Arthritis affects millions of people in the UK and can qualify for PIP when it limits daily activities or mobility. This guide covers all types of arthritis and the PIP descriptors that apply.
Types of Arthritis and PIP
| Arthritis Type | Key PIP-Relevant Symptoms |
|---|---|
| Rheumatoid arthritis (RA) | Joint pain/swelling, morning stiffness, fatigue, hand/wrist involvement |
| Osteoarthritis (OA) | Joint pain, reduced mobility, stiffness, affected knees/hips/hands |
| Psoriatic arthritis | Joint pain, fatigue, skin involvement, hand/foot stiffness |
| Ankylosing spondylitis | Spine stiffness, reduced mobility, pain, fatigue |
| Gout | Severe acute pain, limited walking, difficulty with footwear |
| Lupus (SLE) with arthritis | Joint pain, fatigue, cognitive difficulties, skin sensitivity |
Key PIP Activities for Arthritis
Mobility Activity 2: Moving Around
| Walking Distance | Points |
|---|---|
| 50-200m | 4 |
| 20-50m unaided | 8 |
| 20-50m with walking aid | 10 |
| 1-20m | 12 |
Arthritis in knees, hips, feet, or ankles directly limits walking distance. Remember: assessed on reliable walking — if you can walk 100m but then your knee gives way, that’s not reliable.
Activity 3: Managing Therapy
| Weekly Time on Therapy | Points |
|---|---|
| Up to 3.5 hours | 1-2 |
| 3.5-7 hours | 4 |
| 7-14 hours | 6 |
| 14+ hours | 8 |
What counts as arthritis therapy time:
- Daily stretching/exercise routine (prescribed by physio)
- Applying heat/cold packs to joints
- Soaking hands in warm water for morning stiffness
- Self-administering injections (methotrexate, biologics)
- Managing and attending infusion appointments
- Blood monitoring appointments
- Physio and OT appointments
- Pain management techniques
- Recovery time after therapy
Activity 4: Washing and Bathing
Arthritis in hands, shoulders, hips, and knees commonly affects this:
- Can’t reach to wash hair (shoulder arthritis)
- Can’t get in/out of bath (hip/knee arthritis)
- Can’t grip soap or shower controls (hand arthritis)
- Need shower seat due to standing difficulty
Activity 6: Dressing and Undressing
Hand and shoulder arthritis particularly affects dressing:
- Can’t do buttons, zips, hooks (hand arthritis)
- Can’t put on bras, fasten jewellery (hand/shoulder)
- Can’t bend to put on socks/shoes (hip/knee)
- Can’t pull clothing over head (shoulder)
Activity 1: Preparing Food
- Can’t grip knives, tin openers, kettles (hand arthritis)
- Can’t stand at cooker long enough (knee/hip/foot)
- Can’t lift pans or carry plates (wrist/hand/shoulder)
- Can’t open packaging (hand weakness)
The Importance of Flares
Arthritis is a variable condition - you have good and bad days. PIP should assess the impact over a majority of days (more than 50% of the time).
When describing flares:
- How often do you flare? (weekly? monthly? unpredictable?)
- How long does a flare last?
- What can you do during a flare vs a normal day?
- What triggers flares?
- What do you need during a flare that you normally manage alone?
Example: “I have RA flares approximately 2-3 times per month, each lasting 3-5 days. During a flare, I cannot dress myself, cannot walk beyond my bathroom, and cannot hold a cup. My partner does all cooking, helps me wash, and supports me to the toilet.”
Morning Stiffness
Morning stiffness is a significant PIP factor for inflammatory arthritis:
- How long does stiffness last? (RA: often 1-3 hours)
- What can’t you do during morning stiffness?
- Does soaking or heat therapy help? (Include this in Activity 3 therapy time)
- How does it affect work/appointments in the morning?
Evidence to Gather
| Source | What to Request |
|---|---|
| Rheumatologist | Letter confirming diagnosis, disease activity, impact on function, treatment plan |
| GP | Summary of conditions, medications (including side effects), functional impact |
| Physiotherapist | Assessment of mobility, joint range, functional limitations |
| Occupational therapist | Hand assessment, aids provided, home adaptations |
| Podiatrist | Foot assessment if feet/ankles affected |
| Hand therapist | Grip strength test results, functional assessment |
Useful Medical Evidence
- Disease Activity Score (DAS28) for RA — shows objective disease severity
- X-rays/MRI showing joint damage
- Blood test results (ESR, CRP) showing inflammation
- Hand grip strength measurements
- Walking test results
Assessment Tips
- Bring aids — Wrist splints, walking stick, jar opener, button hook
- Mention all affected joints — List every joint, not just the worst
- Explain grip problems — Try to open a bottle at the assessment if asked
- Describe morning stiffness — Time of assessment may catch you on a better part of the day
- Fatigue matters — Explain energy limitations, not just pain
- Medication side effects — Nausea, cognitive fog, immune suppression from biologics
- Mention falls — If your joints give way, this is critical safety information