What is polyarthritis?
The name polyarthritis comes from two Greek words:
- "poly," meaning "many, much"
- "arthron," meaning "joint"
In this article, we look at some of the different forms of polyarthritis, along with the symptoms that can occur and what can be done to treat them.
Polyarthritis has a number of symptoms similar to rheumatoid arthritis, including pain, swelling, and stiffness in affected joints.
The symptoms of polyarthritis can be similar to those of rheumatoid arthritis. They can develop in the body over a period of many months, or they can have a sudden onset.
- swelling or redness in the affected area
- a rash
- tiredness or a lack of energy
- a high temperature of 100.4 ºF (38 ºC) or above
- lack of appetite
- unexpected weight loss
Polyarthritis can occur as the result of genetic factors. Some people naturally have disease-destroying proteins in their bodies called antibodies that make it easier for the condition to thrive.
Certain triggers can also cause polyarthritis when the body has an infection that weakens the immune system.
Polyarthritis can be either seropositive or seronegative:
- Seropositive: This means the person has antibodies in their blood that may attack their body instead of infections, such as bacteria or viruses, so they may be more likely to develop polyarthritis.
- Seronegative: This diagnosis indicates that these particular antibodies are not present in someone's blood.
Sometimes, polyarthritis is caused by a prior infection or illness, and it can be accompanied by another condition. This parallel occurrence often makes it hard for doctors to diagnose.
The viruses that cause rubella and mumps also activate the body's immune system and can trigger an inflammatory reaction that leads to someone developing polyarthritis.
What are the risk factors?
The risk factors for polyarthritis are of two kinds: those that can be changed and those that cannot.
Factors that can be changed include:
- Lifestyle: Smoking, alcohol consumption and caffeine intake can make someone more open to developing polyarthritis.
- Early life experience: If a child is exposed to factors, such as having parents who smoke, it may increase their risk of developing polyarthritis later in life.
Factors that cannot be changed include:
- Age: People become more prone to developing polyarthritis as they age.
- Gender: The rate of diagnosis of recent cases is higher in women than men.
- Inheritance: Specific genes can make a person more likely to develop polyarthritis.
Types of polyarthritis
According to the United States Centres for Disease Control and Prevention (CDC), around 54.4 million adults annually were diagnosed with a form of arthritis, fibromyalgia, gout, or lupus between 2013 and 2015.
There are several different forms of polyarthritis, including the following:
Polyarticular JIA affects the joints in children and teenagers.
When polyarthritis presents in young people, from an early age to late teens, it is classified as juvenile idiopathic arthritis or JIA.
It can cause very painful swelling in small and large joints from ankles, wrists, and hands to hips and knees. It may even occur in the neck and jaw areas.
Doctors do not always know what causes JIA. In many cases, it is a condition that can improve over time and with good treatment.
As well as affecting a person's joints, this form of polyarthritis often impacts the skin, kidneys, and the central nervous system.
Psoriatic arthritis, as its name suggests, can be present in people who have the skin condition psoriasis. Sometimes, arthritis develops first.
Symptoms to look out for can be a scaly, red rash, and the fingers and toes swelling into a "sausage shape" on one side of the body only.
Polyarthritis is not a specific condition, and people with it may present to their doctor, initially, with something else of concern. For instance, early polyarthritis may cause someone to feel very tired or have flu-like symptoms.
There are some conditions that can accompany polyarthritis or be a sign that there is another problem. These include:
- Dupuytren's contracture: When the connective tissue in the hand contracts to become tighter, any one of the person's fingers may curl into the palm.
- Fibromyalgia: This is a condition that affects the whole body, causing pain and fatigue in numerous areas, including the muscles.
- Hemochromatosis: If the body stores too much iron rather than using it, the buildup can lead to polyarthritis developing.
- Inflammatory bowel disease: IBD, such as ulcerative colitis and Crohn's disease, causes inflammation in a person's small intestine and colon.
- Raynaud's disease: This condition is marked by poor blood circulation in the hands and feet. Fingers can sometimes go white at the ends, or very red or purple.
Diagnosis and when to see a doctor
Polyarthritis can be difficult to diagnose because there are many different forms and doctors have to conduct numerous tests to find out what type they are seeing.
If someone has one or more of the following symptoms, it is a good idea to go and see a doctor:
- stiffness in the joints lasting more than 30 minutes, with swelling or pain remaining
- pain in the joints that makes everyday activities difficult
- joints that can be warm to the touch and red-looking
- any of the above symptoms lasting 3 or more days
- pain or swelling that recurs over a short period of time
The doctor will carry out a variety of tests, including blood tests that may look for evidence of viral infections, or for a marker called rheumatoid factor (RF). RF is a protein that can attack the healthy tissue in the body.
The doctor will also test the joints by seeing if they are swollen or hot to the touch, and how easy or difficult it is to move them. They may also offer an X-ray to help determine what is causing the pain.
To help them further test to find out what type of polyarthritis may be present, they can take a sample of fluid from the painful joints. This process is called aspiration.
Polyarthritis may cause scarring on the lungs, leading to shortness of breath and coughing. A heightened risk of heart attacks is also a potential complication.
If polyarthritis is not treated or controlled well, other organs and parts of the body can be severely affected. Effects on other areas of the body include:
- Lungs: Scarring on the lungs can cause complications, such as shortness of breath and a chronic cough.
- Eyes: Dry eyes or inflammation of the whites of the eyes.
- Skin: A rash or lumps of tissue developing under the skin.
- Heart: The lining around the heart can become inflamed, causing chest pain. Heart attacks and strokes may also be more likely.
There is more likelihood of certain conditions developing if the polyarthritis has been present for a while. These include carpal tunnel, permanent joint damage, and problems with joints at the top of the spine.
While polyarthritis cannot be cured yet, it can be treated with medication and non-medical elements such as diet, exercise, and lifestyle. More and more medications become available as research progresses.
Current medicinal treatments that are available include:
- Painkillers: These include over-the-counter drugs, such as acetaminophen.
- Non-steroidal anti-inflammatory drugs (NSAIDs): Medications, such as ibuprofen, naproxen, and diclofenac, help to reduce pain and stiffness.
- Disease-modifying anti-rheumatic drugs (DMARDs): These work over a longer time than painkillers and help slow the course of the disease. Methotrexate is a commonly used DMARD that can reduce joint damage caused by polyarthritis.
- Biological therapies: These slow the progress of polyarthritis. They use the body's immune system to target the condition. Common examples of these drugs include infliximab and etanercept.
- Steroids: Injections, drips into a vein, or tablets containing steroids can lower inflammation and help control pain. Steroids are only used in the short term as side effects can occur with long-term use.
According to the British National Rheumatoid Arthritis Society, a daily 7.5 milligram (mg) dose of a steroid starts taking effect within a few days of beginning treatment. A one-off injection of a large dose of 25 mg is called a pulse.
In rare instances, methotrexate has been found to cause problems in the liver. As a result, it is advisable to discuss the risks with a doctor, along with how much alcohol someone drinks.
Non-medical treatment for the relief of pain and the stiffness symptoms of polyarthritis can include physiotherapy and low-impact exercises, such as swimming, walking, and cycling. Anything that has a gentle or moderate impact on the joints is helpful.
An exercise plan should suit the needs of the individual. People may find it useful making a plan with their doctor or an exercise specialist.