Signs of arthritis
What is arthritis?
Simply defined, arthritis is an inflammation of one or more joints. By far the most common types of arthritis are osteoarthritis and rheumatoid arthritis.
Arthritis is a very common condition: According to the Centers for Disease Control, about one in four adults in the U.S. – 54 million people – have some form and degree of arthritis.
Many forms of arthritis tend to predominantly affect older people, though it can affect people at any age and there are some rare conditions that cause arthritis in children and teenagers.
Many types of arthritis tend to be characterized by which joints are affected and the usual age at which people are affected.
Signs of arthritis
Signs of early arthritis may come on slowly and mildly, or they may appear suddenly and intensely. Some types of arthritis may start with symptoms that seem unrelated, such as fatigue or a rash. Early signs of arthritis can vary and may be mistaken as the result of excessive amounts of activity or an injury.
Arthritis can be localized in one joint, or it can affect many joints and different structures within a joint, such as the synovium (joint lining), bones, cartilage or supporting tissues. The symptoms can also vary in sensation, severity and frequency. Some forms of arthritis are short-term conditions, while others are long-term and may permanently damage joint function.
- Joint pain
- Stiffness in the joint(s)
- Decreased range of motion in the joint(s)
- Swelling in and around the joint(s), though this is a lot more common in rheumatoid arthritis than in osteoarthritis
Good to know: If experiencing joint symptoms, it is best to seek diagnosis swiftly, as prompt treatment may lessen the progression of the disease.
By far the most common types of arthritis are rheumatoid arthritis and osteoarthritis.
Signs of rheumatoid arthritis
Rheumatoid arthritis, also known as inflammatory arthritis is an autoimmune condition, which usually affects multiple joints. While any joint can be affected, signs of arthritis are most commonly found in the hands, fingers, wrist, shoulders, feet, knees, elbows, lower back and hips.
Pain associated with inflammatory arthritis is usually a throbbing and aching pain. It is often worse in the mornings and after a period of inactivity.
Like joint pain, stiffness is more severe in the morning and after periods of inactivity in the case of rheumatoid arthritis, leading to morning stiffness of more than half an hour, and in many people at least an hour - unlike osteoarthritis, where morning stiffness usually disappears within half an hour.
Inflammation causes the joints to appear swollen and red, and warm or hot. In rheumatoid arthritis, some people may develop so-called rheumatoid nodules, which are lumps under the skin around the affected joints.
- Weight loss and loss of appetite
- Signs of anemia, such as fatigue
- Excessive or more than usual sweating
- In the case of the hands being affected: Carpal tunnel syndrome, tingling in the hands caused by nerve compression
For more information, see the resource on rheumatoid arthritis.
Signs of osteoarthritis
Degenerative or mechanical arthritis, also known medically as osteoarthritis or osteoarthrosis, is a type of arthritis in which there is damage to the joints through wear and tear. It tends to occur more commonly in older people, but sometimes also occurs in younger people if, for example, they have had substantial injuries and/or surgeries to joints. Usually, osteoarthritis affects one or a few joints, often the weight-bearing joints, causing signs of arthritis in the knees, hands, hips, ankle, shoulder, lower back or the neck.
Pain associated with degenerative arthritis tends to worsen with activity and at the end of the day and is relieved by rest. In more severe cases, the pain may be continuous, even when not moving. It may cause a person to wake up at night. Many people report increased joint pain with rainy weather.
There may be morning stiffness but, in the case of osteoarthritis, this usually goes away within 30 minutes, unlike rheumatoid arthritis, where this typically lasts substantially longer.
Swelling from osteoarthritis is rarer than in rheumatoid arthritis, but if it occurs, it tends to be caused by thickening of the joint lining and effusion, in which there is extra joint fluid.
Grinding and instability
As cartilage wears down and disappears, there are sometimes painful grinding or grating sensations when moving the joints owing to bone-on-bone contact. The tissues and ligaments that hold joints in place may become weaker, leading to joint instability (looseness).
The joint may not move as freely or as far as normal. There may be difficulty with fine motor skills such as gripping and twisting, as is needed to, for example open jars or do crafts.
- Muscle wasting around the affected joint
- Bone spurs, knobby bone growths
Joints most commonly affected by arthritis
Each case of arthritis will have a varying set of symptoms, depending not only on the type of arthritis, but also on which joints are affected. This is because each joint tends to have its own characteristic symptoms. Though any joint may be affected by arthritis, the joints most commonly involved include the hands, fingers, wrists, knees, hips, feet and shoulders, which may be affected as follows:
Signs of arthritis in the hands, fingers and wrists
The joints in the hands and wrist may be the most intricate in the body, able to perform elaborate, yet everyday tasks such as tying one’s shoelace or unscrewing a jar when working well. It can be disabling to lose the fine motor skills of the hand.
Arthritis in the hands normally manifests differently in both of the main types of arthritis.
Rheumatoid arthritis, which normally manifests in many joints throughout the body, is often first perceptible in the hands.
- A dull, burning sensation in the fingers
- Swelling, especially first thing in the morning
- Stiffness so that it is hard to grip objects such as keys or a toothbrush
- Pain at the wrist and finger knuckles
Good to know: Early changes of rheumatoid arthritis in fingers may cause dactylitis, an inflammation with swelling of the finger, in which the knuckles may disappear, giving the fingers the appearance of sausages.
- Mild swelling
- Pain deep under the base of the thumb
- Bone spurs, knobby bone growths which the body creates in reaction to joint damage
- Hand weakness
- Carpal tunnel syndrome, a numbness and tingling in the hands and, occasionally, forearms and upper arms
Signs of arthritis in the knee
Arthritis of the knee most commonly occurs in osteoarthritis. In rheumatoid arthritis, involvement in large joints, such as the knee, tends to occur in later stages of the condition.
- Pain, mainly when weight-bearing and moving the knee
- A cracking or grating sensation in the knee when going up and down stairs
- Bony enlargement of the knees
- Deformities of the joint due to ligament damage
- Leg muscle wasting
- Baker’s cyst or popliteal cyst, in which a cyst develops behind the knee and may rupture
Signs of arthritis in the hip
Arthritis of the hip is most common in osteoarthritis, when symptoms develop gradually and are usually most noticeable after inactivity, such as when getting out of bed in the morning. They may also worsen with intense activities such as sports. Arthritis of the hip also occurs in rheumatoid arthritis, often in those with a longer history of the condition.
- Aching and stiffness in the groin, buttock or thigh
- Pain in the side or back of the hip on weight bearing
- Pain may radiate down the thigh and cause knee pain
- Reduced mobility of the hip, including difficulty spreading the legs apart, extending the legs, pointing the toes inward
- Limping or lurching when walking
Signs of arthritis in the feet
- Changing foot shape due to joint damage
- Development of enlarged and/or inflamed bursae, fluid-filled sacs where there is excess rubbing, often causing pain under the ball of the foot
- Nodules, commonly over the Achilles tendon, in the heel pad and over any bony prominences
- Corns and calluses, due to altered foot shape, which can lead to ulcers - open sores on the skin. In the very worst cases, an ulcer may deepen to involve tendons, bones and other deep structures
- Numbness and tingling in the feet due to a trapped nerve
- In osteoarthritis: stiff big toe joint
Signs of arthritis in the shoulders
- Deep ache in the joint
- Pain that radiates or travels to the side of the neck
- Pain throughout the shoulders in rheumatoid arthritis
- Limited range of motion
- Grinding, crunching or popping sound as it moves
- Pain in the night
Arthritis usually affects older people. More rarely, however, there are various arthritic conditions which may affect children and teenagers.
For more information on signs of juvenile arthritis, see the resource on juvenile idiopathic arthritis.
Q: What is the difference between rheumatoid arthritis and gout?
A: Gout and rheumatoid arthritis are both forms of arthritis that may present with similar symptoms of sudden joint pain. However, they have different causes. The cause of rheumatoid arthritis is not completely understood, though it is known to be an autoimmune, inflammatory condition, in which the body attacks its own tissue. Gout is caused by too much uric acid in the blood, a chemical found in certain foods, which forms urate crystal deposits in the joint, leading to a painful, inflammatory immune reaction, usually starting in the foot, when it is known as podagra. It is important to seek prompt and accurate diagnosis of which type of arthritis is present, as the treatments for each type are very different. For more information, see the resources on podagra - gout of the foot, gout and rheumatoid arthritis.
Arthritis Research UK. ["What are the symptoms of rheumatoid arthritis?"](https://www.arthritisresearchuk.org/arthritis-information/conditions/rheumatoid-arthritis/symptoms.aspx. Accessed 24 June 2018. ↩
UpToDate "Clinical manifestations and diagnosis of osteoarthritis." 30 October 2017. Accessed 26 June 2018. ↩
Arthritis-health. "Shoulder Arthritis: Why It Starts and How It's Treated." Accessed 26 June 2018. ↩