

Sources: 

American College of Rheumatology. (2021, December). Rheumatoid arthritis.

Arthritis Foundation. Acupuncture for arthritis.

Arthritis Foundation. Benefits of Massage.

Arthritis Foundation. Do I have arthritis?

Arthritis Foundation. (2021). Rheumatoid arthritis: Causes, symptoms, treatments and more.

Talk with a Senior Living Advisor

Arthritis Foundation. Types of meditation for arthritis.

Arthritis Foundation. Understand your joint surgery options.

Centers for Disease Control and Prevention. (2021, October 12). Arthritis related statistics.

Centers for Disease Control and Prevention. (2020, July 27). Gout.

Centers for Disease Control and Prevention. (2020, July 27). Osteoarthritis (OA).

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Cleveland Clinic. (2019, November 26). Osteoarthritis.

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Johns Hopkins Lupus Center. (2020). How lupus affects the body: Arthritis.

Khuder, S. A., Peshimam, A. Z., & Agraharam, S. (2002, October 1). Environmental risk factors for rheumatoid arthritis. Reviews on Environmental Health, 17(4).

Mayo Clinic. (2021, November 25). Ankylosing spondylitis.

Mayo Clinic. (2020, December 1). Exercise helps ease arthritis pain and stiffness.

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