Arthritis refers to a group of diseases that cause inflammation and swelling of one or more joints. There are more than 100 types of arthritis, with the most common types being osteoarthritis, rheumatoid arthritis, and psoriatic arthritis.
Symptoms vary depending on the type of arthritis, but usually include joint pain and stiffness. Joint pain can either occur symmetrically, affecting both sides of the body, or asymmetrically, causing unilateral symptoms, which only affect one side of your body.
Types of Arthritis That Cause Unilateral Joint Pain
Osteoarthritis (OA), also called degenerative joint disease, affects more than 30 million Americans. While many people associate osteoarthritis with the wear and tear that the body’s joints endure over time with aging, more than half of Americans affected by osteoarthritis are under the age of 65.
Osteoarthritis can affect any joint, although it is most common in the back and spine, hips, knees, neck and shoulders, and fingers and hands. Anyone who overuses their joints, including athletes, military personnel, and those with physically demanding jobs, may be at an increased risk of developing arthritis.
Cartilage is a form of connective tissue that covers the end of each bone in the body and provides cushioning and shock absorption to the joints, allowing them to move smoothly. In OA, cartilage breaks down over time, causing pain and increased difficulty moving the joints.
Bones may begin to break down with worsening arthritis, resulting in painful bone growth called bone spurs, or osteophytes, which can cause further damage to the cartilage.
In severe osteoarthritis, the cartilage wears down so much that bone rubs directly against bone with movement of the joints, causing increased pain, inflammation, and joint damage.
Osteoarthritis often begins unilaterally, affecting one side of the body, but it can progress to both sides of the body over time. The side that you develop OA on may either be your weaker side or the side that you use more often with movements and daily activities, especially your dominant hand.
About 30% of patients with psoriasis, an inflammatory condition of the skin, develop an autoimmune, inflammatory form of arthritis called psoriatic arthritis where the body produces autoantibodies that attack its own joints. Psoriatic arthritis can affect the joints of the entire body and result in permanent joint damage if left untreated.
Psoriasis affects 74 million adults in the United States, and 30% of patients diagnosed with psoriasis will develop psoriatic arthritis. Of these cases, asymmetric psoriatic arthritis, also called asymmetric oligoarthritis, makes up about 60% of all cases of psoriatic arthritis.
Symptoms of psoriatic arthritis can be either symmetric or asymmetric, and joint pain most commonly occurs in the hands, feet, and low back. Sometimes symptoms start on one side and then progress to affect both sides of your body.
Medications may help reduce symptoms of psoriatic arthritis like joint pain and inflammation and prevent disease progression. Treatment is aimed at promoting remission and preventing joint damage.
The prognosis for those diagnosed with arthritis becomes worse the longer your condition goes untreated, so it is important to seek medical attention if you think you have symptoms of arthritis.
Inflammatory arthritis like psoriatic arthritis, ankylosing spondylitis, and rheumatoid arthritis are treated by a rheumatologist, while osteoarthritis treatment can be from multiple providers in areas such as primary care, rheumatology, orthopedic surgery, and physiatry.
A physical exam combined with a review of your medical history, symptoms, and X-ray imaging are used to confirm a diagnosis of arthritis and identify the affected joints. MRIs can give your doctor a clearer look at your cartilage and other parts of the affected joints.
Your doctor may perform joint aspiration, where a needle is inserted into the joint to extract synovial fluid, a thick liquid between your joints. The results of this test can help rule out other conditions or forms of arthritis.
Your doctor may check for symptoms of psoriasis to determine if you have psoriatic arthritis. Signs of psoriasis often appear on the skin first before joint symptoms begin and include:
- Scaly, itching skin patches
- Nail changes
- Pain and swelling within joints
- Tendon and ligament pain
- Chronic fatigue
- Inflammation of the eyes called uveitis
- Digestive symptoms, such as abdominal pain, bloating, constipation, and diarrhea
- Organ damage from inflammation of the heart, lungs, or kidneys
Blood tests that examine your erythrocyte sedimentation rate and levels of C-reactive protein can help confirm a diagnosis of psoriatic arthritis since these markers are typically elevated with this condition.
You may also have bloodwork that examines your rheumatoid factor to rule out a diagnosis of rheumatoid arthritis, an autoimmune type of arthritis that usually occurs symmetrically on both sides of the body.
You may be referred to a rheumatologist, a specialized internal medicine doctor who treats inflammatory conditions of the joints, if you are suspected to have psoriatic arthritis or rheumatoid arthritis.
Symptoms of arthritis can worsen over time if left untreated. If you have been experiencing chronic joint pain, stiffness, decreased mobility, or swelling for more than three months, it is important that you see a doctor to address your symptoms.
Management of your condition is crucial to preventing disease progression and worsening of symptoms, which can significantly impact your ability to move your joints and complete your day-to-day activities.
Psoriatic Arthritis Doctor Discussion Guide
Treatment options for managing your arthritis symptoms include:
- Rest: Resting your arthritic joints by limiting activity and avoiding repetitive movements can help ease pain and inflammation.
- Immobilization: Wearing a hand splint to immobilize the finger joints can reduce pain and inflammation with arthritis of the hands and fingers, especially if it is aggravated by activity.
- Heat: Heat therapy is best used for chronic arthritis to help loosen and relax tight muscles and stiff joints.
- Ice: Applying ice to arthritic joints can help relieve pain and inflammation, especially if swelling is present.
- Medication: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help with symptoms and pain.
- Topical pain relievers: Over-the-counter creams and ointments, especially those containing capsaicin, an extract derived from chili peppers, can be applied topically to joints to help relieve pain by decreasing the intensity of pain signals sent along nerve pathways.
- Paraffin: Warm paraffin wax application to the hands and fingers can help decrease arthritis pain and joint stiffness.
- Exercises: Stretches and exercises can help ease pain, improve range of motion and joint mobility, and increase strength of the muscles surrounding your joints.
- Prescription medication: Higher-strength medications may be prescribed to reduce pain and inflammation, including disease-modifying antirheumatic drugs (DMARDs) and biologics like TNF-inhibitors if you have psoriatic arthritis.
- Rehabilitation: Your doctor may refer you to physical or occupational therapy to improve the mobility of your joints, increase the strength and flexibility of surrounding muscles, and apply therapeutic modalities to alleviate pain, stiffness, and swelling.
- Corticosteroid injections: Your doctor may suggest administering a corticosteroid injection into your arthritic joints to help decrease inflammation and relieve pain if other methods are not effective at improving symptoms.
- Surgery: Surgery is used as a last resort to manage severe arthritis when other methods have failed to relieve symptoms. Arthroscopies, commonly called “scopes,” may be used to debride joints and remove torn pieces of cartilage. When severe arthritis has significantly worn away cartilage, especially in the hips, knees, or shoulders, joint replacement surgery may be considered to reduce pain and improve your overall level of physical functioning.
Aside from treatment options that can be performed at home or under the care of a healthcare provider, maintaining healthy lifestyle habits can help manage your arthritis symptoms by decreasing inflammation throughout your body and promoting a healthy environment for healing.
Tips for a healthy lifestyle include:
- Prioritizing getting enough sleep at night—at least seven to eight hours—to promote healing
- Eating a healthy diet and managing a healthy weight
- Staying adequately hydrated
- Maintaining a positive attitude and learning how to cope with and manage stress
- Following an exercise program as prescribed by a physical therapist
- Exercising and staying active
Some forms of arthritis like osteoarthritis and psoriatic arthritis may affect only one side of your body. For osteoarthritis, you may develop symptoms on the side of your body that you use more often, like your dominant hand, because the condition is caused by repetitive overuse of your joints. For psoriatic arthritis, symptoms can affect one or both sides of your body.
A Word From Verywell
Strengthening the muscles surrounding arthritic joints is essential for decreasing strain on your joints and preventing arthritis from progressing.
It is important that you seek medical attention if you have been experiencing joint pain, stiffness, or swelling for more than three months.
If you have been experiencing other symptoms such as fatigue, tendon pain, and changes to your nails, skin, or eyes, you may be referred to a rheumatologist.
Frequently Asked Questions
Why do I have arthritis on one side of my body?
You may have arthritis on one side of your body if the muscles on that side are weaker and cannot adequately support your joints, leading to increased joint pressure and cartilage breakdown. Alternatively, arthritis may also develop on one side of your body if you repetitively use one side more than the other, especially your dominant hand, since repetitive activities put chronic stress on joints that can wear down cartilage over time.
What are the first signs of psoriatic arthritis?
Most people notice symptoms of psoriasis, particularly dry, scaly skin plaques, before symptoms of psoriatic arthritis. If you have already been diagnosed with psoriasis, the first signs of psoriatic arthritis typically include joint pain, warmth, and swelling, especially in the hands and feet; nail changes such as pitting and separation; and accompanying fatigue.
What’s the difference between psoriatic arthritis and rheumatoid arthritis?
While both conditions are autoimmune, inflammatory types of arthritis, psoriatic arthritis develops only in patients who also have psoriasis, an inflammatory condition of the skin that causes dry, scaly plaques. Psoriatic arthritis also often affects your nails, eyes, and tendons. Unlike psoriatic arthritis, rheumatoid arthritis often causes elevated levels of rheumatoid factor in the blood, and symptoms usually present on both sides of the body.