Is this joint pain ‘arthritis’?
Have you ever wondered when to be concerned about pain in your joints? How do you know what is ‘normal wear and tear’ and what might need medical attention? Did you know that not all arthritis is created equal?
It might be helpful in defining what we mean by ‘arthritis’ – broadly, there are two main types: osteoarthritis and inflammatory arthritis.
Osteoarthritis (or ‘OA’)
This is often described as ‘wear and tear’ and while it isn’t inevitable, it often comes alongside enough birthdays. While it can cause significant pain and stiffness, the outlook is better overall for it than the other type.
Inflammatory arthritis
One of the most common examples of this group is Rheumatoid Arthritis (or ‘RA”). As well as pain and stiffness, the inflammation itself can cause significant join damage, unless this is treated with disease-modifying medication (not just painkillers), typically prescribed by a Rheumatologist.
Fortunately, the two types tend to present quite differently. The textbook experience of OA is waking up with stiff and achy joints that start to feel better after getting up and making that morning cup of coffee, typically lasting less than 30 minutes. With inflammatory arthritis however, the stiffness tends to last longer, and is often up to or beyond an hour of waking.
The joints affected tend to be different also: while inflammatory arthritis can affect any joint, it more often affects the smaller ones, e.g. fingers and knuckles, whereas OA usually affects the knees, hips, hand, spine or shoulder.
The joints themselves tend to look more angry during a flare of RA – you would often see a visible swelling and palpable heat, as well as tenderness and maybe even redness. While you can get swelling and tenderness with OA, it tends to be less dramatic.
While OA tends to only affect the joint, RA can affect the whole body’s health. Someone with a new diagnosis of RA might experience lethargy, unexpected weight loss, generalized weakness and a low-grade fever.
Of course, it is also worth mentioning that OA is far more common than RA, especially as age increases. In fact, one study(1) that looked at over 3000 people WITHOUT back pain showed that 1 in 3 50-year-olds had OA in their spine (specifically, degenerative changes to the facet joints), and that increased with age to affect half of 60-year-olds, 69% of 70-year-olds and 83% of 80-year-olds. Interestingly, these people didn’t have any back pain, despite having visible arthritic changes in their spines on a CT or MRI scan.
Similarly, another study(2) demonstrated that xrays aren’t always helpful when assessing knee pain: only 15% of people with knee pain in one cohort had OA on their xray; from another group of people who ALL had OA on their xrays, less than half had pain.
So, if you are concerned about your joint pain, while an xray MAY be useful, depending on the joint and your symptoms, it isn’t always necessary. What is typically more useful is booking an appointment with a provider who has time to listen and make a plan with you.
Worried about your joints?
If you have new or persistent joint pain, prolonged morning stiffness, swelling or warmth, it’s worth getting it checked — particularly if your symptoms are affecting your day-to-day life.
And remember, an X-ray is only one piece of the puzzle. Understanding where it hurts, when it hurts, how long you feel stiff and what the joint feels like on examination can often tell us much more about what is going on.
At Cimarron Family Practice in Montrose, appointments are unrushed, giving us time to properly assess your symptoms, decide together whether blood tests or imaging would actually be useful, and make a plan from there.
If you’re looking for a primary care doctor in Montrose with time to listen, you can learn more about becoming a patient at Cimarron Family Practice.