2 Types of Arthritis — and How to Tell Which One You Have

Table of Contents

Understanding Your Joint Pain

Sandy always assumed her stiff, aching fingers meant she had arthritis, which clearly indicated “bad inflammation.” After all, her joints had been painful and gradually enlarging for years, making simple tasks—like buttoning a shirt or opening a jar—a daily struggle. But when she got the results of the blood tests, she was shocked: her markers for inflammation were low. “Look at my hands! How could I have arthritis without inflammation?” Sandy questioned, as if the tests were wrong. “No, the labs are pretty consistent.” I replied, “You have multiple tests which indicate low inflammation.” I then explained that she had degenerative arthritis, which is not inflammatory like other kinds of arthritis.

Understanding Joint Pain: More Than Just Aching Joints

Joint pain—whether it’s in your hands, knees, or elsewhere—can feel like a terrible nuisance. Nearly everyone experiences it at some point, but the reasons behind the pain can be very different. Sometimes it’s sharp and sudden, other times it’s a dull, constant ache. You might notice swelling, stiffness, or even redness and warmth. But what’s really going on inside those aching joints? Understanding the cause is key to finding the right treatment.

Degenerative vs. Inflammatory Arthritis: What’s the Difference?

If you’ve ever wondered—like Sandy—why your joint pain doesn’t always match up with lab results, you’re not alone. There are two main types of arthritis that often get confused:

Degenerative Arthritis (Osteoarthritis): This is the classic “wear-and-tear” arthritis. It happens when the cushioning cartilage in your joints gradually breaks down, usually with aging or injuries. Joints, like knees, hips, and fingers are common targets. The pain tends to come with enlarged joints but not much heat, redness, or swelling. Inflammation markers in your blood may be normal or just slightly raised.
Inflammatory Arthritis: This type is all about the immune system going into overdrive. Conditions like rheumatoid arthritis, lupus, and psoriatic arthritis cause your immune system to attack your own joint tissues. The result? Swollen, hot, red joints and high inflammation markers on blood tests. This form can strike at any age and often affects multiple joints symmetrically.

Distinguishing between these types is crucial because the treatments are very different.

Osteoarthritis: Symptoms, Diagnosis, and Treatment Options

Common Symptoms:

Joint pain that worsens with activity and improves with rest
Stiffness, especially after periods of inactivity or upon waking
Enlarged or bony-feeling joints
Limited range of motion
Grating sensation or clicking sound with joint movement
Minimal heat, redness, or swelling

Joints Most Often Affected:

Knees
Hips
Fingers (especially the joint nearest the tips and base of the thumb)
Spine (neck and lower back)

Tests Used in Diagnosis:

X-rays to reveal joint space narrowing, bone spurs, and cartilage loss
MRI or ultrasound to see the soft tissues, usually for knees or hips.
Blood tests (as noted below) should be normal.

How to Diagnose Osteoarthritis:

Clinical evaluation based on symptoms and physical examination
Imaging studies (X-ray, MRI, ultrasound) to confirm joint changes typical of osteoarthritis
Exclusion of other causes such as inflammatory arthritis, infection, or crystal deposits

Causes of Osteoarthritis:

Osteoarthritis develops when the balance disrupts the joint wear-and-tear and the body’s natural repair process. Key contributing factors include insufficient nutrients that are vital for maintaining cartilage and joint health.[i]

Vitamin D – Supports calcium absorption and bone health. Helps maintain normal joint structure by reducing inflammation and aiding cartilage repair.
Collagen – Provides structural support to cartilage, tendons, and ligaments, improving joint flexibility and resilience, and helping slow cartilage degeneration.
Omega-3 fatty acids – Possess anti-inflammatory properties that help reduce joint pain and swelling.
Sulfur (MSM, DMSO) – Essential for synthesizing cartilage and connective tissue, sulfur helps maintain joint elasticity and supports repair processes.
Glucosamine – Plays a key role in building cartilage and maintaining joint lubrication, which can help slow cartilage loss.
Chondroitin – Helps retain water in cartilage for shock absorption, inhibits enzymes that break down cartilage.

Inactivity or lack of regular exercise also impairs circulation and joint nourishment, further accelerating cartilage breakdown. Just like your brain, your bones, and your muscles, if you don’t use your joints, you lose them. The body repairs and improves according to need, so if you don’t exercise, your body thinks there is no need to strengthen your joints, and they don’t get repaired.

Another important factor in degenerative arthritis is a lack of anabolic metabolism, due to poor circadian rhythm. Inadequate sleep can reduce the body’s nighttime repair of joint tissues. While joints normally experience daily wear-and-tear, robust anabolic metabolism each night should allow for effective tissue repair; when compromised, osteoarthritis may progress.

Treatment Options:

It doesn’t matter if the underlying cause is from trauma or “overuse” the treatment of degenerative arthritis is the same.

Weight loss: Losing 30 pounds reduces the strain on joints.
Exercise: Weight-bearing, like bouncing and running, and low-impact activities like walking, swimming, or cycling
Supplements:
- Vitamin D3 250 mcg (10,000 IU) per day
- Vitamin K2 150 mcg per day
- Collagen peptides 6-10 grams per day
- Glucosamine and Chondroitin 500mg of each daily
- MSM – 500mg per day.
- Vitamin C 1,000 mg daily
Pain management: Over-the-counter topical creams are best for temporary relief, but the correct treatment should reverse the pain within a week.
Diet: Weight loss is essential.[ii] Burn fat for energy every week. Do a “keto” diet or fasting.[iii]
- Avoid processed sugar since it raises insulin, which promotes inflammation, and reduces the production of growth factors that stimulate cartilage repair and regeneration.[iv]
- Get adequate protein – some studies show that 30-40 grams of a good protein, such as a milk protein, helps re-build tissues. A protein powder in water is OK too. Some recommend 1 cup of unflavored yogurt with protein powder to get to 40 grams of protein. If you use other protein, such as pea protein or collagen peptides, add some BCAA (Branch-chain amino acids) powder to make it more complete. [v]
Sleep 7-9 hours every night.[vi]
Surgical options: The above program will prevent the need for joint replacement.[vii]

Inflammatory Arthritis: Types, Symptoms, Diagnosis, and Treatments[viii]

Inflammatory arthritis is a group of conditions where the immune system attacks the joints, leading to pain, swelling, and damage. Common types include rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and gout. Gout is unique in that it results from uric acid crystal buildup in the joints, causing sudden and severe inflammation and pain, most often in the joint at the base of the big toe.

Rheumatoid Arthritis (RA): A chronic autoimmune disease affecting joints symmetrically, commonly the hands and feet. This problem is caused by an enzyme that changes the proteins, causing them to have an amino acid called citrulline, which makes the immune system attack them.[ix]
Psoriatic Arthritis: Linked to psoriasis, this type can affect both skin and joints. This is caused by internal reactions, often to foods. If you have psoriasis AND arthritis, it is probably psoriatic arthritis.[x]
Ankylosing Spondylitis: Primarily impacts the spine, causing stiffness and inflammation. This is a genetic condition most often triggered by toxins or other reactions.[xi]
Gout: Characterized by episodes of intense joint pain, redness, and swelling, most often in the big toe. This is caused by a poor diet among those who are susceptible. Foods that contain DNA/RNA (purines) are broken down into uric acid. Also, Fructose, the most common sweetener in sugar and fruit, increases uric acid in the blood. As the uric acid increases, it forms crystals which create inflammation in the joints, damages the lining of the arteries, and injures the filters in the kidneys.[xii]

Common Symptoms

Joint pain and swelling
Redness and warmth around affected joints
Stiffness, especially in the morning or after inactivity
Fatigue and general malaise
In gout: the above symptoms come on with sudden, severe pain and tenderness, often at night, and most of the time at the base of the big toe.

Diagnosis

Diagnosis typically starts with a physical exam and a review of symptoms. Get blood tests to check for markers of inflammation and specific antibodies, as well as measure uric acid levels for gout. Imaging studies like X-rays, ultrasound, or MRI may reveal joint damage or inflammation.

Several specific markers checked in blood tests help to diagnose inflammatory arthritis and understand its underlying cause. Here are some of the most common markers and what each indicates:

Rheumatoid Factor (RF): An antibody found in many people with rheumatoid arthritis (RA). A positive RF test suggests RA, but isn’t specific.
Anti-Cyclic Citrullinated Peptide (Anti-CCP) Antibodies: Highly specific for RA, the presence of these antibodies helps confirm the diagnosis.
Erythrocyte Sedimentation Rate (ESR): A nonspecific marker of general inflammation.
C-Reactive Protein (CRP): A nonspecific marker of inflammation, more of cellular distress.
Antinuclear Antibodies (ANA): Can indicate general autoimmune activity.
HLA-B27: A genetic marker associated with ankylosing spondylitis.
Uric Acid: Elevated levels over 6.0 are specifically associated with gout. Crystals begin to form when it reaches about 7.0.

These markers, along with clinical symptoms and imaging studies, can help you diagnose and differentiate between types of inflammatory arthritis.

Natural Treatments

For inflammation of all kinds: Find the underlying cause of the problem and remove it. This is the key. I have found that most inflammatory arthritis responds well when a cause is found, but sometimes you need to just start with something.
- The AIP (Autoimmune Paleo) diet has worked for many people.
- Find any food sensitivities and avoid them. Common offenders are:
  - Nightshades
  - Dairy
  - Nuts/seeds
  - Lectins
- For RA (rheumatoid arthritis) add the following:
  - Biotin 300mg per day – shuts down the enzyme that “ages” your joints.
  - Diet changes require getting off any foods that may trigger citrulline.
  - Magnesium Glycinate 400mg per day
  - Consider Calcium Channel Blocker medications to inhibit “aging” proteins.
- For gout:
  - Consider medications to lower uric acid levels.
  - Avoid fructose or any sweets, even artificial sweeteners.
  - Avoid organ meats, Alcoholic beverages, and decrease beans.
  - Dairy helps to excrete uric acid so it may help to prevent gout.

If your joints are inflamed with swelling, redness, heat, and tenderness, this is an inflammatory arthritis. It is important to take care of this problem, as the inflammation will destroy the joints if it isn’t addressed.

Beyond Quick Fixes: Why Treating the Cause Matters

Karen had severe rheumatoid arthritis for many years, with deviated joints. It debilitated her in many ways. We tested her food allergies and found she had a problem with nightshades. She went off nightshades, and her arthritis went away. It wasn’t just a little better, it was gone! She came back a few months later and told me she tried eating something with tomato sauce, and it came back with pain, swelling, redness and stiffness. Since she has been off tomatoes, she still has deviated joints in her hands, but no more pain.

Remember Sandy? Once she understood that her arthritis was degenerative—not inflammatory, she was able to focus on nutrition, exercise, and sleep, and finally saw improvement in her pain. However, to her dismay, the joints in her hands did not shrink back to normal. That’s why it’s important to address the cause early.

It’s tempting to reach for painkillers or herbal remedies for quick relief. However, while these can ease symptoms temporarily, they don’t fix the underlying problem—and long-term use may even bring unwanted side effects. That’s why it’s so important to pinpoint the cause of arthritis and choose treatments that address the root issue.

[v] The Journal of Nutrition; Volume 147, Issue 12, December 2017, Pages 2252-2261; Protein Ingestion before Sleep Increases Overnight Muscle Protein Synthesis Rates in Healthy Older Men: A Randomized Controlled Trial; Kouw, et. al. ; https://www.sciencedirect.com/science/article/pii/S0022316622106322

2 Types of Arthritis — and How to Tell Which One You Have

Understanding Your Joint Pain

Understanding Joint Pain: More Than Just Aching Joints

Degenerative vs. Inflammatory Arthritis: What’s the Difference?