Arthritis: Types, Symptoms, Diagnosis and Treatment Options in Ludhiana
Arthritis: Types, Symptoms, Diagnosis and Treatment Options in Ludhiana
Joint pain is not always a sign of ageing. If your knees hurt when you climb stairs, your hips feel stiff after sitting, or your fingers remain swollen or stiff in the morning, arthritis could be one possible explanation. But arthritis is not a single disease, and not every type of joint pain requires the same treatment.
Some forms of arthritis gradually affect the cartilage and other structures within a joint. Others develop because the immune system causes inflammation. Identifying the type of arthritis is important because the right treatment may range from exercise and medication to joint-preserving procedures or joint replacement. [1,2]
If you are looking for an orthopaedic surgeon in Ludhiana, understanding your symptoms and the available treatment options is a useful first step towards making an informed decision.
What Is Arthritis?
Arthritis is a broad term for conditions that cause problems in the joints, often resulting in pain, stiffness, swelling and reduced movement. It can affect one joint or several joints and may interfere with activities such as walking, climbing stairs, getting up from a chair or gripping objects. [1]
The two important categories to understand are osteoarthritis and inflammatory arthritis. Although their symptoms can overlap, their underlying mechanisms are different.
1. Osteoarthritis (OA): When Joint Tissues Change Over Time
Osteoarthritis is one of the most common forms of arthritis. It involves changes in the entire joint, including cartilage, underlying bone and surrounding tissues. It is not simply the result of cartilage wearing away.
OA commonly affects the knees, hips and hands. Symptoms may develop gradually and fluctuate over time. Pain often increases with activity, while stiffness after rest is usually relatively brief. Some people also experience swelling, tenderness or a grating sensation during movement. [2,3]
Several factors can contribute to osteoarthritis, including:
- Increasing age.
- Previous joint injuries or surgery.
- Excess body weight, particularly for weight-bearing joints.
- Joint alignment or structural abnormalities.
- Family history and other individual risk factors.
Osteoarthritis can affect younger adults too, particularly following an injury or when there are underlying structural problems.
The important point: An X-ray showing osteoarthritis does not automatically tell you how much pain you should experience. Treatment decisions should consider your symptoms, physical examination and the effect on your daily life. [2]
2. Rheumatoid Arthritis (RA): When the Immune System Attacks the Joints
Rheumatoid arthritis is a chronic autoimmune disease. The immune system mistakenly attacks the lining of the joints, causing inflammation that can eventually damage cartilage and bone.
RA frequently affects the small joints of the hands and feet, although other joints can also be involved. It often affects joints on both sides of the body. Common symptoms include persistent swelling, tenderness, prolonged morning stiffness and fatigue. [4]
Unlike typical osteoarthritis, rheumatoid arthritis is not primarily a mechanical problem. Early diagnosis and treatment with appropriate disease-modifying medication can help control inflammation and reduce the risk of permanent joint damage. [4,5]
If rheumatoid arthritis is suspected, assessment by a rheumatologist is important. An orthopaedic surgeon may also be involved when structural damage, deformity or a need for surgical treatment develops.
3. Other Forms of Inflammatory Arthritis
Not all inflammatory arthritis is rheumatoid arthritis. Other conditions can cause joint inflammation and require different approaches to diagnosis and treatment.
Examples include:
- Psoriatic arthritis: An inflammatory condition associated with psoriasis in some people. It can affect joints, fingers, toes and the areas where tendons attach to bone.
- Gout: Caused by the deposition of urate crystals in joints. It can produce sudden episodes of severe pain, redness and swelling, often affecting the big toe.
- Axial spondyloarthritis: An inflammatory condition that commonly affects the spine and joints around the pelvis, causing persistent back pain and stiffness. [1,6]
A hot, red, swollen joint, particularly when accompanied by fever or feeling unwell, requires urgent medical assessment because a joint infection can sometimes resemble inflammatory arthritis.
Knee Osteoarthritis: Why Does the Pain Keep Returning?
The knee is one of the joints most commonly affected by osteoarthritis. Early symptoms may appear during activities that place greater demands on the joint, such as climbing stairs, walking longer distances, squatting or standing up after sitting.
As symptoms progress, knee pain may begin to affect routine activities. Some people experience swelling, reduced bending, stiffness after rest or difficulty walking comfortably.
Knee osteoarthritis does not progress at the same rate in everyone. Treatment depends on the severity of symptoms, the joint’s structure, overall health and how much daily function has been affected. [2,7]
Management may include strengthening exercises, physical activity adapted to the person’s ability, weight management when appropriate and medication for symptom relief.
For selected patients, joint-preserving approaches may also be considered. In advanced cases where pain and functional limitations remain substantial despite appropriate non-surgical treatment, knee replacement may be an option.
Hip Arthritis: Symptoms That May Be Mistaken for Back Pain
Hip osteoarthritis can cause pain in the groin, upper thigh or buttock. Some people experience discomfort that travels towards the knee. Stiffness may make it difficult to put on socks and shoes, get into a car or rotate the leg.
Because hip pain can overlap with symptoms arising from the lower back or other structures, identifying its source is important.
Assessment may include examining hip movement, walking pattern and the relationship between symptoms and activity. Imaging may be useful when the diagnosis is uncertain or when it will help guide treatment.
When hip osteoarthritis substantially affects quality of life and non-surgical management is no longer effective or suitable, hip replacement may be considered. [2,8]
How Is Arthritis Diagnosed?
There is no single test that diagnoses every type of arthritis. Evaluation generally begins with the patient’s symptoms, medical history and a physical examination.
Depending on the suspected condition, assessment may include:
- Joint examination: To assess tenderness, swelling, warmth, movement and functional limitations.
- X-rays: To assess joint-space changes, bone changes, alignment and structural damage.
- Blood tests: To investigate suspected inflammatory arthritis. Tests may include inflammatory markers, rheumatoid factor or anti-CCP antibodies.
- Additional investigations: Ultrasound, MRI or joint-fluid analysis may be appropriate in selected cases.
Blood tests alone cannot confirm or exclude every form of inflammatory arthritis. Similarly, imaging findings must be interpreted alongside the clinical picture. [3,5,6]
Arthritis Treatment: From Joint Preservation to Joint Replacement
Arthritis treatment should match the underlying condition. A treatment suitable for osteoarthritis may not be appropriate for rheumatoid arthritis, where controlling immune-driven inflammation is essential.
Non-surgical treatment
For osteoarthritis, treatment commonly begins with an individualised exercise programme, strengthening, activity modification and weight management when appropriate. Medication may help control symptoms, depending on the person’s medical history and other risk factors. [2,7]
For rheumatoid and other inflammatory arthritis, treatment may require specialist medication to control inflammation and reduce the risk of joint damage. Early treatment is particularly important in rheumatoid arthritis. [5]
PRP for knee osteoarthritis
Platelet-rich plasma (PRP) is prepared from a patient’s own blood and contains concentrated platelets and associated biological mediators. It is used in some settings as an injection-based treatment for knee osteoarthritis.
Research suggests that PRP may improve pain and function in some patients, but results vary. Preparation methods, the number of injections, patient selection and the quality of available evidence differ. Its potential benefits, limitations and costs should be discussed before treatment. [9]
Read more about [PRP Treatment for Knee OsteoarthritisPRP treatment for knee pain]
Joint preservation
Joint preservation refers to approaches intended to maintain the function prolong pain free status of the natural joint and, where appropriate, address factors contributing to abnormal loading or damage.
Depending on the diagnosis, this may involve rehabilitation, weight management, selected injections or procedures that address joint alignment. Not every patient is suitable for every approach, and joint preservation cannot reverse all established structural damage.
When is joint replacement necessary?
Knee or hip replacement may be considered when arthritis causes substantial pain, stiffness or functional limitation and appropriate non-surgical treatments have not provided sufficient relief or are unsuitable. The decision should be based on symptoms, clinical assessment, overall health and the patient’s goals, rather than an X-ray alone. [2,8]
Joint replacement is not automatically the next step when arthritis is diagnosed. Equally, patients should not have to live indefinitely with severe limitations if surgery is an appropriate option.
When Should You See an Orthopaedic Surgeon in Ludhiana?
Consider a clinical assessment if joint pain keeps returning, stiffness limits movement, swelling persists or walking and other everyday activities are becoming difficult.
Seek urgent medical attention if a joint becomes suddenly hot, red and swollen, particularly if you also have a fever or feel unwell.
Choosing an appropriate specialist depends on the suspected condition. An orthopaedic surgeon in Ludhiana can assess structural joint problems, osteoarthritis, alignment issues and whether a surgical or joint-preserving approach may be appropriate. If symptoms suggest rheumatoid arthritis or another systemic inflammatory condition, referral to a rheumatologist may also be necessary.
At N K Aggarwal Joints & Spine Centre, Ludhiana, an assessment can help establish the likely cause of joint symptoms and identify appropriate options, from non-surgical management to joint preservation or replacement when indicated.
The goal is not simply to treat an X-ray finding. It is to understand what is causing the symptoms, protect joint function where possible and help the patient make an informed decision about the next step.
References
[1] National Health Service (NHS). Arthritis. Available at: NHS: Arthritis
[2] National Institute for Health and Care Excellence (NICE). Osteoarthritis in over 16s: diagnosis and management. NICE Guideline NG226. Published 19 October 2022. Available at: NICE Guideline NG226
[3] National Health Service (NHS). Osteoarthritis. Available at: NHS: Osteoarthritis
[4] National Health Service (NHS). Rheumatoid arthritis. Available at: NHS: Rheumatoid arthritis
[5] National Institute for Health and Care Excellence (NICE). Rheumatoid arthritis in adults: management. NICE Guideline NG100. Available at: NICE Guideline NG100
[6] National Institute for Health and Care Excellence (NICE). Spondyloarthritis in over 16s: diagnosis and management. NICE Guideline NG65. Available at: NICE Guideline NG65
[7] American Academy of Orthopaedic Surgeons (AAOS). Osteoarthritis of the Knee: Clinical Practice Guideline. Available at: AAOS: Osteoarthritis of the Knee
[8] American Academy of Orthopaedic Surgeons (AAOS). AAOS Updates Clinical Practice Guideline for the Management of Osteoarthritis of the Hip. 23 January 2024. Available at: AAOS: Hip Osteoarthritis Guideline Update
[9] American Academy of Physical Medicine and Rehabilitation (AAPM&R). Platelet-Rich Plasma (PRP) for Knee Osteoarthritis: Clinical Guidance. Available at: AAPM&R: PRP for Knee Osteoarthritis