Arthritis

Arthritis is a catch-all word for more than 100 conditions that cause joint pain, swelling, and stiffness. The label hides an important fact: the three types older adults encounter most often are separate diseases with separate treatments. Osteoarthritis comes from decades of wear on cartilage. Rheumatoid arthritis is an autoimmune condition in which the body attacks its own joints. Gout is a metabolic problem in which uric acid crystals collect in a joint and set off sudden attacks. A drug that helps one can be useless or harmful for another.

The distinction matters because the most common form, osteoarthritis, responds best to things that are easy to underrate: regular movement, weight management, and physical therapy. The inflammatory forms, by contrast, now have drugs that can change the course of the disease if started early. Sorting out which one you have is the first step, and it usually takes a doctor rather than a guess.

Nearly half of adults 65 and older report doctor-diagnosed arthritis, so if your joints ache, you are in ordinary company. That does not mean the pain is untreatable or that stiff joints are simply the price of getting older.

Three different diseases#

Osteoarthritis (OA) is by far the most common. Cartilage, the smooth cushion on the ends of bones, thins and roughens over years, so bones move against each other with less padding. It usually shows up in the knees, hips, hands, and spine, comes on gradually, and tends to hurt more with use and after periods of rest. About 33 million US adults have osteoarthritis, making it the leading arthritis subtype ².

Rheumatoid arthritis (RA) is an autoimmune disease. The immune system inflames the lining of joints, most often the small joints of the hands and feet, and it usually strikes the same joints on both sides of the body. Morning stiffness that lasts more than an hour is a hallmark, and untreated RA can damage joints permanently and affect the eyes, lungs, and heart. An analysis of insurance claims estimated that about 1.3 million US adults had RA in 2014 ⁹, and roughly three in four people with RA are women ¹⁰.

Gout is caused by too much uric acid in the blood, which can crystallize in a joint. The classic first attack is a red, hot, exquisitely painful big toe that flares over hours, often at night. Gout affected about 3.9 percent of US adults, roughly 9.2 million people, in the 2015-2016 national health survey, and it is more common in men ¹¹. Left unmanaged, repeated attacks can damage joints and deposit lumps of crystals called tophi under the skin.

Sources for this section: [2] [9] [10] [11]

How common arthritis is#

Arthritis becomes more common with each decade. In the 2019-2021 National Health Interview Survey, 21.2 percent of all US adults (about 53 million people) reported doctor-diagnosed arthritis, but the share rose sharply with age ¹.

Arthritis is also more common alongside other conditions. Among older adults with heart disease, diabetes, or obesity, more than half also have arthritis ¹. It is a leading reason older adults limit activity, which is part of why staying active with the right kind of exercise matters so much.

Sources for this section: [1]

Getting a diagnosis#

Osteoarthritis is usually diagnosed from the pattern of symptoms and a physical exam, sometimes with an X-ray to confirm joint-space narrowing. Imaging and symptoms do not always match: some people with severe changes on film have little pain, and some with mild changes hurt a great deal.

Rheumatoid arthritis is diagnosed with blood tests (rheumatoid factor and anti-CCP antibodies), markers of inflammation, and the joint pattern. Because early treatment protects joints, a suspected case is worth a prompt referral to a rheumatologist. Gout can be confirmed by drawing fluid from an inflamed joint and finding uric acid crystals under a microscope, which is the most certain test; a blood uric acid level supports the diagnosis but can be normal during an attack.

What helps osteoarthritis#

There is no drug that regrows cartilage. The goal is to reduce pain and keep the joint working, and several approaches have real evidence behind them.

Exercise is first-line treatment, not an optional extra. The American College of Rheumatology and Arthritis Foundation guideline strongly recommends it for hand, hip, and knee osteoarthritis, and gives tai chi the same strong recommendation ¹². Tai chi slightly improves knee and hip pain and function, and the benefit lasts at least 24 weeks ¹³. A 2024 Cochrane review pooled 139 trials with more than 12,000 people and found that land-based exercise probably reduces knee osteoarthritis pain and improves function in the short term, though average gains were modest, around 9 to 13 points on a 100-point scale ³. Strengthening the muscles around a joint, gentle range-of-motion work, and low-impact aerobic activity such as walking, cycling, or water exercise all help. The details of building a routine safely are covered in exercise for seniors, and because painful joints raise the risk of falling, the balance work in fall prevention is worth adding.

Weight loss changes the mechanics directly. In a study by Messier and colleagues, each pound of body weight lost took roughly four pounds of load off the knee with each step ⁴. Over a day of walking, that adds up. The same guideline strongly recommends weight loss for people with knee or hip osteoarthritis who are overweight or obese ¹², and even a 5 percent loss noticeably improves knee and hip pain ¹³; nutrition for seniors covers doing this without shortchanging protein or nutrients.

Weight-loss medication has also been tested directly against knee osteoarthritis pain. In a 68-week randomized trial published in 2024 and funded by the manufacturer, adults with obesity and moderate knee osteoarthritis who took weekly semaglutide alongside diet and activity counseling lost 13.7 percent of their body weight, versus 3.2 percent with placebo, and their knee pain scores fell by 41.7 points versus 27.5 on a 100-point scale ¹⁴. More semaglutide users than placebo users stopped treatment because of side effects, most often stomach and digestive problems (6.7 percent versus 3 percent) ¹⁴.

Physical therapy teaches specific exercises, gait adjustments, and the use of braces or supportive shoes. It is often more effective than a general instruction to "stay active" because it targets the affected joint.

Medications involve more tradeoffs for older adults. Acetaminophen (Tylenol) is gentle but modest in effect. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen work better for many people but raise the risk of stomach bleeding, kidney problems, higher blood pressure, and fluid retention, and those risks grow with age and with other medications. Geriatric prescribing guidance (the American Geriatrics Society Beers Criteria) urges caution with long-term NSAID use in older adults. Topical NSAID gels applied to the skin over a joint deliver less drug to the rest of the body and are often a safer starting point for knee or hand osteoarthritis. Duloxetine, an antidepressant that also dampens pain signals, helps some people.

Injections offer short-term help with honest limits. A corticosteroid (cortisone) injection can calm a flared joint for a few weeks to a few months, but repeated injections into the same joint are used sparingly because of concerns about cartilage over time. Hyaluronic acid injections (sometimes called gel or viscosupplementation) have mixed evidence; some guidelines recommend against them for the knee because trials have not consistently shown benefit beyond placebo ¹³. The American College of Rheumatology also recommends against platelet-rich plasma and stem cell injections, which have safety concerns and no demonstrated benefit ¹³. It is reasonable to ask a doctor what a given injection is likely to do and for how long.

Joint replacement is worth considering when pain and loss of function persist despite the steps above. Modern knee and hip replacements are among the more reliable operations in medicine. Most implants last decades, and roughly 8 in 10 people are satisfied after knee replacement, with hip replacement satisfaction typically higher still ⁸. The 1 in 5 who are less satisfied after knee surgery often had expectations the operation could not meet, so a frank conversation with a surgeon about the likely result matters. Recovery takes months of rehabilitation, and planning the home for it connects to home modifications and the broader goal of aging in place.

Note: New or worsening joint pain with fever, or a single hot and swollen joint, can signal an infected joint or a gout attack rather than ordinary arthritis. Both need prompt medical attention.

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Treating rheumatoid arthritis#

Rheumatoid arthritis treatment has changed the outlook for the disease. The strategy, called treat-to-target, means starting medication early, measuring disease activity regularly, and adjusting drugs until inflammation is in remission or close to it ⁶.

The usual first drug is methotrexate, a disease-modifying antirheumatic drug (DMARD) taken weekly, often alongside folic acid to reduce side effects ⁶. When methotrexate alone does not control the disease, doctors add or switch to biologic drugs (such as TNF inhibitors) that target specific parts of the immune system, or to targeted synthetic drugs called JAK inhibitors taken as pills. JAK inhibitors carry a boxed warning about blood clots, heart problems, and cancer, which weighs more heavily in adults over 65, so the choice is individualized. Controlling RA well also lowers the inflammation that can affect the heart and other organs.

Sources for this section: [6]

Managing gout#

Gout is one of the more manageable forms of arthritis once it is understood as a uric acid problem. Treatment has two parts. During an acute attack, doctors calm the inflammation with an NSAID, colchicine, or a corticosteroid ⁷. To prevent future attacks, a urate-lowering drug (most often allopurinol) is taken daily and adjusted until blood uric acid falls below about 6 mg/dL, which over time dissolves the crystal deposits ⁷.

Diet helps at the margins. Cutting back on alcohol (especially beer), sugary drinks, and organ and red meats can lower uric acid somewhat, and weight loss reduces gout flares ⁷, but for many people diet alone is not enough, and urate-lowering medication is what ends the cycle of attacks. Blood pressure treatment can interact with gout: for people who take the diuretic hydrochlorothiazide, the American College of Rheumatology guideline advises switching to losartan when possible ⁷.

Sources for this section: [7]

Supplements and complementary approaches#

Glucosamine and chondroitin are among the most-used joint supplements. The large NIH-funded GAIT trial found that, overall, they worked no better than placebo for knee osteoarthritis pain, though a subgroup with moderate to severe pain saw some benefit from the combination ⁵. The American College of Rheumatology guideline recommends against glucosamine, alone or with chondroitin, because trials without industry funding show no improvement in knee or hip osteoarthritis ¹³. They appear safe, so a time-limited trial is low-risk, but expectations should be modest.

Turmeric (curcumin) has small trials suggesting standardized extracts may ease knee pain about as well as an anti-inflammatory drug over a few weeks, though the studies are short and the products vary; the spice in food does not deliver the doses studied. Fish oil has better evidence in rheumatoid arthritis than in osteoarthritis. Any supplement can interact with prescription drugs, so it is worth telling your doctor what you take.

Sources for this section: [5] [13]

Aids for daily life#

Small tools reduce strain on painful joints. Jar openers, built-up utensil handles, long-handled reachers, and shoe horns spare the hands and back. A cane held in the hand opposite a bad hip or knee offloads the joint. Raised toilet seats, grab bars, and lever door handles reduce the force joints must generate. An occupational therapist can suggest aids matched to your specific joints, and many are inexpensive. Persistent joint pain also wears on mood and sleep, which is why arthritis often overlaps with the topics in mental health in older adults; untreated pain and low mood tend to worsen each other.

Most arthritis care is outpatient, and Medicare Part B covers doctor visits, physical therapy, and medically necessary injections and surgery, though it does not cover most over-the-counter supplements or aids. Because inflammation and inactivity are linked to other conditions of aging, including bone loss covered in osteoporosis and the risk factors discussed in dementia and Alzheimer's disease, keeping joints working is part of staying generally healthy, not a separate project.

RetiredWiki. (2026, July 18). Arthritis. https://retiredwiki.com/article/arthritis