The two largest groups: osteoarthritis and rheumatoid arthritis
Most people with arthritis have either osteoarthritis or rheumatoid arthritis. These are very different conditions that happen for different reasons, progress differently, and respond to different treatments.
Osteoarthritis happens when the cartilage that cushions your joints wears down over time. It usually starts in joints you use most — your knees, hips, hands, and spine. It develops slowly, often over years, and is more common as you age. Pain usually gets worse when you move the joint and better when you rest.
Rheumatoid arthritis is an autoimmune disease, meaning your immune system attacks the lining of your joints by mistake. It often affects both sides of your body at the same time — both hands, both knees — and can come on suddenly over weeks or months. You may feel stiff in the morning, tired during the day, or have swelling that lasts for hours.
Key Takeaways
- Osteoarthritis is wear-and-tear damage to cartilage and is the most common type, especially in people over 65.
- Rheumatoid arthritis is an autoimmune disease where your body attacks joint linings, and it often affects multiple joints at once.
- Gout, lupus, and psoriatic arthritis are less common types that have specific causes and different treatment approaches.
- Your doctor can tell which type you have through blood tests, X-rays, and a description of how your symptoms started and where they appear.
- Different types of arthritis respond to different medications, so knowing which type you have changes how your doctor will treat you.
Gout: sudden pain from uric acid crystals
Gout is a type of arthritis caused by uric acid crystals building up in your joints. It usually strikes one joint at a time — often the big toe — with sudden, severe pain, redness, and swelling that can last days or weeks. Between attacks, you may have no symptoms at all.
Gout happens when your body has too much uric acid, either because you produce too much or your kidneys do not remove it well enough. Certain foods (red meat, organ meats, some seafood), alcohol, and some medications can raise uric acid levels. Men are more likely to get gout than women, and it often runs in families.
Gout is treated differently than osteoarthritis or rheumatoid arthritis. During an attack, anti-inflammatory medications bring down the pain and swelling. Long-term, your doctor may prescribe medications that lower uric acid levels to prevent future attacks, along with changes to diet and alcohol use.
Lupus and other systemic types
Systemic lupus erythematosus (often called lupus) is an autoimmune disease that affects many parts of your body, not just joints. Joint pain and swelling are common, but lupus can also cause rashes, fatigue, fever, and problems with your kidneys, heart, or lungs. It is more common in women and in people of African, Hispanic, and Asian descent.
Lupus is diagnosed through blood tests that look for specific antibodies your body makes when you have the disease. Treatment depends on which parts of your body are affected and how severe your symptoms are. Some people take antimalarial medications, corticosteroids, or immunosuppressants to calm the immune system.
Other systemic types include Sjögren's syndrome (which causes dry eyes and mouth along with joint pain) and scleroderma (which hardens skin and can affect joints and internal organs). These are less common than osteoarthritis or rheumatoid arthritis, but they need specialized care from a rheumatologist.
Psoriatic arthritis: arthritis linked to psoriasis
Psoriatic arthritis develops in some people who have psoriasis, a skin condition that causes red, scaly patches. Not everyone with psoriasis gets arthritis — it happens in about one in three people with the skin disease. The arthritis can appear before, during, or after the skin symptoms show up.
Psoriatic arthritis can affect any joint, but often hits the fingers, toes, knees, and lower back. It can cause swelling in whole fingers or toes (sometimes called "sausage digits"), pitting of the nails, and pain in the tendons where they attach to bone. Like rheumatoid arthritis, it is an autoimmune condition, so treatments are similar — biologics and other immune-modifying drugs often work well.
Less common types: ankylosing spondylitis, reactive arthritis, and others
Ankylosing spondylitis is an autoimmune arthritis that mainly affects the spine. It causes pain and stiffness in the lower back that is often worse in the morning or after sitting still. Over time, vertebrae can fuse together, limiting how much you can bend. It is more common in men and often runs in families.
Reactive arthritis develops after a bacterial infection elsewhere in your body — often in the gut or urinary tract. Joint pain and swelling appear weeks after the infection and usually go away on their own, though they can last months. It is less common now than it was before modern antibiotics.
Other types include septic arthritis (a joint infection that needs urgent treatment), polymyalgia rheumatica (muscle pain and stiffness, usually in people over 50), and juvenile idiopathic arthritis (arthritis in children). Each has different causes and needs different care.
How your doctor figures out which type you have
Your doctor will ask detailed questions about when your pain started, which joints hurt, whether both sides of your body are affected, and what makes it better or worse. They will examine your joints and may order blood tests to look for markers of rheumatoid arthritis, lupus, gout, or other conditions. X-rays or ultrasound can show how much damage has happened and help rule out other problems.
Some types are obvious from blood tests — rheumatoid arthritis shows up as a positive rheumatoid factor or anti-CCP antibody, and lupus shows specific antibodies. Gout can be confirmed by finding uric acid crystals in fluid drawn from the joint. Osteoarthritis is usually diagnosed by X-ray showing cartilage loss, combined with your symptoms and medical history.
Getting the right diagnosis matters because treatments differ. A medication that works for rheumatoid arthritis may not help osteoarthritis, and gout needs its own approach. If your first doctor is not sure, ask for a referral to a rheumatologist — a specialist in arthritis and autoimmune diseases.
What to ask your doctor
When you see your doctor about joint pain, ask: "What type of arthritis do you think I have, and what tests will confirm it?" "What causes this type?" "How will it likely progress?" "What are my treatment options, and what are the side effects?" "Should I see a rheumatologist?" "Are there foods, activities, or habits I should change?"
If you have been diagnosed, ask: "Is my current treatment working, or should we try something else?" "What should I watch for that would mean I need to come back sooner?" "Are there support groups or resources for people with my type of arthritis?" "What can I do to protect my joints and stay as active as possible?"
Frequently Asked Questions
Can you have more than one type of arthritis at the same time?
Yes. Some people have both osteoarthritis and rheumatoid arthritis, or rheumatoid arthritis and gout. Your doctor can sort this out through blood tests and imaging. Treatment may need to address both conditions.
Does the type of arthritis I have determine how fast it will get worse?
It is one factor, but not the only one. Osteoarthritis usually progresses slowly over years. Rheumatoid arthritis can progress faster if not treated early. Gout may stay stable between attacks. Your age, genetics, how well you follow treatment, and your overall health all play a role.
If I have osteoarthritis in one knee, will I definitely get it in the other?
Not necessarily, but it is common. Osteoarthritis often affects joints on both sides of the body, especially weight-bearing joints like knees and hips. Keeping a healthy weight, staying active, and protecting your joints can slow progression in the unaffected knee.
Can arthritis go away on its own?
Osteoarthritis does not go away — cartilage does not regrow — but pain can be managed and progression slowed. Reactive arthritis sometimes goes away after weeks or months. Rheumatoid arthritis, lupus, and gout are chronic and need ongoing treatment, though symptoms can go into remission with the right medications.
Is there a blood test that tells me what type of arthritis I have?
Blood tests help narrow it down but are not always definitive on their own. Rheumatoid arthritis and lupus have specific antibodies doctors look for. Gout is confirmed by finding crystals in joint fluid. Osteoarthritis is usually diagnosed by X-ray and symptoms, not blood tests. Your doctor uses the full picture — your history, exam, blood work, and imaging — to make the diagnosis.