Arthritis and joint pain (rayuma): types, medicine and when to get help

Arthritis means a joint that is painful, stiff or swollen. Many Filipinos call any pain in the joints or muscles rayuma. But rayuma can be different problems, and each is treated differently:

• Osteoarthritis (OA) is the most common type. The smooth cartilage that cushions the ends of the bones slowly breaks down. It usually affects the knees, hips, hands, neck and lower back.
• Rheumatoid arthritis (RA) is an autoimmune disease: the body's defence system attacks the lining of the joints by mistake. It often starts in the small joints of the hands and feet.
• Gout comes from too much uric acid and causes sudden, very painful attacks, often in the big toe. See our gout guide.
• Chikungunya, a virus spread by the same day-biting mosquitoes as dengue, starts with a sudden fever and severe joint pain. The joint pain can last for weeks, months or even longer.
• A joint infection (septic arthritis) is serious and needs a hospital fast. People with RA, diabetes, a weak immune system, recent joint surgery, an artificial joint or gonorrhea (tulo) are more at risk.

Osteoarthritis affected about 528 million people worldwide in 2019 (WHO). Most were over 55, and 6 in 10 were women. Only a health worker can tell which kind of joint pain you have.

Osteoarthritis usually builds up slowly. Pain is worse when you use the joint and better with rest. Stiffness in the morning or after sitting usually eases within about 30 minutes.

Rheumatoid arthritis causes throbbing, aching pain, swelling and warmth, often on both sides of the body (both hands or both feet). Morning stiffness often lasts longer than 30 minutes. Some people also feel very tired, lose their appetite or weight, or have a fever.

• Knee (tuhod): osteoarthritis often affects both knees over time. Pain is worse on stairs, and the knee may give way. Knee pain can also come from a sprain, torn cartilage or bursitis (a swollen fluid sac near the joint).
• Hands (kamay): osteoarthritis causes bony bumps on the finger joints and pain at the base of the thumb, so opening jars gets hard. With RA you may not be able to make a full fist. RA can also press on a nerve in the wrist and cause numbness: see our numbness and tingling guide.
• Feet (paa): RA often starts in the small joints of the feet. A sudden, hot, very painful big toe is more typical of gout.
• Neck (leeg): wear and tear of the neck bones (cervical spondylosis) and RA can cause neck pain and stiffness. But most neck pain comes from posture, an awkward sleeping position or a strained muscle, and it eases within a few weeks. Neck pain with numbness, pins and needles or weak arms or legs needs a check the same day.

Osteoarthritis is more likely with older age (it usually starts in the late 40s to mid-50s), being a woman, being overweight, a past joint injury or surgery, work or sports that strain the same joint, family history, and other conditions such as RA, gout or diabetes.

Rheumatoid arthritis is more likely in women and older adults, and if you have family with RA, smoke or are overweight. Breathing in silica and other dusts, or polluted air, also raises the risk.

Cold weather and rain are not among the known causes. Symptoms can come and go, though, and some people notice changes with the weather.

In adults aged 45 or older, a doctor can often recognise osteoarthritis from the symptoms and an examination, without an X-ray. For rheumatoid arthritis there is no single test. Doctors may use blood tests (such as rheumatoid factor and anti-CCP) and X-rays of the hands and feet. Normal blood tests do not rule RA out.

Don't wait if joints stay swollen. UK guidance says swollen joints with no clear cause should see a specialist (rheumatologist), urgently if the small joints of the hands or feet or more than one joint are affected. Early treatment helps prevent joint damage.

Start at your barangay health station, rural health unit (RHU) or PhilHealth YAKAP clinic. Find care near you.

Osteoarthritis can't be cured, but it does not always get worse, and it can slowly improve. The main treatments are exercise and, if you are overweight, losing weight.

• Exercise every week. Strengthen the muscles around the joint and add brisk walking, swimming or cycling. Pain may rise a little when you start. Keep going, because regular exercise is what brings the benefit. A physical therapist can give you a safe plan.
• Lose weight if you need to. Any weight loss helps the knees and hips.
• Hot or cold packs can ease pain. Wrap a cold pack in a towel and hold it on for up to 20 minutes. Never put ice right on the skin.
• Shoes with soft, cushioned soles, and a walking stick (baston) held in the hand opposite the sore leg.
• Keep moving. Rest a sore joint briefly, but don't stop using it.
• Steroid injections into the joint can ease pain for a few weeks, sometimes a couple of months. Joint replacement surgery may be offered when pain seriously affects your life and other treatments have not worked.

Rheumatoid arthritis also needs exercise, physical therapy and joint protection, together with the medicines below.

Not sure what is safe? Ask Joy, our AI symptoms guide.

No medicine cures osteoarthritis. Pain medicines help you keep moving. Use them for the shortest time that helps, and follow the label or your pharmacist. This guide gives no doses.

• NSAID pain gels (anti-inflammatory gels such as diclofenac or ibuprofen gel) are a good first choice for knee and hand osteoarthritis. Many are sold without a prescription. Don't use them on broken skin, and keep them away from your eyes and mouth.
• NSAID tablets such as ibuprofen or naproxen, or celecoxib (prescription), ease pain and swelling. Ask a doctor or pharmacist first. They can cause stomach ulcers and bleeding, and can harm the kidneys and heart. They may not suit people with asthma, a past stomach ulcer, kidney, liver or heart disease, a past stroke, bleeding problems, or who take blood thinners or aspirin. A doctor may add a medicine to protect your stomach. Never take two NSAIDs together.
• Paracetamol has fewer side effects than NSAIDs, but UK guidance says there is no strong evidence it helps osteoarthritis. Don't take two products with paracetamol at once.
• Fever with joint and body pain? Don't take ibuprofen, naproxen, aspirin or other NSAIDs until a doctor has ruled out dengue. They can raise the risk of bleeding.

Pregnant or breastfeeding, or is it a child? Ask a doctor before using any medicine.

Rheumatoid arthritis needs prescription treatment from a doctor. The main medicines are DMARDs such as methotrexate, leflunomide, hydroxychloroquine or sulfasalazine, which slow the disease. They take a few months to work, and some need regular blood tests. Biologic injections may be added. They can wake up an old TB infection, so tell your doctor if you ever had TB. A doctor may also give a steroid for a short time, for example during a flare; long-term use has serious side effects. Pain medicines ease RA pain but don't stop the damage.

Questions? Ask Paolo, our AI medicines helper.

Fast-acting "herbal" rayuma capsules. Be careful. US FDA tests found hidden dexamethasone (a strong steroid), diclofenac and a muscle relaxant in arthritis products sold as supplements, with names containing "Artri" or "Ortiga". People who used them had stomach bleeding, liver damage and other serious problems, and some died. If you have taken such a product for a long time, don't stop it suddenly: see a doctor and bring it with you. Buy medicines from a licensed botika and ask the pharmacist if a product is registered with FDA Philippines.

Glucosamine, gel injections and "stem cells." UK guidance does not recommend glucosamine or hyaluronan (gel) injections for osteoarthritis, and the WHO says there isn't enough evidence for stem cell therapy.

Liniments and warming oils may feel soothing, but research shows they do little for osteoarthritis. Hilot or massage on its own has not been shown to treat osteoarthritis. Hands-on therapy may help hip and knee osteoarthritis only together with exercise. Never rub or massage a joint that is suddenly hot, red and swollen: it could be gout or an infection, and it needs a check.

"Rayuma is just old age." Osteoarthritis is not something that must happen as you age, and exercise helps at any age.

• PhilHealth YAKAP clinics give free check-ups, and the lab tests your YAKAP doctor orders, to the people registered with them. A private YAKAP clinic may charge up to ₱900 per patient for the whole year (as of July 2025).
• Free medicines through GAMOT. Medicines your YAKAP doctor prescribes from the GAMOT list are free at accredited GAMOT pharmacies, up to ₱20,000 per person a year (as of July 2025). Branded medicines priced above PhilHealth's set price are not covered. As of 2026 the list includes celecoxib and naproxen for osteoarthritis and RA, plus ibuprofen, paracetamol and prednisone, given a week or two at a time. The list we checked did not include RA medicines such as methotrexate, so ask what is covered.
• Public hospitals have specialists, physical therapy (rehab) and surgery. Ask the price before X-rays, injections or surgery.
• Hospital bills: see our Malasakit Center guide.

Find a health center, book a call with a nurse, or see more everyday health guides.

Pace heavy chores and use tools like jar openers. A physical or occupational therapist can show you ways to protect your joints at home and at work. Long-term pain can affect sleep, mood and work: talk to your doctor or someone you trust. If you ever feel hopeless or think of harming yourself, call 1553, the NCMH crisis line. RA raises the risk of heart attack and stroke, so keep up your yearly check-up.

• Stay active: about 150 minutes of moderate activity a week, such as brisk walking, plus muscle-strengthening on 2 or more days. More ideas are in our guide to preventing diabetes.
• Keep a healthy weight to ease the load on your knees and hips.
• Avoid joint injuries, and let an injured joint heal before using it hard again.
• Don't sit or stand in one position too long, and keep a good posture at your desk or work.
• Don't smoke, look after your teeth and gums, and avoid breathing in dust at work: these may lower the risk of RA.
• Avoid mosquito bites and empty standing water every week to prevent chikungunya and dengue.
• Eat a balanced diet rich in vegetables, fruit, beans, nuts, fish and whole grains. No special diet cures arthritis.