Inflammatory arthritis: just how common is it and what are the different types?

Inflammatory arthritis, as the name indicates, causes joint and tissue inflammation, and should be treated promptly in order to avoid the condition becoming a debilitating one. It is extremely common and there are a variety of different forms. 

In our latest article, revered consultant rheumatologist, Dr Robert Marshall, reveals just how common inflammatory arthritis is, how it should be treated, as well as what foods patients should consume in order to help reduce inflammation.

How common is inflammatory arthritis?

There are probably over 200 different forms of arthritis and by far the most common is osteoarthritis. Although it is an over-simplification, osteoarthritis is often thought to be a wear and tear phenomenon, as a direct consequence of ageing. It is more complex than that, however, as we know that other factors (such as genetics) play a big part.

On the other hand, many of the other types of arthritis are auto-immune problems, where the body’s immune system malfunctions and starts to cause inflammation in and around the joints. Inflammatory arthritis is essentially an ‘umbrella term’ that is used to describe these forms of arthritis.

The most common form of inflammatory arthritis is rheumatoid arthritis (RA), which affects approximately one in 50 to one in 100 people. Other types of inflammatory arthritis include psoriatic arthritis, and axial spondyloarthropathy. Both of these kinds of inflammatory arthritis are somewhat less common than rheumatoid arthritis. We know that the chances of getting different types of arthritis depends on your age, sex, family history, and ethnicity.

Can inflammatory arthritis be cured?

‘Cure’ is a word that many doctors don’t use. To me, it conjures up images of a magician’s wand, or a magic potion that you swallow, and all of your problems suddenly disappear. A small proportion of people (about 10%) who develop inflammatory arthritis find that it goes away on its own within six months, without the need for any treatment.

For the majority of other people, though, it is unfortunately persistent. It tends to vary day to day in severity, and move around in terms of the joints affected. However, modern medicine has given us some remarkable medications that are highly effective in controlling arthritis. Rheumatologists are not only experts in diagnosing the different types of arthritis, but also in the use of medications to treat them.

Which non-surgical treatments should be tried?

At a simple level, non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can help. However, many patients benefit from the use of disease-modifying anti-rheumatic drugs (DMARDs), including the newer, more complex, and more expensive biologic drugs. It is important not to forget, too, that exercise and physiotherapy is almost always a good idea.

When is surgery a good idea?

Despite the medicines that we have available, sometimes the arthritis causes severe damage to the joints. Equally, as the ageing process takes over, osteoarthritis can also develop. When someone’s symptoms are not adequately controlled with medication, then surgical options (such as joint replacement) may be recommended. Rheumatologists usually work closely with orthopaedic surgeons to decide when the time is right.

What foods do you recommend to help reduce inflammation?

There is a huge amount of information available – particularly on the internet - but a lot of it is based on speculation rather than proper scientific studies. It is actually extremely difficult to study the effects of diet on arthritis in an accurate way, particularly as arthritis symptoms tend to vary from one day to the next.

The most important things are to maintain a healthy weight, avoid excess alcohol, and definitely not to smoke (there is very good evidence that smoking is bad for arthritis). Eating plenty of fresh fruit and vegetables, and avoiding processed foods, is good advice.

There is also some evidence (albeit relatively weak) that the so-called “Mediterranean diet” (that includes fresh fruit and vegetables, olive oil, nuts, and fish) may be beneficial, but the take-home message is just to eat a healthy, home-cooked, balanced diet.

Dr Robert Marshall is a highly experienced Bristol-based consultant rheumatologist who specialises in conditions such as inflammatory arthritis, amongst many other arthritis-related conditions. Schedule a consultation with him today via his Top Doctors profile.