ARTHRITIS

The following information is to be used as a guide and at the discretion of the end-user and should not replace a doctor’s opinion.

OVERVIEW

“Arthritis” means joint inflammation. Arthritis is not a single disease — it’s an umbrella term for conditions that cause pain, swelling and stiffness in the joints. Arthritis is extremely common, and can affect people of any age, including children (juvenile arthritis). There are many types of arthritis, each with its own symptoms and which may need different treatments:

Osteoarthritis is the most common form of arthritis worldwide. It is caused by the degeneration of cartilage, particularly in the hips and knees. This most commonly affects women after the age of 50.
Inflammatory arthritis, like rheumatoid arthritis and psoriatic arthritis, affect fewer people but can be more aggressive. This arthritis is caused by the immune system attacking joints, causing pain, swelling, and stiffness. This most commonly begins in women between the ages of 25 and 45.
Juvenile arthritis is a chronic autoimmune condition in children under 16 that causes joint inflammation, pain, and stiffness, and may also affect the eyes and internal organs.

There is no universal “cure” for most types of arthritis, but many can be controlled to reduce pain, preserve function and even reach long periods of remission (particularly rheumatoid arthritis with modern treatments).

Prevention strategies (managing weight, preventing injuries, avoiding triggers) can lower risk and slow progression. There are several practical steps you can take to protect your joints and maintain an active and productive life.

ARTHRITIS IN SOUTH AFRICA

Data from population and clinic studies show that arthritis is common in South Africa. Women are more likely than men to develop several types of arthritis and in South Africa, this risk is influenced by socio-economic factors like access to care, rates of obesity and physical workload.

Osteoarthritis is the most prevalent type of arthritis in South Africa, affecting an estimated 30% of the general population (with 83% of those over 65). It is more common in men at a younger age (before 55) and in women after age 65.
Rheumatoid arthritis affects about 2.5% of South Africans. Women are 3-6 times more likely to develop it, and smoking is a known risk factor.
Juvenile arthritis affects an estimated 19 000 to 75 000 children in South Africa. A significant number are likely undiagnosed or receiving inadequate treatment.
Psoriatic arthritis: A prevalence of 4.4% in urban South Africa has been reported.
Gout: A prevalence of 0.7% in urban South Africa has been reported.
Ankylosing spondylitis: A prevalence of 0.1% in rural South Africa has been reported.

THE MAIN TYPES OF ARTHRITIS

There are over 100 different types of arthritis but the most common are:

Osteoarthritis

This is known as the “wear-and-tear” arthritis. It is the most common form of arthritis; and affects knees, hips, hands, spine. Risk rises with age, obesity, joint injury and heavy joint use. Osteoarthritis is a leading cause of disability; you cannot reverse the damage to your joints, but you can largely manage the symptoms and slow the progression of the disease through lifestyle changes, such as maintaining a healthy weight and staying active. Severe symptoms are managed with pain relief and sometimes joint replacement.
Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune in disease where your body’s immune system mistakenly attacks the lining of your joints and causes damage to the nearby cartilage, bone and soft tissues. It is a chronic inflammatory disorder that can also affect other parts of the body, beyond bones and joints. It is more common in women, and severe disease can cause significant physical disability. Early diagnosis and the use of disease-modifying antirheumatic drugs (DMARDs) and biologic therapies slow the progression of the disease.
Ankylosing spondylitis

Ankylosing spondylitis is a chronic inflammatory disease of the joints in the lower part of the spine. It is a common cause of backpain. If left untreated, it eventually leads to structural damage and even paralysis. It affects both men and women equally. You cannot undo the damage to your spine caused by ankylosing spondylitis, but there are treatments that can lessen your symptoms and slow the progression of the disease.
Gout

Gout is caused by the build-up of uric acid in the blood. This leads to the deposit of urate crystals in the joints, causing extreme pain (the most common area is in the big toe). Gout flares are intensely painful but preventable and treatable with lifestyle changes and medications to lower uric acid. Gout prevalence is rising where diets, obesity and metabolic disease are common. While anyone can get gout, it is more common in men or people with a family history of the condition.
Juvenile arthritis

Juvenile arthritis is the most common form of arthritis in children. It is an autoimmune disease, and the cause is unknown. Some children may only experience symptoms of arthritis for a few months; others may have them for the rest of their lives. As some types of juvenile arthritis can cause serious complications, like growth problems, joint damage and eye inflammation, it is important to access treatment as early as possible.

Juvenile arthritis is distinct form adult arthritis in significant ways and requires a paediatrician to diagnose and treat. Unfortunately, there are only 10 paediatric rheumatologists in South Africa, so educating parents on how to rise a child with juvenile arthritis is essential. You can learn more about it juvenile arthritis here.
Psoriatic arthritis

Psoriatic arthritis is an inflammatory condition linked to psoriasis. There is no cure for psoriatic arthritis, and the correct treatment is important both to manage symptoms and prevent severe damage to your joints. If left untreated, psoriatic arthritis can be disabling.
Septic Arthritis

Septic arthritis is a serious joint infection that requires urgent medical attention and can lead to joint destruction if not treated promptly. Immediate diagnosis and treatment are vital to prevent permanent joint damage and loss of function. Common causes include bacteria from the bloodstream or direct injury, and the condition can be complicated by factors such as HIV, diabetes, rheumatoid arthritis, and prosthetic joints. Treatment typically involves antibiotics and draining the infected joint fluid.
Systemic lupus erythematosus (Lupus)

Systemic lupus erythematosus is an autoimmune disease that causes joint problems as well as other complications. It is more prevalent and often more severe in individuals of African and mixed ancestry; particularly young women aged between 15-40. Kidney and cardiac involvement are common and can be severe, even in childhood-onset cases. Diagnosis requires prompt medical attention, especially in children, and management often involves a multidisciplinary approach with a combination of treatments, including antimalarials and corticosteroids.
Remember, people on the spectrum CAN do physical and intellectual work!

Many people with autism face challenges, but with the right support and resources, they can lead fulfilling and meaningful lives. This means people with autism can be employed and attend school like everyone else. Most can lead ‘normal’ lives and are as capable of achieving their goals and dreams as anyone else.

WHAT CAUSES ARTHRITIS?

Arthritis is caused by a variety of factors, including joint wear and tear (osteoarthritis), autoimmune disorders (like rheumatoid arthritis), and metabolic conditions (like gout). Other causes and risk factors include previous joint injuries, obesity, increasing age, family history, and certain repetitive motions from activities or jobs. The cause will determine what type of arthritis you have.

The most common risk factors for arthritis in general include:

Age: The risk of many types of arthritis increases with age, particularly osteoarthritis, gout, and rheumatoid arthritis.
Genetics: Some types of arthritis seem to run in families. Inheriting certain genes may make you more susceptible to environmental factors that can trigger arthritis.
Sex: Women have a higher risk of developing many types of arthritis, except for gout which is seen largely in men. Hormonal changes, particularly the decline of oestrogen after menopause, and the higher prevalence of autoimmune diseases in women are key factors contributing to this increased risk.
Obesity: Excess body weight puts more stress on weight-bearing joints, increasing your chance of developing arthritis.
Repetitive stress: Jobs or hobbies that involve repeated bending or pressure on a joint can increase risk.
Previous joint injury or surgery: You are more likely to develop arthritis in a joint that you have injured or that has been operated on.
Other health conditions: Other diseases, such as autoimmune disorders or obesity, can increase the chance of developing arthritis.
Tobacco: Smoking and using other tobacco products increase your risk.

Regardless of the cause or type of arthritis, the main disease process is the same: There is breakdown of the cartilage that cushions the ends of the bones between joints. Cartilage is a firm but slippery tissue that enables frictionless joint motion, and if it wears down, bone can rub on bone, causing the signs and symptoms of arthritis.

CAN ARTHRITIS BE AVOIDED?

While you cannot always prevent arthritis, maintaining a healthy lifestyle is the best way to lower your risk:

Maintain a healthy weight:

Extra body weight places added stress on weight-bearing joints such as the knees, hips, and lower back. This accelerates wear and tear, increasing the likelihood of developing osteoarthritis. Losing even a small amount of weight can dramatically reduce your arthritis risk. Every 5kg of extra weight you lose decreases the amount of extra pressure on each knee during exercise by 20kg.
Exercise:

Staying active is one of the best ways to prevent arthritis symptoms. Exercise helps for multiple reasons: it reduces inflammation, keeps the joints fluid and prevents stiffness, and helps you maintain a healthy weight. Do low-impact exercise such as walking, swimming, yoga, or cycling to reduce pressure on your joints while improving strength and circulation. Try to get at least 150 minutes of moderate exercise per week.
Quit smoking:
Drink sufficient water
Eat a healthy diet:

Your diet plays a powerful role in joint health. Nutrient-rich foods help reduce inflammation, maintain a healthy weight, and provide vitamins that support bone and joint strength. Eat a balanced diet rich in fruits, vegetables, and omega-3s, and avoid or limit processed foods, sugar, and excess salt—these contribute to inflammation and weight gain.
Limit inflammatory foods:

Reduce the consumption of processed foods, sugary snacks, refined carbohydrates, and saturated fats as these foods can contribute to inflammation in the bod. Instead, opt for anti-inflammatory options like leafy greens, olive oil, nuts, and seeds. These foods can help reduce systemic inflammation and support joint health. Whole grains support a healthy gut and reduce inflammation.
Prevent joint injuries:
Previous joint injuries—especially those caused by sports, falls, or improper lifting—can increase your chances of arthritis later in life. Protect your joints now to prevent inflammation and damage in the future.

Wear supportive gear like helmets, knee pads, or wrist guards when playing sports or lifting heavy objects.

Use proper technique when exercising or working physically. Always lift with your knees and hips, not your back.

Stretch before and after physical activity to reduce the risk of strains.
Control your blood sugar:
Drink moderately:
Get treatment early:

See your doctor as soon as symptoms of arthritis appear. The longer you delay, the more joint damage the arthritis may cause. Regular medical check-ups are a great preventative healthcare strategy as they allow doctors to assess personal risk factors, family history, and early signs of arthritis. Your doctor can then suggest lifestyle changes that could help to reduce your risk or slow the progress of your arthritis.
Maintain good oral hygiene:

Good dental hygiene and regular visits to the dentist help improve overall health by reducing inflammation and potentially lowering the risk of respiratory infections. Good oral hygiene also helps reduce the risk of developing gum disease, which can trigger an autoimmune response that can increase your risk for rheumatoid arthritis.
Support joint health:

Maintain good posture to help prevent joint wear and tear, cartilage degeneration, and the development of arthritis. Gentle stretching also supports joint health by improving your range of motion and keeping your joints limber. Try to work in simple stretches into every day.

CAN ARTHRITIS BE CURED?

No, arthritis cannot be cured, but its symptoms can be managed to relieve pain, preserve joint function, and improve quality of life. Treatment focuses on managing symptoms through a combination of medications, physical and occupational therapy, exercise, weight management, and, in some cases, surgery. For certain types like rheumatoid arthritis, early diagnosis and treatment can help achieve remission (where the disease is inactive).

Treatment options:

Medication: This includes over-the-counter pain relievers (like NSAIDs), prescription corticosteroids, and disease-modifying antirheumatic drugs (DMARDs) for types like rheumatoid arthritis.
Physical and occupational therapy: These therapies can help improve strength, flexibility, and the range of motion in joints.
Exercise: Low-impact activities like swimming, walking, and water aerobics can help keep joints flexible and may also help with weight management.
Diet: A healthy, balanced diet and moderate alcohol consumption can manage triggers as well as help with weight management. Common food triggers for arthritis include sugary and highly processed foods, excessive saturated and trans fats, and refined carbohydrates because they can increase inflammation.
Weight management: Losing excess weight can reduce the stress on weight-bearing joints.
Surgery: Procedures like joint fusion or joint replacement are typically reserved for severe cases when other treatments have not been effective.
Lifestyle and home remedies: Applying heat or ice packs, using assistive devices, and making dietary changes can also help manage symptoms.

SYMPTOMS OF ARTHRITIS (WHEN TO SEE A HEALTHCARE PRACTITIONER)

Common red flags to consult your clinic or doctor:

Severe joint pain, swelling, warmth or redness – especially if it lasts for over a week. Rheumatoid arthritis has symmetrical joint pains with morning stiffness. Osteoarthritis affects the joints used more often and the stiffness get worse during the day.
Significant morning stiffness (more than 30–60 minutes) or prolonged fatigue (this suggests inflammatory arthritis like RA).
Sudden severe pain and swelling in one joint (a classic gout attack).
Reduced ability to do daily tasks (walking, dressing, cooking).

Early assessment is important — especially for inflammatory arthritis where early treatment prevents joint damage. Your healthcare provider can do an initial evaluation and refer you to a rheumatologist if necessary.

HOW ARTHRITIS IS TREATED

Arthritis treatment focuses on managing symptoms and may include medications, physical therapy, surgery, and lifestyle changes.

Non-drug approaches:
Structured exercise programmes (strength, flexibility, aerobic).

Weight loss if overweight — even modest weight loss reduces osteoarthritis knee pain.

Physiotherapy, occupational therapy and assistive devices (sticks, splints, shoe inserts).

Applying heat and cold can be used to relieve pain and swelling in your joints. Heat can help relax muscles, while cold can relieve muscle aches after exercise and decrease muscle spasms.
Medications:
Analgesics (paracetamol, certain NSAIDs) for pain relief — use under advice as NSAIDs have side-effects.

Topical NSAIDs for localised osteoarthritis pain.

DMARDs (methotrexate, sulfasalazine, leflunomide) for rheumatoid arthritis and other inflammatory diseases — given early to prevent damage.

Biologic and targeted synthetic DMARDs for rheumatoid arthritis and spondyloarthritis when conventional DMARDs fail; these are highly effective but more costly and require specialist oversight.
Procedures and surgery:
Joint injections (steroid or hyaluronic injections) for some osteoarthritis or inflammatory flares.

Joint replacement surgery (hip or knee) for advanced osteoarthritis to restore mobility and relieve pain.

PREGNANCY AND ARTHRITIS

Severe, uncontrolled arthritis is linked to higher risks of miscarriage, growth issues, premature birth, and low birth weight.

If you are planning to have a child, it is essential to discuss your arthritis and any medications you are taking with your doctor before becoming pregnant. Some arthritis medications can harm a developing baby, so it is crucial that your doctor reviews any medications you are taking.

Once pregnant, you should discuss birth plans. For certain conditions, an anaesthetist may be consulted to plan for delivery. Your unborn baby will also have to be monitored. Blood checks may be needed to check for antibodies that could affect your baby, and extra heart checks may be recommended.

Move regularly:
Eat anti-inflammatory foods:

Diet affects arthritis by influencing inflammation and joint health; anti-inflammatory foods like fruits, vegetables, fatty fish, and whole grains can help reduce symptoms, while foods high in saturated fat, sugar, and processed ingredients may worsen them. Be sure to include lots of foods rich in calcium in your diet. Calcium is essential for strong, healthy bones.
Limit your alcohol consumption:
Quit smoking:
Protect your joints:

Use correct lifting techniques, use ergonomic aids at home/work, and comfortable shoes. Shoe inserts (orthotics) that can provide support for your feet and ankles. You can also find adaptive equipment like easy-grip utensils and adapted tools to help you with everyday tasks like preparing meals independently and safely.
Watch your weight:
Manage other health risks:
Know your medicines:

Use NSAIDs only as advised (they carry a risk of stomach, kidney, cardiovascular side effects) and take DMARDs under specialist supervision. Certain Bonitas plans provide support to members with chronic medication. Bonitas also provides a Back and Neck Care Programme for severe back and neck pain, which is covered by the scheme and will not impact your savings or day-to-day benefits.
Mental health matters:

ARTHRITIS

ARTHRITIS

The following information is to be used as a guide and at the discretion of the end-user and should not replace a doctor’s opinion.

OVERVIEW

ARTHRITIS IN SOUTH AFRICA

THE MAIN TYPES OF ARTHRITIS

WHAT CAUSES ARTHRITIS?

CAN ARTHRITIS BE AVOIDED?

CAN ARTHRITIS BE CURED?

SYMPTOMS OF ARTHRITIS (WHEN TO SEE A HEALTHCARE PRACTITIONER)

HOW ARTHRITIS IS TREATED

PREGNANCY AND ARTHRITIS

LIVING WELL WITH ARTHRITIS

FURTHER READING