Arthritis: Non-inflammatory vs Inflammatory
While symptoms can overlap, the treatment for non-inflammatory vs inflammatory arthritis is very different. Non-inflammatory sources of pain can be managed by non-rheumatology health care providers. Inflammatory arthritis patients benefit from rheumatology care.
This is the most common form of arthritis and it is considered a non-inflammatory form of arthritis. Most of the population over age 50 either have or will go on to get osteoarthritis. Osteoarthritis is commonly associated with aging, obesity, and prior joint injury or damage. The primary symptoms of osteoarthritis are joint pain, stiffness and joint restriction. There is no medication that stops or slows the progression of joint damage from osteoarthritis. Osteoarthritis patients do not benefit from rheumatology care and can be managed by a primary care provider with a focus on symptom relief.
With inflammatory arthritis, the body's immune system is causing inflammation, which can lead to joint damage. Patients with inflammatory arthritis present with inflammation of the lining of the joints, and soft, squishy, often warm or red swelling over the joints. Patients with inflammatory arthritis may have significant morning stiffness, lasting more than 30-60 minutes. Inflammatory arthritis patients benefit from rheumatology care.
Rheumatoid arthritis is the most common form of autoimmune inflammatory arthritis, affecting about 1% of the population. It is an autoimmune disease in which the body’s immune system attacks the lining of the membranes that surround joints. It causes chronic inflammation which can results in joint pain, swelling and stiffness. The joint swelling is usually squishy and warm involving the small joints. Larger joints such as elbows, shoulders, hips, ankles and knees can be involved.
Rheumatoid arthritis can also cause inflammation in internal organs, blood vessels, nerves and skin. Untreated patients have shorter life expectancy and higher risk for cardiovascular disease and lymphoma. Rheumatoid arthritis patients benefit from rheumatology care.
This form of autoimmune inflammatory arthritis can occur in patients with psoriasis or in some cases, without psoriasis but usually have a family history of psoriasis. Patients with a parent, child, or sibling with psoriasis are much more likely to develop psoriatic arthritis. Psoriatic arthritis can present with different patterns of joint involvement, often with asymmetric joint involvement. Psoriatic arthritis can also cause inflammatory back pain. Some of the treatments used to treat psoriatic arthritis can also help with psoriasis. Psoriatic arthritis patients benefit from rheumatology care.
Inflammatory back pain
Back pain is a common complaint in the general population. About 80% of the population develops back pain at some point. Patients with ankylosing spondylitis and axial spondyloarthritis present with inflammatory back pain. Inflammatory back pain usually starts before age 45. Inflammatory back pain causes chronic back pain and does not start abruptly as with injury. Inflammatory back pain patients benefit from rheumatology care.