How Arthritis Affects Daily Living and Mobility (2024)

How Arthritis Affects Daily Living and Mobility

Arthritis and musculoskeletal (MSK) conditions affect over 17 million people across the UK; of these, over 10 million people have arthritis. That is one in six people living with pain, immobility, disability, reduced dexterity, fatigue and often anxiety, depression or social isolation. These conditions disproportionately affect those who are socially and economically disadvantaged. People who live in the most deprived fifth of society are more likely to report arthritis or a long-term MSK condition compared to those living in the least deprived fifth.

Public Health England (PHE) has reported that there are 9.11 million people living with long-term back pain in England alone, and over 8.75 million people aged 45 and over have sought treatment for osteoarthritis. Conditions such as arthritis are generally not fatal, meaning people can live with them for many years. However, the impact of arthritis is huge for the individual as these conditions can intrude on their everyday life, affecting their ability to work, care for a family, move free from pain and live independently. People with arthritis are 20% less likely to be in work than someone without arthritis, and MSK conditions such as arthritis are responsible for 30 million working days lost each year, causing a substantial impact on the economy.

Living with arthritis isn’t easy and carrying out simple, everyday tasks can often be painful and difficult.

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What is arthritis?

Arthritis is not just one disease alone, it is an umbrella term for more than 100 conditions that affect the joints of the body particularly the wrists, knuckles, hips, knees and ankles. The word arthritis simply means inflammation of the joint. The reasons for that inflammation, however, vary between the different forms. The three most common forms of arthritis are:

Osteoarthritis – this is the most common form of arthritis, affecting millions of people worldwide. It occurs when the protective cartilage that cushions the ends of the bones wears down over time. It is a degenerative disease that most commonly affects joints in the hands, knees, hips and spine, although it can damage any joint. The signs and symptoms of osteoarthritis typically appear more often in individuals over the age of 50, and one third of people over the age of 45 in the UK have sought treatment for osteoarthritis. However, osteoarthritis can affect much younger people, too, especially those who have had a prior joint injury. It typically develops slowly over time, but after such an injury, it can develop much more rapidly, within just a few years. An estimated 5.4 million people in the UK have knee osteoarthritis, and an estimated 3.2 million people in the UK have hip osteoarthritis. Almost all (98%) of initial knee replacements are due to osteoarthritis.

Rheumatoid arthritis – this is an auto-immune disease, meaning that the symptoms such as pain and inflammation are caused by the immune system attacking healthy tissue; in this case, the lining of the joints. Although rheumatoid arthritis can occur at any age, the typical age of onset is around 40–60 years of age, and it affects around 1% of the UK population. Women are more likely than men to develop rheumatoid arthritis. The exact causes of this immune response are unknown, though experts do know that genetics and environmental factors play a part.

Gout – this is a type of inflammatory arthritis that can cause painful swelling in the joints. It typically affects the big toe, but it can also affect other joints in the body. Gout is a common and complex form of arthritis that can affect anyone. Gout occurs when urate crystals accumulate in the joint, causing the inflammation and intense pain of a gout attack. Urate crystals can form when a person has high levels of uric acid in their blood. Certain purine-rich foods, including red meat and organ meats (such as liver), seafood including anchovies, sardines, mussels, scallops, trout and tuna, alcoholic beverages, especially beer, and drinks sweetened with fruit sugar (fructose) promote higher levels of uric acid. Gout occurs more often in men, primarily because women tend to have lower uric acid levels. After menopause, however, women’s uric acid levels approach those of men. Men are also more likely to develop gout earlier in life, usually between the ages of 30 and 50 years, whereas women generally develop signs and symptoms after menopause.

Other forms of arthritis include, but are not limited to:

Spondylarthritis – this describes a number of conditions that cause pain and swelling, mainly around the joints of the spine. In these conditions there is inflammation of small pieces of connective tissues, called entheses. These are tough little cords that join either ligaments or tendons to bones. A type of spondylarthritis is ankylosing spondylitis, which causes pain and swelling, mainly around the joints of the spine. In response to inflammation around the spine, the body can create more of the mineral calcium. This mineral is normally used by the body to make bones strong. However, in ankylosing spondylitis the extra calcium can make new bits of bone grow in the spine, and this will cause pain and stiffness. Ankylosing spondylitis usually occurs between the ages of 20 and 30 years and it is more common among men.

Psoriatic arthritis – this is an auto-immune condition, which is also a type of spondylarthritis. The body’s immune system can cause painful swelling and stiffness within and around the joints, as well as a red scaly skin rash called psoriasis. The rash can affect several places in the body, including the elbows, knees, back, buttocks and scalp. It is also common to have severe tiredness or fatigue. Psoriatic arthritis usually affects people who already have psoriasis. However, some people develop the arthritis before the psoriasis. It’s possible to have the arthritis but no psoriasis at all. This condition can affect people of any age, but tends to affect adults.

Juvenile idiopathic arthritis – this is the term used for anyone diagnosed with inflammatory arthritis before their sixteenth birthday. It typically causes joint pain and inflammation in the hands, knees, ankles, elbows and/or wrists, although it may affect other body parts too.

Systemic lupus erythematosus (lupus) – this is an autoimmune disease. In this disease, the immune system of the body mistakenly attacks healthy tissue. It can affect the skin, joints, kidneys, brain and other organs. It is more common in women than men by nearly 10 to 1, although it may occur at any age. It appears most often in young women between the ages of 15 and 44 years. Whilst symptoms vary from person to person, and may come and go, everyone with systemic lupus erythematosus has joint pain and swelling at some time and some people go on to develop arthritis.

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According to a 2023 report by the charity Versus Arthritis in the UK:

5.4 million people are estimated to have knee osteoarthritis
3.2 million people are estimated to have hip osteoarthritis
450,000 adults have a recorded diagnosis of rheumatoid arthritis
1,600,000 people have recorded diagnoses of gout
90,000 adults are estimated to have psoriatic arthritis
60,000 adults have a recorded diagnosis of axial spondylarthritis
12,000 children have juvenile idiopathic arthritis

Symptoms and variability

Unusual or strenuous physical activities can cause aches and pains in your muscles and joints from time to time; however, there are differences between normal pain and stiffness and the early signs of arthritis. The symptoms of arthritis vary from person to person. But if you have arthritis, you will almost certainly have symptoms relating to your joints, such as:

Pain
Swelling in a joint
Redness and warmth in a joint
Stiffness or reduced movement of a joint

Osteoarthritis symptoms often develop slowly and worsen over time. Signs and symptoms of osteoarthritis include:

Pain – affected joints might hurt during or after movement.
Stiffness – joint stiffness might be most noticeable upon wakening or after being inactive.
Tenderness – joints might feel tender when you apply light pressure to or near them.
Loss of flexibility – you might not be able to move your joint through its full range of motion.
Grating sensation – you might feel a grating sensation when you use the joint, and you might hear popping or crackling.
Bone spurs – these extra bits of bone, which feel like hard lumps, can form around the affected joint.
Swelling – this might be caused by soft tissue inflammation around the joint.

Rheumatoid arthritis is a systemic condition, meaning that it has an effect on the body as a whole, whereas osteoarthritis tends only to affect individual joints. Signs and symptoms of rheumatoid arthritis may include:

Tender, warm, swollen joints
Joint stiffness that is usually worse in the mornings and after inactivity
Fatigue, fever and loss of appetite

Early rheumatoid arthritis tends to affect your smaller joints first, particularly the joints that attach your fingers to your hands and your toes to your feet. As the disease progresses, symptoms often spread to the wrists, knees, ankles, elbows, hips and shoulders. In most cases, symptoms occur in the same joints on both sides of your body. Some sufferers also experience signs and symptoms that don’t involve the joints. Areas that may be affected include:

Skin
Eyes
Lungs
Heart
Kidneys
Salivary glands
Nerve tissue
Bone marrow
Blood vessels

Rheumatoid arthritis signs and symptoms may vary in severity and may even come and go. Periods of increased disease activity, called flares, alternate with periods of relative remission, when the swelling and pain fade or disappear. Over time, rheumatoid arthritis can cause joints to deform and shift out of place.

Gout is characterised by sudden, severe attacks of pain, swelling, redness and tenderness in one or more joints, most often in the big toe. An attack of gout can occur suddenly, often waking you up in the middle of the night with the sensation that your big toe is on fire. The affected joint is hot, swollen and so tender that even the weight of the bedsheet on it may seem intolerable. The signs and symptoms of gout almost always occur suddenly, and often at night. They include:

Intense joint pain – gout usually affects the big toe, but it can occur in any joint. Other commonly affected joints include the ankles, knees, elbows, wrists and fingers. The pain is likely to be most severe within the first four to 12 hours after it begins.
Lingering discomfort – after the most severe pain subsides, some joint discomfort may last from a few days to a few weeks. Later attacks are likely to last longer and affect more joints.
Inflammation and redness – the affected joint or joints become swollen, tender, warm and red.
Limited range of motion – as gout progresses, you may not be able to move your joints normally.

Spondylarthritis is a group of diseases characterised by inflammation in the spine ‘spondylitis’ and joints ‘arthritis’. Symptoms of spondylarthritis vary between patients but may include:

Longstanding low back pain
Back stiffness
Back pain and stiffness are typically worse at night and improve with exercise
Fatigue
Painful swelling of joints
Sausage-like appearance of fingers or toes
Heel pain
Skin and nail changes of psoriasis
Episodes of eye inflammation (uveitis)

Psoriatic arthritis can affect joints on one or both sides of your body. The signs and symptoms of psoriatic arthritis often resemble those of rheumatoid arthritis. Both diseases cause joints to become painful, swollen and warm to the touch. However, psoriatic arthritis is more likely to also cause:

Swollen fingers and toes – psoriatic arthritis can cause a painful, sausage-like swelling of your fingers and toes.
Foot pain – psoriatic arthritis can also cause pain at the points where tendons and ligaments attach to your bones, especially at the back of your heel (Achilles tendinitis) or in the sole of your foot (plantar fasciitis).
Lower back pain – some people develop spondylitis as a result of psoriatic arthritis.
Nail changes – nails can form tiny dents and crumble or separate from the nail beds.
Eye inflammation – uveitis can cause eye pain, redness and blurry vision. If untreated, uveitis can lead to vision loss.

Juvenile idiopathic arthritis can cause persistent joint pain, swelling and stiffness. Some children may experience symptoms for only a few months, while others have symptoms for many years. Like other forms of arthritis, juvenile idiopathic arthritis is characterised by times when symptoms flare up and times when symptoms may be minimal. The most common signs and symptoms of juvenile idiopathic arthritis are:

Pain – while a child might not complain of joint pain, you may notice that they limp, especially first thing in the morning or after a nap.
Swelling – joint swelling is common but is often first noticed in larger joints such as the knee.
Stiffness – the child appears clumsier than usual, particularly in the morning or after naps.
Fever, swollen lymph nodes and rash – in some cases, high fever, swollen lymph nodes or a rash on the trunk may occur, which is usually worse in the evenings.

Systemic lupus erythematosus – no two cases of lupus are exactly alike. Signs and symptoms may come on suddenly or develop slowly, may be mild or severe, and may be temporary or permanent. Most people with lupus have mild disease characterised by episodes called flares, when signs and symptoms get worse for a while, then improve or even disappear completely for a time. The signs and symptoms of lupus that you experience will depend on which body systems are affected by the disease. The most common signs and symptoms include:

Fatigue
Fever
Joint pain, stiffness and swelling
Butterfly-shaped rash on the face that covers the cheeks and bridge of the nose or rashes elsewhere on the body
Skin lesions that appear or worsen with sun exposure
Fingers and toes that turn white or blue when exposed to cold or during stressful periods
Shortness of breath
Chest pain
Dry eyes
Headaches, confusion and memory loss

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Daily challenges

Living with arthritis can be challenging for many people and carrying out everyday tasks that many others take for granted can be difficult for someone with arthritis, such as, but not limited to:

Personal care – raising arms to wash or brush their hair, holding and using a toothbrush or razor, getting into and out of a bath, turning on taps and showers.
Dressing – selecting clothing that is easy to put on and take off; fasteners such as buttons or zips can be problematic for someone with dexterity issues. Putting on socks or tights, even wearing tight clothing can be problematic because the pain in particular joints covered by the clothing can be intense.
Meal preparation – opening tins, bottles or packaging, lifting kitchen equipment such as full kettles, saucepans etc. carrying plates or hot drinks, using kitchen equipment such as knives and graters, reaching into high cupboards or bending to access low cupboards.
Around the home – using household equipment such as vacuum cleaners, dusters etc., opening and closing windows, turning keys in locks.
At work – using work equipment whether office equipment such as a computer keyboard and mouse, industrial hand tools, or accessing ladders, steps or stairs. Even being seated or standing for long periods can exacerbate the condition.

These and many other challenges faced by people living with arthritis can be physically exhausting to carry out and this exhaustion disrupts their daily life. Lack of or disruptive sleep due to pain also contributes to this fatigue which can lead to increased inactivity, loss of muscle mass and weight gain, all of which can make arthritis symptoms worse. Having arthritis can increase a person’s risk of other health problems, such as heart disease, lung disease, diabetes, inflammatory bowel disease and chronic fatigue syndrome, all of which can be associated with fatigue.

Impact on mobility

Mobility can be a problem for those with arthritis especially when there is active inflammation. Because of the nature of arthritis some people have difficulty walking, even for short distances. Others may experience difficulties sitting or standing for long periods. Those with severe rheumatoid arthritis find it particularly hard to get up in the morning, stand for any length of time, get out of chairs or kneel on the floor and find it difficult to get in and out of the bath.

Some people with arthritis find stairs or steps difficult and some people have a fear of falling, particularly if they couldn’t put their hands out to save themselves from a nasty fall or bump.

Driving can be a challenge for someone with arthritis, particularly steering and getting into and out of the vehicle. However, you only need to tell the Driver and Vehicle Licensing Agency (DVLA) about your arthritis if:

It is affecting your ability to drive
You use special controls for driving

Any disabilities you disclose to the DVLA will also need to be disclosed to your car insurance provider; it may make no difference to your insurance premium but may invalidate your policy if not disclosed.

Using public transport can bring its own set of challenges, such as finding it hard to climb on and off buses and trains. Others may find getting around stations or changing platforms a challenge. Being unable to stand for long periods presents problems when unable to get a seat on public transport. Whilst older people may be offered a seat by other passengers, this is seldom the case for younger people with arthritis as the disease is not particularly visible to others.

Arthritis can lead to muscle weakness and atrophy. If a person has weak muscles in a particular area of their body, such as their legs, it can make mobility, walking and running extremely difficult. This not only reduces exercise outdoors but also movement around the house. However, exercise is especially important for people with arthritis. Exercise increases strength, makes moving easier and helps fight tiredness. Even moderate exercise can ease and reduce joint pain and help a person to stay at a healthy weight. Exercises for arthritis might include exercises that put joints through their full range of motion and strengthening exercises. Exercise that raises heart rate, known as aerobic exercise, is also important.

Emotional and social impact

Having arthritis can take people through a range of emotions including:

Shock – feeling surprised at receiving a diagnosis of a chronic disease.
Confusion – feeling unsure what the diagnosis means.
Anger – because aspects of your life have changed. You may feel angry at yourself for being ill or at others for not ‘fixing’ it or giving you more support.
Frustration – because of persistent pain, reduced abilities and loss of control over life.
Anxiety and fear – scared for the present and for what arthritis may bring in the future. This can be especially true if you have known someone who had severe arthritis.
Loss – for things you can’t do anymore.
Isolation – feeling isolated and detached from your family, friends and community when you can’t participate in the same way you used to.
Helplessness – if you have to start relying on others to do things you used to do on your own.
Guilt – at not being able to ‘pull your weight’ around the house or at work due to pain and fatigue.
Jealousy or resentment – of friends or family members who can do things you want to be able to do.
Embarrassment or shame – at reduced mobility or having to ask for help. You don’t want to draw attention to yourself and your reduced abilities or be reliant on others.
Irritability – pain, fatigue, frustration and anxiety can make you irritable.
Stress and tension – physical, financial, relationship and self-image challenges can cause you to feel tense and stressed.
Sadness – feeling low because of what you are dealing with.
Depression – experiencing a range of emotions because of your situation that are debilitating and affect your ability to function.

Arthritis pain can take a person away from doing the things that they have previously enjoyed, causing them to become short-tempered or withdraw from friends and family. It can be tempting to avoid telling friends and family about an arthritis diagnosis, not wanting to be treated differently or to stop being included in activities and events.

People with chronic pain are more vulnerable to social isolation, so being able to talk to someone about how you feel and any help that you may need will definitely be a benefit. Consider explaining your limitations to your social circle, but also let them know that you are still yourself. Be as open and honest as possible, and don’t be afraid to ask for help. When making plans with friends, you may need to alter the types of activities you participate in, but this can lead to enjoying new experiences.

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Coping strategies

There are a vast selection of assistive devices, adaptive tools and gadgets that can help to make daily tasks easier for someone living with arthritis, including but not limited to:

Mobility aids such as wheelchairs, walking canes, walkers or scooters can help those with arthritis to be more independent.
Home modifications such as grab rails, level-access showers, easy access baths, ramps and stairlifts help with mobility and independence.
Smartphones now have voice activated features which include message dictation, web searches and hands-free phone calls. Voice activated software can be a good alternative to typing on a keyboard.
Specially designed grips to help turn dials and knobs, and open bottles etc. They also make plugs easier to pull out; electric tin openers make opening tins easier.
Zipper pulls and buttoning aids can help reduce hand strain when dressing and undressing.
Flexible drinking straws to make it easier to sip drinks without lifting cups or glasses.
Key turners can help with inserting and turning the key in the lock.
For gardeners, using lightweight and easy grip tools and hoses, kneeler pads take the pressure off knees, or installing raised beds limits bending.

Developing relaxation and coping skills can help you maintain balance in your life, giving you a greater feeling of control over your arthritis and a more positive outlook.

One of the best, but sometimes the hardest, ways to manage arthritis pain is to manage body weight and adopt healthy lifestyle habits. A common misconception is that a painful joint requires rest; however, not enough movement can cause muscle weakness, worsening joint pain and stiffness. Activities such as walking, aerobics, yoga and Pilates can keep the joints limber and prevent arthritis pain from becoming worse. Physical activity strengthens the muscles and connective tissues around your joints, helping support joints that have been damaged by arthritis.

There is no conclusive evidence to suggest that what you eat can make arthritis either better or worse. However, being overweight can put excess strain on your joints. To work normally, your body needs food to supply energy, vitamins and minerals. Healthy eating will help you manage your weight and give you the energy to complete your daily activities, as well as promote a strong immune system and bone and tissue health.

Using heat and/or cold can help with arthritis symptoms. Heat is ideal for relieving pain, muscle spasms and tightness, and enhancing the range of motion. However, do not use heat on an already inflamed joint, as it can make symptoms worse. Cold is ideal for constricting blood flow to an inflamed joint and decreasing pain and swelling. A hot-water bottle filled with either hot or cold water and applied to the affected area can be very effective in reducing pain.

Relaxing the muscles around a sore joint helps to reduce pain. There are many ways to practise relaxation. Try meditation or deep breathing exercises. Try mindfulness, which is breathing deeply, remaining present in the moment, and noticing small details of your surroundings – sights, sounds, smells and sensations. Mindfulness means being present and grounded in the current moment rather than fixating on the past or future.

Access to healthcare

The treatment and medical support for people living with arthritis can vary depending upon the form of arthritis and a person might have to see several health professionals to look after all aspects of their care.

General Practitioners (GPs) are usually a person’s first port of call. You should see your GP if you have persistent symptoms of arthritis so that they can confirm the diagnosis and prescribe any necessary treatment. Treatments for the symptoms of arthritis may include:

- Lifestyle measures – such as maintaining a healthy weight and exercising regularly.
- Medication – to relieve pain.
- Supportive therapies – to help make everyday activities easier.
- Where other treatments have not been helpful, surgery to repair, strengthen or replace damaged joints may also be considered.

Your GP may refer you to a rheumatologist if you need further tests to confirm your diagnosis or you require more specialist treatment. A consultant rheumatologist is a doctor who specialises in diagnosing and treating arthritis and related conditions. Your rheumatologist will recommend treatment programmes. This may include drug treatments, which they may help monitor or carry out. They can also recommend that you see therapists for specialist advice, including:

Physiotherapists – these are healthcare professional who help you to remain active and independent. They are experts in:

- Assessing movement
- Addressing individual needs
- Helping to improve function through, for example, massage and/or transcutaneous electrical nerve stimulation (TENS)
- Managing pain

Occupational therapists – these are trained healthcare professionals who work with people to help them carry out everyday activities, to be able to work and to lead fulfilling lives. Many occupational therapists have specialist skills in treating people with arthritis. They can help you identify and obtain specialist equipment to help you get about and manage everyday tasks. Social Services occupational therapists are experts in home adaptations such as level-access showers and ramps. Workplace recommended occupational therapists are experts in workplace adaptations and reasonable adjustments.
Podiatrists – these are experts on problems with the feet and ankles. Some specialise in problems caused by arthritis and related conditions. Podiatrists, sometimes called chiropodists, may work either in the NHS or in private clinics. They can help with problems such as corns, calluses and troublesome nails, and give advice and help with getting special shoes or insoles to correct foot deformities.
Orthotist – they specialise in the use of devices (orthoses) to support weakened joints, correct deformities and reduce pain and strain when the affected joints are being used in everyday life. If you have complex needs you may require several meetings with an orthotist so that they can analyse and discuss with you how best to help you. The devices most commonly used by an orthotist in treating arthritis are special shoes or insoles for problems in the feet and legs, and splints for the hands and wrists.
Neurologists – these are specialists in disorders of the nervous system. Some neurologists also have expertise in particular areas, such as the immune system.
Orthopaedic surgeons – these specialise in surgical treatments for problems caused by disease and injury (trauma) in the bones, joints and other structures involved in making the body move, although most people with arthritis won’t need surgery. Some treatments offered by orthopaedic surgeons include:
– Joint replacements
– Surgical fusion of a joint
– Keyhole surgery to remove bone and cartilage debris
– Fixing of fractures resulting from injury or osteoporosis
– Repairs or reconstructions to tendons or ligaments

In addition to prescribed medication, over-the-counter topical treatments including non-steroidal anti-inflammatory drug (NSAID) creams can help to alleviate pain. There are also a variety of over-the-counter NSAIDs in tablet form which include ibuprofen which can treat inflammation. Other therapies often used to help manage arthritis symptoms include:

Acupuncture – this is a traditional Chinese therapy that is said to help restore the body’s energy flow (Qi) by inserting thin needles into areas of the body that follow energy lines, known as meridians. Acupuncture is sometimes used to alleviate pain and treat various physical and mental health conditions. Acupuncture has been shown to yield anti-inflammatory effects and regulation of immune system function. However, there is limited research evidence regarding its impact on arthritis symptoms. Because of its low risk of harm, acupuncture combined with standard arthritis medication strategies may be beneficial in reducing pain and improving quality of life.
Massage of muscles and other soft tissues by a registered massage therapist may help provide short-term relief of stiffness and pain. Other potential benefits include a reduction in stress and anxiety as well as improved mobility and overall function of the joints. However, there currently isn’t enough research evidence to suggest massage should be recommended for everyone managing arthritis symptoms. You should always consult your GP or rheumatologist to see if massage therapy is safe and appropriate for your form of arthritis.

Final thoughts

There are a number of organisations in the UK that provide advice and support to those who suffer from arthritis and their families and friends who support them. These include:

Arthritis Action – a UK charity giving hands-on, practical help to improve the quality of life of people affected by arthritis. Telephone number: 020 3781 7120. WhatsApp number: 770 281 3737.

National Rheumatoid Arthritis Society (NRAS) – offering information and emotional support for people with rheumatoid arthritis. Helpline: 08002987650.

Versus Arthritis – provides information for people living with arthritis on their website, by calling their helpline 0800 5200 520, asking their virtual assistant or on their online community forum.

CCAA – this is a charity supporting children with juvenile idiopathic arthritis (JIA) in England and Wales.

World Arthritis Day was established in 1996 by Arthritis and Rheumatism International (ARI) and aims not only to raise awareness, but also to improve the quality of life of people with arthritis and rheumatism, provide a forum for exchange of knowledge and experience among organisations of people affected by arthritis and rheumatism, and to strengthen their voice through worldwide cooperation. World Arthritis Day is celebrated each year on 12th October. People with rheumatic and musculoskeletal diseases (RMDs) from around the world can join together to make their voices heard on this day.

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