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That Unwanted Ouch!

Updated: May 28, 2020

Early Signs of Arthritis You Should Never Ignore.

What symptoms look and feel like, and what to do if you can't shake the ache.

It's not unusual to experience pain in your joints on occasion, especially if you're active and participate in high-impact activities such as running.

That unwanted ouch can be caused by injured muscles, tendons and ligaments around the joint, by tendonitis or by a sprain or a strain.

But if you start experiencing aching, pain and stiffness on a routine basis — and particularly if the pain is right at the joint — you may be developing arthritis, says rheumatologist Uzma Haque, codirector of clinical operations at the Johns Hopkins Arthritis Center in Baltimore.

"The cardinal feature of arthritis is a swollen joint,” Haque says. “However, pain, discomfort and stiffness can be early signs."

Haque recommends paying attention to what triggers your symptoms: “If you walk a block and consistently have aching in your right knee, but it improves when you sit down, that's when you should think, Do I need a medical evaluation?”

And yes, you might need to book that appointment even if you're well under 50. Arthritis doesn't only affect older people. Although your risk increases as you age, more than half of arthritis patients are younger than 65, according to the Centers for Disease Control and Prevention (CDC). It's a leading cause of disability in the U.S., affecting around 54 million people.

Inflammatory arthritis vs. osteoarthritis: Causes and symptoms

Arthritis actually describes over 100 different conditions that affect joints and the surrounding tissue. They fall into two main categories: inflammatory arthritis and osteoarthritis (OA).

Inflammatory arthritis is a systemic disease in which the mechanisms that normally protect your body attack your own joints and tissues instead. The most well-known example is rheumatoid arthritis (RA); its hallmark symptom is prolonged stiffness and achiness in the morning after waking up. RA also tends to be symmetrical, meaning you'll have problems in the same joints on both sides of your body, like both wrists or both knees.

The second type of arthritis — and the most common form — is osteoarthritis. A degenerative disorder, it's caused by trauma or age-related wear and tear on your joints over time. Osteoarthritis is most likely to affect weight-bearing joints such as the knees, hip, lower spine or big toe, but it can also cause pain and stiffness in your thumb or finger joints.

When to see a doctor about early arthritis signs

You should see a doctor right away if one of your joints suddenly becomes swollen, red and hot to the touch, or if you can't bear weight on it at all, since those can be signs of gout or a serious infection, Haque says.

Arthritis has no cure, but there are steps you can take to minimize pain and stiffness, says Rochelle Rosian, a rheumatologist with the Cleveland Clinic Department of Rheumatologic and Immunologic Diseases. “There is a lot we can do to help you feel better,” she says. “You can live a long and healthy life with arthritis.”

Your primary care doctor may be able to treat your symptoms if they're mild, or he or she may refer you to a rheumatologist, a sports medicine doctor, an orthopedist or a podiatrist, depending on your symptoms and where your problem is located.

Expect your doctor to ask you what makes the pain better and what makes it worse, how long you've had the pain and stiffness and whether you have had any trauma to the area. It's not unusual for a high school sports injury to manifest as arthritis in a joint decades later, Rosian says.

Here are some steps your doctor may recommend to help ease your pain:

Weight loss: You may not want to hear it, but the extra pounds you're carrying are putting stress on your joints. “For every pound you carry, the force on your knee is multiplied by three,” Rosian says. “If you gain 10 pounds, your knee feels 30 pounds of pressure. Maintaining an ideal body weight is critical for managing arthritis.”

Exercise: If you are in pain, you may be tempted to move less, but studies show physical activityhelps reduce pain and improve movement in arthritis patients. “Keeping the muscles around your joint active and strong is key in protecting and stabilizing the joint,” Haque says. Low-impact activities like cycling or swimming will be easier on the joints.

Physical therapy: A physical therapist can teach you specific exercises to do to strengthen the muscles around your joint, Haque says. He or she can also work with you to correct any gait abnormalities that are putting extra stress on your knees, feet or hips.

Medication: If you have osteoarthritis, acetaminophen (Tylenol) is the safest over-the-counter pain reliever for long-term use, Rosian says, but NSAIDs (nonsteroidal anti-inflammatory drugs) like Advil or Motrin may be more effective if your joints are swollen and feel warm to the touch. Some NSAIDs are also available as liquids or gels, which can be rubbed on joints. For rheumatoid arthritis patients, early treatment with specific drugs can improve the long-term outcome.

Topical treatments: Over-the-counter or prescription creams and sports ointments can help relieve pain. Some patients have also reported success with cannabidiol (CBD) oils and creams, Rosian says.

Joint supports or splints: A splint or brace can help support and protect a damaged joint. Some immobilize and rest the joint in the ideal position to minimize stress. Others provide support while you perform a task. Examples include wrist splints, knee braces and orthotics.

Injections: If you are still experiencing pain despite trying other therapies, your doctor may suggest injections of cortisone (or hyaluronic acid) for short-term relief. However, two recent studies suggest that repeated cortisone injections may lead to more joint damage and pain. Some doctors have started offering platelet-rich plasma (PRP) or stem cells as an alternative, but as of now there is no definitive proof of their effectiveness, Haque says.

Surgery: Eventually, your doctor may recommend surgery to replace or stabilize your joint. There are many different surgical options, depending on where you have pain and how bad it is. For severe cases, you may need a total joint replacement.

Early signs of arthritis

  • Pain right at the joint itself (most commonly a knee, hip, spine, or big toe)

  • Swelling around the joint (but NOT heat at the joint; a sign of infection or gout)

  • Pain, discomfort or stiffness (which may be triggered by being active)

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