Chronic pain caused by arthritis affects millions of people in the United States every year. About one in four adults with arthritis—15 million people—report experiencing severe joint pain related to arthritis. Additionally, nearly half of adults with arthritis have persistent pain.

Children with arthritis have pain as well. There is limited information about pain in children in the general population.

Defining Pain

Severe joint pain: When an individual rates his or her pain as 7 or higher out of 10 on a scale of 0 (no pain) to 10 (as bad as it can be).

Persistent pain: When an individual reports having pain (of any severity) on most or all days in the past 3 months.

Arthritis-related severe joint pain affects adults of all ages, both sexes, and all races and ethnicities. Most of what we know about severe joint pain is for adults. The age-standardized prevalence of severe joint pain among adults with arthritis varies by state, ranging from 20.8% in Colarado to 45.2% in Mississippi.

In 2017 in the United States, severe joint pain prevalence among adults with arthritis was:

• Higher among women (36.0%) than men (27.3%).
• Highest among adults aged 45 to 64 years  (35.6%). Prevalence was next highest for adults aged 18 to 44 years (33.0%) and lowest for adults aged 65 years or older (25.1%).
• Highest among non-Hispanic Blacks ( 50.9%), followed by Hispanics and American Indian/Alaska Natives, (both 42.0%), then Other/Multiple Races (37.4%) and Asians (27.7%), and lowest among non-Hispanic whites (27.4%).
• Highest among obese (37.2%) compared to overweight (28.6%) and underweight adults (29.1%).

• Severe joint pain is more common among adults with arthritis who also have other chronic conditions including diabetes (40.9%) and heart disease (34.1%), and among adults with a disability (45.6%).
• More than half (56.3%) of adults with arthritis and serious psychological distress reported having severe joint pain.

Rheumatic disease refers to arthritis and several other conditions that affect the joints, tendons, muscle, ligaments, bones, and muscles.

How rheumatic disease causes severe pain

Rheumatic disease is an umbrella term that refers to arthritis and several other conditions that affect the joints, tendons, muscle, ligaments, bones, and muscles (arthritis refers to disorders that mainly affect the joints). Rheumatic diseases, like osteoarthritis, can lead to severe joint pain from the breakdown of cartilage, the firm but soft tissue that protects a joint, when not managed well.

The most common rheumatic diseases include osteoarthritis, the most common form of arthritis, and rheumatoid arthritis—sometimes referred to as RA. Rheumatoid arthritis is a condition in which the immune system attacks healthy cells. It can cause inflammation, swelling, and pain in several joints at once. Other common rheumatic disease include:

• Fibromyalgia: a rheumatic disorder that affects 4 million people and causes pain all over the body (also referred to as widespread pain), sleep problems, fatigue, and often emotional and mental distress.
• Gout: a form of arthritis in which urate crystals build up in a joint, usually the large joint of the big toe.
• Childhood/juvenile arthritis: arthritis in children; the most common form is juvenile rheumatoid arthritis.
• Lupus: a chronic autoimmune disease that occurs when the body’s immune system attacks the tissues and organs, causing damage to any part of the body.

Risk factors for rheumatic diseases depend on the specific disease. You can read more about rheumatic diseases and arthritis risk factors on the Arthritis Risk Factors web page. Inflammation of joints and other ligaments can cause long-lasting or chronic pain and lack of balance. CDC recognizes programs and has resources for adults living with arthritis and rheumatic diseases to improve their quality of life and relieve related symptoms.

How to ease pain related to arthritis and rheumatic diseases

Nearly 1 in 3 US adults with doctor-diagnosed arthritis (which includes gout, fibromyalgia, lupus, rheumatoid arthritis, and osteoarthritis) have severe joint pain, according to a recent CDC study. That means about 19 million US adults report pain so severe that it can limit their daily activities. An earlier CDC study found some groups are more affected by severe joint pain than other groups, including Black and Latino adults and those in fair to poor health, with serious psychological distress, who are unable to work, or with diabetes or heart disease.

People can help manage pain and stiffness from arthritis in a few ways:

• Get physically active! Studies show that physical activity can help ease joint pain and stiffness, and improve function, mood, and quality of life for adults with arthritis. Strength training is also recommended. You can do low-impact physical activity, like swimming, walking, and biking, to reduce joint pain.
• Check out CDC-recognized physical activity programs to help adults get or stay active and manage arthritis and other chronic conditions. Many of these programs are now offered remotely.
• Join one of the CDC-recognized self-management education classes that are proven to improve the quality of life of adults with arthritis.

Almost 15 million US adults live with severe joint pain related to arthritis. Severe joint pain limits a person’s ability to do basic tasks and affects their quality of life. Learning self-management skills and being active can help manage severe joint pain.

CDC Study on Severe Joint Pain

A CDC study looked at severe joint pain among adults aged 18 years or older with arthritis. Study highlights include

• Severe joint pain from arthritis is from the breakdown of cartilage (tissues around a joint) in the body and pain that is not managed well.
• Severe joint pain occurs in more than one third of 58 million adults with arthritis.
• Some groups are affected by severe arthritis pain more than others and include Black or African American persons, Hispanic or Latino persons, people in fair to poor health, adults with serious psychological distress, people who are unable to work, and people with diabetes or heart disease.

What to Do to Ease Severe Joint Pain

People with severe joint pain related to arthritis have multiple ways to improve how they feel and enjoy life.

• Get physically active. It is recommended that adults with arthritis be moderately physically active for at least 150 minutes per week. Strength training is also recommended. Further, physical activity has been proven to reduce arthritis pain. You can do low impact physical activity to reduce joint pain.
• Go to CDC-recognized physical activity programs. Particular community-based programs (such as EnhanceFitness and Walk With Ease) are helpful in learning how to exercise safely and reduce joint pain and disability related to arthritis. These programs can improve mood and ability to move as well. Classes take place at local Ys, parks, and community centers and help people with arthritis feel their best.
• Enroll in proven programs. Adults living with joint pain can benefit from joining CDC-recognized self-management education classes, which are designed to teach people with arthritis and other chronic conditions how to control their symptoms (like severe join pain), live well with these conditions, and learn more about how to manage health problems that affect their lives.

Many professional organizations have guidelines for managing arthritis pain. A common theme across guidelines is that pain management strategies should be flexible, include options that do not involve medication, and be tailored to meet the needs of the patient. Such guidelines suggest the following for managing arthritis symptoms such as pain:

• Over-the-counter medications like acetaminophen (e.g., Tylenol®) or ibuprofen (e.g., Advil® or Motrin®) and other nonsteroidal anti-inflammatory drugs (NSAIDs).
• Physical activity/exercise or community-based physical activity programs.
• Exercise therapy, including physical therapy.
• Self-management education workshops.
• Weight loss, if overweight or obese.
• Cognitive behavioral therapy—a psychological, goal-directed approach in which patients learn how to modify physical, behavioral, and emotional triggers of pain and stress.

Over-the-Counter Medications

Emerging evidence suggests that these are safer and more effective treatments for managing long-term arthritis pain than opioids.

• A recent study of individuals with knee and hip osteoarthritis, the most common types of arthritis, found that after one year, people who took over-the-counter medications had greater reductions in pain severity than people who took opioids.

Prescription Opioids

Prescription opioids are medications that can be used to treat moderate to severe pain. In 2015, nearly one in three US adults with arthritis purchased at least 1 prescription opioid from a pharmacy that year. Furthermore, adults with arthritis accounted for more than half of US adults with at least 1 opioid prescription dispensed. There is limited evidence of prescribed opioids’ long-term effectiveness when used for chronic conditions such as arthritis.

Safer options exist to help manage arthritis pain.

Community-Based Physical Activity Programs

Community-based physical activity programs teach people how to be physically active safely and are a good option for people who are concerned about making their joint pain or arthritis worse. Physical activity programs can result in clinically important improvements in pain and function.

CDC recognizes several community-based physical activity programs that are proven to improve the quality of life of adults with arthritis. Local programs are available at YMCAs, parks, and recreation or community centers across the country.There are multiple ways for adults with arthritis to reduce their pain without using medications.

Physical Activity

• Regular physical activity can help relieve adult arthritis pain as effectively as over-the counter medications.
• Physical activity has many additional benefits, including improved physical function and mood, decreased disability and reduced anxiety.
• Walking, biking, swimming, and other water activities (e.g., water aerobics, aqua jogging) are all effective ways to ease arthritis pain and are safe for most adults.
• Learn more about physical activity for arthritis.

Physical Activity Recommendations

The Physical Activity Guidelines for Americans, 2 Edition recommend:

• Two hours and 30 minutes (150 minutes) of moderate-intensity aerobic activity (i.e., brisk walking) every week. This can be broken down into smaller increments such as three, 10-minute sessions throughout the day.
• Muscle strengthening activities that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms) on 2 or more days a week.
• Aerobic and strengthening activities that improve balance and strengthen legs for adults aged 65 years or older to prevent falls.

Self-Management Education Workshops

Self-management education workshops teach participants life skills to reduce or manage arthritis pain and improve quality of life.

• CDC recommends adults with arthritis participate in self-management education workshops, like the Chronic Disease Self-Management Program (CDSMP), designed for people with arthritis or other chronic conditions. These workshops teach participants strategies to control or limit their symptoms, including pain, and to develop more confidence in managing health problems that affect their lives.
• Workshop participants reported significant improvements in their physical health, including less pain and increased ability to do social and household activities.
• They also noted positive changes in their mental health, including decreased depression, fear, worry, and frustration, as well as increased confidence in their ability to manage their arthritis and other chronic conditions.
• Additionally, participants also reported positive health behaviors such as increased exercise.

Learn how physical activity can ease arthritis pain over time.

About 15 million US adults with arthritis report having severe joint pain, that is, pain rated at a 7 or higher on a scale of 0 (no pain) to 10 (as bad as it can be). Joint pain can interfere with daily activities such as:

• Gripping and carrying grocery bags.
• Holding a mug to drink coffee and tea.
• Walking to the car or mailbox.
• Climbing a short flight of stairs.
• Getting dressed, for example, buttoning and zipping clothes.
• Grooming, for example, brushing and styling hair, shaving, or trimming nails.
• Cleaning and housework, for example, dusting, sweeping, or vacuuming.

Nearly a third of adults with arthritis are physically inactive. Yet a CDC study shows that severe joint pain is more common among adults with arthritis who are physically inactive. Physical inactivity is more common among adults with arthritis who live in states in the Southeast and are disabled or unable to work. Arthritis, severe joint pain, and physical inactivity are linked to limitations in daily activities like holding a mug or cup, lifting and carrying a grocery bag, or walking to the car.

What can People with Arthritis Do?

Physical activity is a way to manage and reduce arthritis pain and decrease the likelihood of activity limitations. CDC, health departments, and national partners promote several physical activity programs to help with that. These programs are designed to engage people of all ages and fitness levels in physical activity to help reduce arthritis pain and minimize activity limitations so they can have a better quality of life. These evidence-based programs use low-impact exercises that work for people with arthritis, like walking, biking, and swimming.

What can Providers Do?

In addition to telling patients with arthritis about the benefits of physical activity, health care providers can encourage them to become physically active by starting slowly and gradually increasing activity over time. Providers can also recommend physical activity programs that are available in the community and remotely.

Arthritis is more common than you may think. Globally, millions of people are affected by arthritis. In the US, about 1 in 4 adults have arthritis that has been diagnosed by a doctor. Arthritis can lead to severe joint pain, thereby limiting the activities people normally do in their everyday lives. This can affect their mental health and ability to work and participate in beneficial physical activity. These four facts about arthritis provide information and resources to help support adults with arthritis, as well as their caregivers and providers.

1. Arthritis is not just limited to older adults.

While arthritis is more common among older adults, arthritis develops in younger people too:

• Among adults aged 65 and older, 50% report ever having been diagnosed with arthritis.
• Among adults aged 45 to 65 years, 31% report ever having been diagnosed with arthritis.
• Among adults aged 18 to 45 years, 7% report ever having been diagnosed with arthritis.

In terms of numbers, however, the majority of US adults with arthritis—nearly 60% —are of working age (18-64 years) and may experience activity limitations that affect their ability to work.

Perhaps lesser known is the fact that arthritis can also develop in children. The symptoms of childhood arthritis may come and go and are similar to those in adults. While there is no cure for childhood arthritis, some children with arthritis achieve permanent remission. This means the disease is no longer active, but any permanent damage to the joints will remain. Early diagnosis and proper treatment are important to prevent or minimize permanent damage.

2. Certain risk factors increase your chances of developing arthritis.

Some behaviors and characteristics, called risk factors, increase an adult’s likelihood of getting certain types of arthritis or making it worse. Risk factors that you cannot control include:

• Genetics or inherited traits.
• Age.
• Sex.

Risk factors that are within your control to change include:

• Extra weight.
• Joint injury or overuse.
• Job or occupation.
• Infection.
• Smoking.

By making certain lifestyle changes like eating healthier and becoming more physically active, you can decrease your risk of getting or worsening arthritis. Visit the Risk Factors page to find out more about what you can do to lower your risk of arthritis.

3. Joint-friendly physical activity is beneficial for people with arthritis.

If you have arthritis, joint-friendly physical activity is one of the most effective ways to manage your symptoms. It’s also a great option for arthritis management without medications or in addition to medications that are carefully monitored by your doctor. Walking, gardening, dancing, and swimming are some examples of joint-friendly activities.

Benefits of physical activity for people with arthritis include:

• Decreased pain.
• Improved range of motion and function.
• Increased energy.
• Improved mood.
• Weight loss and weight maintenance.
• Prevention or improvement of other chronic (long-lasting) conditions, like diabetes and heart disease.

When starting or increasing physical activity, it’s normal to have some pain, stiffness, and swelling for the first 6 to 8 weeks. Nonetheless, sticking with your activity plan can help you form healthy habits and achieve long-term pain relief. Modify your plan as needed and try these other tips to minimize pain while your joints adjust to the new activity.

Virtual and community-based physical activity programs offer structured guidance on how participants can safely engage in physical activity, create action plans, and overcome obstacles.

4. Self-management is important for taking control of your arthritis.

Maybe you’ve heard of self-love or self-care, but what is self-management? Self-management is what you do day-to-day to manage your condition and stay healthy. It’s the ability to take control of one’s own health by tracking symptoms, making healthy choices, going to appointments with health care providers, and seeking help from loved ones or professionals on tasks that are challenging or require expert recommendations.

Self-management involves learning strategies to cope with the physical and emotional challenges of living with a chronic disease. Self-management education workshops empower participants with strategies, skills, and confidence to manage their chronic disease and live healthier lives. These workshops can help participants with arthritis:

• Manage pain and other symptoms.
• Reduce stress.
• Improve mood.
• Communicate better with family, friends, and healthcare providers.
• Make lifestyle changes about food and physical activity.