Inflammatory Arthritic pain

This year’s World Physiotherapy Day is focusing on inflammatory arthritic pain.  But what is this?  Most of you have heard of arthritis, which usually refers to what is known as Osteoarthritis, or wear and tear in the joints.  This happens to all of us at some point as we get older, and our joints become a little bit worn out with age.  Certain people and sports people tend to suffer from arthritic joint pain from a young age due to repetitive use of their joints.  E.g.:  footballers tend to have knee arthritis and rugby players tend to have neck arthritis at a younger age than the normal population due to several impact injuries and overuse during their careers.

But there is another set of arthritis – these are the ones that are Inflammatory in nature such as:

  • Rheumatoid Arthritis
  • Axial Spondylarthritis

Rheumatoid Arthritis (RA) is a type of Inflammatory arthritis and one of the most common.  It is an autoimmune disease that most commonly affects the joints of the hands, wrists, shoulders, elbows, knees, ankles and feet.  It can affect adults of any age, but most common starts in people over 40 and is more common in women.

SYMPTOMS include:

  • Swollen and painful joints
  • Swelling and stiffness in the mornings
  • Severe tiredness
  • A general feeling of being unwell
  • Loss of stamina
  • Loss of muscle bulk
  • Reduced ability to do daily activities.
  • Skin lumps (nodules), eye dryness or redness


People with RA and other inflammatory joint disorders have an increased risk of cardiovascular disease.  People with RA have an increased risk of heart problems.

Healthy lifestyle choices including regular physical activity are important in patients with RA.


People with RA tend to be more sedentary due to their pain.  However, being physically active is recommended for people with RA because it can help:

  • Physical fitness & strengthening your heart
  • Muscle strength and endurance
  • Flexibility and range of joints
  • Balance
  • Pain and fatigue
  • Depression
  • Prevent a loss of bone density

Aim to do a mixture of:

  • Stretching exercise
  • Muscle strengthening
  • Aerobic / cardio exercise
  • Balance exercise

Even if you can manage 10 minutes at a time, it is important to start somewhere.  Aim to reduce your time spent sitting and the time of inactivity. Slowly increase your activity.  Speak to your physiotherapist for guidance. Read here for more information on when and how to exercise with arthritis.


The symptoms of RA can vary from day to day.  They can go from your joints feeling quite good one day, to feeling extremely painful the next day.  Often, this is accompanied by a significant feeling of fatigue.  When the symptoms increase more than usual, this is known as a flare-up.  The ‘fear’ of causing a flare can discourage physical activity.  Speak to your physiotherapist so that s/he can guide you on how to exercise (or not exercise) during flare-ups.



Axial spondylarthritis (Axial SpA) is a type of arthritis that commonly affects the spine.  Axial SpA is an inflammatory condition that mainly affects the bones, joints and ligaments of the spine and pelvis.  This causes pain, swelling and stiffness.  It can also cause tendon pain, inflammation of the eye and symptoms in other joints away from the spine.  The most common is AS – Ankylosing Spondylitis.  These are diagnosed in the late teens and early 20s and are common in both females and males.


  • Pain and stiffness in the pelvis spine, and sacroiliac joints
  • Symptoms worse at night or after rest
  • Pain and stiffness which improves with exercise
  • Joint pain and swelling in the limbs
  • Swelling of fingers and/or toes
  • Waking up at night in pain
  • Symptoms improve with anti-inflammatory medication such as Ibuprofen
  • Recurrent tendon pain
  • Decreased ability to function at work or at home
  • Fatigue and tiredness
  • Other organs can be affected such as the eyes, skin and digestive system


A specific exercise programme can help maintain spine flexibility and whole-body flexibility and reduce pain.  Even when you have pain, continuing to exercise at levels that suit you has significant benefits. In addition to medication, regular exercise is important.  Exercise will:

  • Help you keep moving
  • Help you do things that are important to you
  • Reduce pain and stiffness
  • Strength muscles and joints
  • Improve heart and lungs
  • Manage fatigue and sleep

Speak to your physio to help you formulate an exercise plan for your management of symptoms.  Read here for more information on when and how to exercise.

Information obtained from the World Physiotherapy 2023 website.  More information is found here.