What is arthritis?
Arthritis is inflammation of a joint, but the word covers conditions with very different causes. Rheumatoid arthritis is autoimmune: the immune system attacks the joint lining, typically affecting the small joints of both hands and feet symmetrically, with stiffness that lasts more than an hour each morning. Osteoarthritis is degenerative, affecting knees, hips and hands, with brief morning stiffness and pain that worsens with use.
Gout, psoriatic arthritis, reactive and post-viral arthritis, and arthritis associated with lupus each behave differently again. Because the treatments diverge completely — and because inflammatory arthritis erodes bone within the first two years — establishing which one is present is the first job of the consultation.
Symptoms to watch for
- Pain, swelling or warmth in one or more joints
- Morning stiffness lasting more than 30 to 60 minutes (suggests inflammation)
- Symmetrical involvement of small joints of the hands, wrists or feet
- A sudden, intensely painful, red big toe or ankle (suggests gout)
- Reduced grip strength or difficulty with buttons, taps and jar lids
- Fatigue, low-grade fever or unintended weight loss
- Skin rash, psoriasis, mouth ulcers, dry eyes or eye redness alongside joint pain
When to seek urgent care
A single hot, swollen, extremely painful joint with fever may be a septic joint and needs same-day assessment.
How it is diagnosed
Investigation is chosen to answer a specific question rather than as a blanket screen. For arthritis that usually means:
- Detailed history of pattern, timing and duration of stiffness, and joint examination with a formal joint count
- Inflammatory markers (ESR, CRP) and full blood count
- Rheumatoid factor and anti-CCP antibodies for rheumatoid arthritis
- Serum uric acid, and joint fluid analysis for crystals where gout or infection is suspected
- ANA and extended antibody panels where connective tissue disease is suspected
- X-rays for erosion and joint space, with ultrasound or MRI to detect early synovitis
Treatment options at Siva Sakthi
Which of these applies to you depends on what the assessment shows. The options are discussed with you, including what each involves and what recovery looks like.
- Disease-modifying drugs (DMARDs)Methotrexate, sulfasalazine, hydroxychloroquine and leflunomide suppress the autoimmune process itself and are started early in inflammatory arthritis to prevent erosion.
- Biologic and targeted therapyWhere conventional DMARDs are insufficient, biologic agents or targeted synthetic drugs are considered, with screening and monitoring.
- CorticosteroidsShort courses or intra-articular injection settle a flare while longer-term treatment takes effect; long-term use is minimised.
- Analgesia and anti-inflammatoriesNSAIDs and analgesics control symptoms but do not alter the disease, so they supplement rather than replace DMARDs.
- Gout managementAcute attacks are treated, then urate-lowering therapy is titrated to a target serum uric acid to prevent recurrence and tophi.
- Osteoarthritis careWeight management, structured exercise, physiotherapy, topical and oral analgesia, injections, and orthopaedic referral when appropriate.
- MonitoringRegular disease-activity scoring and blood monitoring for medication safety, with treatment adjusted at each review.
Common questions
Morning stiffness lasting over an hour, swelling you can see, symmetrical small joint involvement, and pain that improves with movement rather than worsening all point toward inflammation. Blood tests and imaging confirm it.
Many people with rheumatoid arthritis achieve low disease activity or remission and continue on a reduced regimen. Some can taper carefully under supervision. Stopping abruptly commonly causes a flare.
It is the most established DMARD and is used with weekly dosing, folic acid supplementation and regular blood monitoring for liver and blood counts. Side effects are checked for at every review.
Diet helps in gout, where reducing alcohol, red meat and sugary drinks lowers uric acid, and weight loss reduces load in knee osteoarthritis. No diet replaces disease-modifying treatment in rheumatoid arthritis.
Book a consultation in Guntur
Arthritis is assessed and treated by Dr. Deepika Ponnuru, MD (Internal Medicine), DM (Rheumatology), at our Kothapeta clinic. Request an appointment or call +91 00000 00000.