Air pollution linked to spikes in rheumatoid arthritis activity and flare risk

From medicalxpress.com

A study shows that exposure to air pollution, especially fine particulate matter like dust, soot and smoke (PM2.5), is associated with increased disease activity and flare risk in rheumatoid arthritis (RA).

The findings from an article in the journal Annals of the Rheumatic Diseases (ARD) underscore the importance of health care providers and policymakers recognizing its impact on RA management.

RA is a chronic autoimmune disease characterized by joint inflammation and damage, and widespread systemic symptoms can affect other parts of the body beyond the joints. Globally, it affects about 0.5% to 1% of the adult population. Many factors contribute to the development of RA, such as genetics, immune system changes and environmental exposures. These environmental factors may play a critical role in both the onset and exacerbation of RA; importantly, many are modifiable. Smoking is one of the well-established risk factors, while climatic factors, such as air temperature and humidity, and certain pollutants, like silica, have also been implicated.

Previous epidemiological studies have shown an association between air pollution and an increased risk of developing RA. A team of investigators in South Korea conducted research to evaluate the effects of air pollution on disease activity and flare occurrence in patients with established RA and explore its underlying mechanisms.

Credit: Sun Hwan Shim

Editorial sees broad implications

In an accompanying editorial, Jeffrey A. Sparks, M.D., M.M.Sc., of the Division of Rheumatology, Inflammation, and Immunity at Mass General Brigham / Brigham and Women's Hospital and Harvard Medical School, comments, "This is one of the largest studies to use robust methods to link air pollutants with RA disease activity. Considering rising levels of air pollutants, these results have significant clinical, biological and public health implications."

"They also further reinforce that inhalants may have broad implications for risk and progression of RA and perhaps other autoimmune diseases. From a clinical perspective, this may offer avenues to lower the risk of RA flares by avoiding poor-quality air and provide some potential explanation for otherwise idiosyncratic RA flares."

Tracking pollution against clinic visits

This prospective cohort study tracked 1,070 patients with RA across 12,583 real-world outpatient visits over four years (2021–2024) at a major South Korean medical centre. Air pollution exposure was estimated using monthly concentrations of six major air pollutants (sulphur dioxide, SO2; nitrogen dioxide, NO2; ozone, O3; carbon monoxide, CO; particulate matter with a diameter of 10 µm, PM10; and particulate matter with a diameter of 2.5 µm, PM2.5), which were matched with disease activity and flare outcomes longitudinally recorded at each outpatient visit.

The statistical analysis was adjusted for demographic characteristics, serologic status (the presence of specific antibodies typical for RA in the blood), medication use, socioeconomic factors and meteorological variables. For a sensitivity analysis to better control for time-invariant confounding and avoid potential reverse causation inherent in the monthly analysis, investigators applied a case-crossover design using daily air pollutant concentrations preceding each visit. They used conditional logistic regression to assess changes within the same patient.

Fine particles stood out

"Our study found that higher PM2.5 concentrations were associated with increased disease activity and flare risk, particularly with prolonged exposure to elevated PM2.5 over more than two weeks," explains lead investigator Eun Bong Lee, M.D., Ph.D., of the Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, and Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea.

The investigators identified PM2.5 as the key contributor to increased RA disease activity. Because these microscopic particles are smaller than red blood cells, they can easily travel from the lungs into the bloodstream, circulating to distant organs. They can then trigger the overproduction of harmful molecules called reactive oxygen species, thereby inducing cellular stress, damaging DNA and sparking inflammatory responses in organs.

Questions beyond one population

Lee concludes, "Our study has important implications for public health policymaking. While further studies are warranted to determine whether improving air quality can reduce disease activity in RA patients, we recommend that these patients avoid prolonged exposure to poor air quality, particularly high PM2.5 levels."

ARD Editor-in-Chief Josef Smolen, M.D., of the Medical University of Vienna, adds, "As always, this paper underwent thorough peer review, and it was nice to learn that all reviewers agreed on the importance and interest of these findings. Nevertheless, we should be aware that the observations pertain to the studied Korean population, with a specific genetic background and under specific environmental circumstances.

Whether these data hold true in other regions of the world should be a focus of future investigations. However, it is an excellent starting point for our better understanding of factors that may play a role in influencing disease activity and therapeutic responses of patients with RA. And it is an important wake-up call. The environment is likely an essential contributor to pain and inflammation in the patients for whom we care."

https://medicalxpress.com/news/2026-08-air-pollution-linked-spikes-rheumatoid.html#google_vignette 

Think Arthritis Is Only for Seniors? Obesity Is Changing the Rules

From timesnownews.com

Authored by: Ashima Sharda Mahindra

Obesity increases joint stress and inflammation, raising the risk of early-onset arthritis. Losing weight can reduce pain and improve mobility

For decades, arthritis was considered a condition that mainly affected older adults. However, doctors are now seeing a worrying trend - more people in their 30s and 40s are developing early-onset arthritis, with obesity emerging as one of the biggest risk factors. While genetics, injuries, and aging still play important roles, carrying excess weight can significantly accelerate joint damage and increase the risk of chronic pain much earlier in life.

Why does obesity increase the risk of arthritis?

According to Dr. Rajesh Chandra, Consultant – Gastroenterology, Manipal Hospitals, Vijayawada, obesity affects joints in two major ways: through mechanical stress and chronic inflammation.

“Every extra kilogram of body weight increases the pressure placed on weight-bearing joints such as the knees, hips, ankles, and lower back. During everyday activities like climbing stairs or standing up from a chair, the force on the knees can be several times a person's body weight,” said Dr. Chandra. Over time, this repeated stress wears down cartilage—the smooth tissue that cushions joints and allows pain-free movement.

As cartilage deteriorates, bones begin rubbing against each other, leading to pain, stiffness, swelling, and reduced mobility.

Obesity triggers inflammation too

The damage isn't caused by excess weight alone.

Body fat is metabolically active and releases inflammatory proteins known as cytokines. These chemicals contribute to long-term inflammation throughout the body, increasing joint damage and worsening arthritis symptoms. This inflammatory effect also explains why obesity-related arthritis may affect joints that do not carry body weight, including the hands.

                                                         Obesity May Be the Hidden Reason Arthritis Strikes Earlier

Younger adults are increasingly at risk

Doctors are becoming increasingly concerned about rising obesity rates among children, teenagers, and young adults.

When excess weight begins in adolescence, joints remain under continuous stress during their developmental years. As a result, some individuals experience chronic knee pain and arthritis years - even decades - earlier than previous generations.

Orthopaedic clinics are reporting a growing number of patients under 40 seeking treatment for joint pain that was once considered a disease of older age. “Someone who has carried excess weight since adolescence may begin experiencing knee pain or early arthritis decades before it was once considered typical. That shift is becoming harder to ignore in everyday practice,” said Dr. Chandra.

How arthritis affects daily life

Early-onset arthritis is more than occasional joint discomfort.

Persistent pain often discourages physical activity, creating a vicious cycle. Reduced movement weakens muscles that support the joints, leading to further instability and pain. Many people begin avoiding walking, climbing stairs, exercising, or even household chores. Over time, arthritis may reduce work productivity, disturb sleep, and negatively affect mental health due to limited mobility and chronic discomfort.

Can weight loss help?

The encouraging news is that obesity is one of the few arthritis risk factors people can change. Research shows that losing just 5 to 10 per cent of body weight can significantly reduce knee pain, improve joint function, and decrease pressure on weight-bearing joints. “Even modest weight loss reduces the force placed on knees with every step, providing meaningful long-term benefits,” Dr. Chandra added.

Best exercises for painful joints

Many people fear exercise will worsen arthritis, but complete rest usually makes symptoms worse. Doctors recommend low-impact activities that strengthen muscles without overloading joints, including:

• Walking at a comfortable pace
• Swimming
• Cycling
• Water aerobics
• Physiotherapist-guided strengthening exercises

These activities improve flexibility, muscle strength, and overall joint function while minimizing additional stress.

When should you see a doctor?

Don't ignore persistent joint pain simply because you're young. Seek medical advice if you experience knee pain lasting several weeks, morning stiffness, swollen joints, difficulty climbing stairs, and reduced range of motion.

Early diagnosis and treatment can slow arthritis progression, relieve symptoms, and help preserve mobility.

https://www.timesnownews.com/health/think-arthritis-is-only-for-seniors-obesity-is-changing-the-rules-article-155227899

No, arthritis isn’t just an old person’s problem: Five common myths busted

From stuff.co.nz

More than 850,000 New Zealanders live with arthritis, but despite how common it is, plenty of myths and misconceptions remain.

We asked Arthritis New Zealand Mateponapona Aotearoa to bust five of the most common myths it hears every day.

                                                                                                                     Photo: 123rf

Myth 1: Arthritis is just part of getting older

False.

‘Oh, arthritis? That’s just something only old people get’ – right? Wrong, and I should know. In my early 40s (shut up, that’s not old), I got a severe form of reactive arthritis from a food bug. You can read about my ‘fun’ journey here.

Sure, osteoarthritis becomes more common as we age, but there are more than 140 types of arthritis, including mine. Arthritis affects people of all ages, including children, teenagers and young adults.

Bottom line: Arthritis can affect anyone, regardless of age.

Myth 2: If my X-ray shows arthritis, that's why I'm in pain

Not necessarily.

An X-ray gives you a snapshot of what the bones in your joints look like, but it doesn’t necessarily show the whole picture.

Arthritis NZ says that in some cases, people can have significant changes on an X-ray but experience very little pain, while in others, there may be severe pain despite only minor changes showing up on an X-ray.

X-rays are a piece of the puzzle, but healthcare professionals look at the person and their symptoms as a whole, rather than relying on an X-ray alone.

Bottom line: Treat the person, not just the X-ray.

Myth 3: Gout is caused by eating rich food and drinking too much alcohol

False.

Not everyone will know that gout is a form of arthritis. It develops when too much uric acid builds up in the blood and forms crystals in the joints, often because the kidneys aren't removing enough uric acid from the body. Genetics also play a major role.

While certain foods and alcohol can trigger attacks – such as beer, sugary food and drinks, liver, some meats and seafood – they aren't usually the underlying cause.

Thankfully, gout, although painful, is also highly treatable. Urate-lowering medication can help prevent attacks and protect the joints.

Bottom line: Gout can be effectively managed.

Myth 4: Exercise wears out your joints if you have arthritis

False.

A particularly bad bout of reactive arthritis for me came during Christmas one year. I could hardly walk without screaming in pain, but my partner, later husband, decided to buy me a Fitbit. The irony was dripping as I put it on my wrist.

But he was actually right – appropriate exercise can reduce pain, strengthen muscles and help maintain joint function.

Don’t push through pain, but find movement that works for you. Long-term inactivity won't help – it can lead to weaker muscles, stiffer joints and potentially more pain.

Bottom line: Movement can be one of the best ways to manage arthritis.

Myth 5: Osteoarthritis is just 'wear and tear'

Not anymore.

In the past, osteoarthritis was described as joints simply wearing out with age and use. Not now – we know it’s more complex than that.

Arthritis NZ describes it as a “whole-joint condition involving cartilage, bone, muscles and inflammation”.

“While age and previous injury can increase the risk, staying active, strengthening muscles and managing symptoms early can help people continue living well with osteoarthritis.”

Bottom line: Osteoarthritis is more complicated than simply "worn-out" joints.

Bonus: Cracking your knuckles gives you arthritis

False.

The cracking sound comes from changes involving gas within the fluid that lubricates your joints. There's no evidence that regularly cracking your knuckles causes arthritis.

https://www.stuff.co.nz/health/361010099/no-arthritis-isnt-just-old-persons-problem-five-common-myths-busted 

A gut health supplement found in common vegetables may reduce knee arthritis pain in six weeks, study finds

From economictimes.indiatimes.com

Synopsis

New research suggests a daily gut health supplement may reduce knee arthritis pain. Inulin, a prebiotic fibre, significantly lowered pain and improved grip strength in participants. This dietary change also reduced pain sensitivity and increased a key gut hormone. The supplement proved easier for participants to adhere to compared to physiotherapy.

A daily gut health supplement may do more than improve digestion. New research suggests it could also help reduce knee arthritis pain, improve strength, and even change how the body processes pain. Researchers found that inulin, a naturally occurring prebiotic fibre found in foods such as “chicory root, Jerusalem artichokes and other vegetables,” significantly reduced pain and improved grip strength in people with knee osteoarthritis after just six weeks.

The findings suggest that targeting gut bacteria could become a valuable addition to existing arthritis treatments, though the researchers stress that larger studies are still needed before the supplement can be recommended routinely.

What did the study investigate?

The study, published in Nutrients, titled "Effect of Prebiotic Supplementation With and Without Physiotherapy on Pain and Pain Sensitivity in People with Knee Osteoarthritis," was conducted by researchers from the University of Nottingham and collaborators.

It examined whether improving gut health through a prebiotic supplement could reduce pain associated with knee osteoarthritis, either alone or alongside physiotherapy.

The researchers recruited 117 adults with symptomatic knee osteoarthritis and randomly assigned them to one of four groups:

• Inulin supplementation
  
• Physiotherapy-supported exercise
  
• A combination of inulin and physiotherapy
  
• Placebo
• 
  
• Participants followed their assigned treatment for six weeks, after which researchers assessed changes in pain, physical function, pain sensitivity, and biological markers linked to gut health and inflammation.

                                                                                                                         (Representative image)

• 
  
• The supplement reduced pain and improved strength

Compared with those receiving the placebo, participants taking inulin experienced:

• Reduced knee pain
  
• Improved grip strength
  
• Lower pain sensitivity
  
• Increased levels of GLP-1, a gut hormone linked to pain regulation and muscle function
  

Interestingly, while exercise also helped reduce knee pain, it did not improve grip strength or pain sensitivity to the same extent as the prebiotic supplement.

According to the researchers, the findings suggest that altering the gut microbiome may influence not only inflammation but also the nervous system's response to pain.

“This study raises the exciting possibility that a simple dietary change - adding a fibre supplement to your breakfast or yogurt - could meaningfully reduce pain and improve physical function." Afroditi Kouraki, lead author of the study said.

How can a gut supplement affect arthritis?

Unlike probiotics, which introduce beneficial bacteria into the digestive system, prebiotics serve as food for the beneficial bacteria already living in the gut. When gut microbes ferment inulin, they produce short-chain fatty acids, including butyrate, which are known to influence immune function, inflammation, and communication between the gut and the brain.

The researchers propose that these biological changes may partly explain why participants reported less pain and showed reduced pain sensitivity after supplementation. Higher GLP-1 levels were also associated with stronger grip strength, suggesting a possible connection between gut health, muscle function, and pain perception.

Participants found the supplement easier to stick with

The study also highlighted an important practical advantage. Only 3.6% of participants receiving the inulin supplement dropped out of the trial, compared with 21% of those assigned to physiotherapy-supported exercise.

Not a cure for arthritis

Despite the encouraging results, the authors caution against viewing inulin as a cure. The trial lasted only six weeks and involved a relatively small group of participants with knee osteoarthritis. The findings cannot yet be applied to other forms of arthritis, such as rheumatoid arthritis, and longer-term studies involving larger populations will be needed to confirm the benefits and determine the optimal dosage.

https://economictimes.indiatimes.com/us/news/a-gut-health-supplement-found-in-common-vegetables-may-reduce-knee-arthritis-pain-in-six-weeks-study-finds/articleshow/132656329.cms?from=mdr

Suffering From Arthritis? Here Are Seven Things You Need To Know

 From dailyvoice.com

Many newly diagnosed arthritis patients find themselves filled with questions and misconceptions about the painful condition. In honour of Arthritis Awareness Month, and to help set the record straight, Dr. Oliver Kurucz, chief of rheumatology at Montefiore Nyack Hospital, discussed the most common questions he hears from newly-diagnosed patients

Q: What is arthritis?

A: The word “arthritis” means joint inflammation. In fact, there are more than 100 kinds of arthritis and related diseases, osteoarthritis being the most common. Symptoms include achy joints after physical work or exercise as well as joint swelling and bony enlargement of the joints.

Rheumatoid arthritis is an autoimmune disease, meaning the body’s immune system mistakenly attacks the joints, causing swelling and pain in and around the joints. It most often affects the joints of the hands, feet, wrists, elbows, knees and ankles.

An arthritis diagnosis is often mistakenly filled with misinformation and fear, says Dr. Oliver Kurucz.

Photo Credit: Montefiore Nyack Hospital

Q: Is arthritis more likely to develop as a person ages? Are women more likely to develop it?

A: It depends on the type of arthritis. About 80 percent of people over age 50 have some form of osteoarthritis, and it is equally common in men and women. Rheumatoid arthritis is most common in people between the ages of 30 and 50 and occurs more often in women.

Q: Can arthritis be treated through diet?

A: Eating a so-called “anti-inflammatory” diet, also known as a Mediterranean diet, can help reduce inflammation associated with both osteoarthritis and rheumatoid arthritis. This diet includes fish, nuts and seeds, fruits and vegetables, whole grains and beans. Other anti-inflammatory foods include avocado and dark chocolate. 

Q: Will exercise make my arthritis worse?

A: No -- exercise can improve arthritis symptoms. Strengthening exercises help support muscles around affected joints, easing the burden on those joints and reducing pain.

Q: Should I take glucosamine/chondroitin for my arthritis?

A: Glucosamine and chondroitin are popular supplements used to treat the pain and loss of function associated with osteoarthritis. My recommendation to patients who ask about these supplements is to try them for three months and see if it helps. If you don’t notice a benefit in that time, it’s probably not worth your money.

Q: Are there any medications that can cure arthritis?

A: There are currently no treatments that can cure osteoarthritis. Treatment generally starts with diet, exercise, physical therapy and weight loss, and then moves to pain relievers if non-drug treatments are not effective. 

Rheumatoid arthritis treatment includes nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen, naproxen and naproxen sodium to relieve pain and inflammation, and disease-modifying antirheumatic drugs or biologic agents to slow or stop the progression of the disease and damage to the joints.

Q: Does my arthritis need to be treated by a rheumatologist, or can I be treated by my internist?

A: Many people with osteoarthritis can be successfully treated by their internist. If you have an inflammatory type of arthritis, such as rheumatoid arthritis or psoriatic arthritis, I would recommend treatment by a rheumatologist.

https://dailyvoice.com/article/suffering-from-arthritis-here-are-seven-things-you-need-to-know/ 

Why joint pain may worsen before it rains

From indianexpress.com

Can rainy weather make joint pain worse? A doctor explains how changes in barometric pressure, cold weather and a sensitised nervous system may influence chronic pain and arthritis symptoms

Many people with arthritis, old injuries, or chronic pain say they can predict changes in the weather before the first raindrops fall. In an Instagram video, US-based doctor and content creator Dr Kunal Sood addressed this commonly discussed issue. He said, “Can joint pain or chronic pain really flare when it rains? For some people, the answer comes down to how sensitive the nervous system and irritated tissues have become. After an injury, surgery, or an inflammatory pain condition, the affected area can become more reactive than before. Weather changes can add another layer.” Explaining a possible mechanism, he added, “Before rain, barometric pressure can shift, and that may slightly change pressure around already sensitive joints, tendons, or nerves. Cold weather can also reduce local blood flow and make muscles, tendons, and connected tissue feel stiffer. This can happen with arthritis, fibromyalgia, nerve pain, recent inflammation, or pain after surgery.”

Dr Sood also emphasised that worsening pain during rainy weather does not necessarily indicate that the underlying condition has deteriorated. He explained, “That doesn’t always mean new damage is happening. It may mean the pain system is more sensitive to changes the body used to ignore. That is why some people can feel pain flare before or during rainy weather, even when nothing new has happened structurally.” Summing up, he said, “The weather may not be creating the pain from scratch, but it can amplify pain signals in a body that is already sensitised.” His explanation raises broader questions about the relationship between weather, the nervous system and chronic pain. We asked an expert to explain what current evidence shows.

                                                                Dr Kunal Sood discusses joint pain | Source: Canva

Weather and chronic pain

Dr P C Jagadeesh, senior orthopaedic surgeon at Kauvery Hospital, tells indianexpress.com, “While many patients report worsening pain before or during rainy weather, scientific evidence remains mixed. Some studies have found an association between changes in barometric pressure and increased joint discomfort, particularly in individuals with osteoarthritis and inflammatory arthritis, while others have shown only a weak correlation. Clinically, however, it is common to hear patients describe weather-related fluctuations in pain. Conditions most frequently associated with this phenomenon include osteoarthritis, rheumatoid arthritis, old fractures or ligament injuries, chronic back pain, and fibromyalgia. Some individuals with nerve-related pain may also report increased sensitivity during periods of weather change.”

Managing weather-related joint and muscle pain

Maintaining regular movement is one of the most effective ways to manage weather-related pain. Dr Jagadeesh suggests that gentle stretching, strengthening exercises, walking and physiotherapy-guided routines help keep joints mobile and muscles conditioned. Applying heat, staying physically active indoors, maintaining a healthy weight and ensuring good sleep can also reduce symptom severity. Patients should avoid becoming sedentary during painful periods, as inactivity often worsens stiffness and discomfort.

“Medical evaluation is important if the pain becomes progressively worse, starts interfering significantly with daily activities, is associated with swelling, redness, warmth, weakness or loss of function, or if there is a sudden change in symptoms. Persistent worsening pain may indicate progression of arthritis, a new injury, nerve involvement or another underlying condition that requires proper assessment and treatment,” concludes Dr Jagadeesh.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.

https://indianexpress.com/article/lifestyle/health/doctor-joint-pain-rainy-weather-barometric-pressure-10793509/