7 Early Warning Signs of Arthritis

Pain, yes -- but also beware these other symptoms of osteoarthritis, rheumatoid arthritis, and gout.
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Think arthritis is just for the old? Half of those who get it are under age 65. One in five adults -- 50 million Americans -- has been diagnosed with arthritis. Most wait to see a doctor until pain interferes with daily life -- but pain isn't the only sign of trouble.

"Early is better with arthritis diagnosis," says Arthritis Foundation Vice President Patience White, a professor of medicine and pediatrics at the George Washington University School of Medicine and Health Sciences in Washington, D.C. Treating the autoimmune disease rheumatoid arthritis (RA) within the first months of onset, for example, can minimize joint deformities and even put the disease into remission, thanks to the latest treatments. With osteoarthritis (OA), a degenerative joint disease that's the most common kind of arthritis, the sooner you start behavioral changes, the better you may be able to manage pain and preserve mobility, White says.

Here's what to watch for:

Warning sign #1: Morning stiffness

Look for: Waking up and being unable to move about easily for half an hour or longer. Everybody has some morning stiffness, but normally it fades as you stretch and start moving. "With rheumatoid arthritis, it can take 30 minutes or more to loosen up -- sometimes hours, or even all day," says Chaim Putterman, chief of rheumatology at the Albert Einstein College of Medicine and Montefiore Medical Center in New York City. "People affected say they feel encased, like prisoners, and the feeing of being unable to move can be even more burdensome than the actual pain."

Why pay attention: Stiffness after inactivity is a hallmark symptom of rheumatoid arthritis. It can recur later in the day when you've been sitting still for awhile -- after watching a movie, for example. With osteoarthritis, the more you use your affected joints, the worse they tend to feel; with rheumatoid arthritis, the more you move, the better it feels, Putterman says.

Warning sign #2: Pain when climbing stairs

Look for: Your knee joint locking or sending stabs of pain when you bend it, as when going up or down stairs. Added red flag: Knee pain if you're overweight. "Every extra pound you gain feels like an extra load of four pounds on your knees," White says. Excess weight raises your risk of developing arthritis, which some 60 percent of obese people develop.

Related types of painful physical function include limping, being unable to extend your elbow, changes in how steadily you can stand or walk, and trouble standing on tiptoe.

Why pay attention: The knee is the largest joint in the body and the second-most common site for osteoarthritis, according to White. (A bow-legged "cowboy" walk can result from osteoarthritic knees.) Other key targets: the hips, the back, the ankles, the thumbs, and the hands. "People really don't go to the doctor until they can't do what they want to do -- lift a baby, walk a block, get out of bed easily -- and pain is the number-one reason why," White says.

Caregivers should beware of a debilitating cycle in loved ones with arthritis, Putterman says. If activity is painful, you avoid it, you stay inside more, you sit home and eat, you gain weight, which makes you even less able to get out -- and before you know it, you're on a path to losing independence.

Warning sign #3: Sudden, excruciating pain in a big toe

Look for: A joint that suddenly hurts like crazy -- many sufferers give it a "ten" on a pain scale of one to ten, likening the pain to kidney stones, White says. The joint is likely also red, hot to the touch, and tender. Although this pattern can happen to other joints, the big toe is the most common site. Usually only one joint is affected at a time.

While the vast majority of cases have a sudden onset, some people notice a joint becoming hot, red, and tender, but the pain is bearable. It clears, then recurs.

Some people can connect the onset of pain to eating a lot of protein or drinking more alcohol than usual.

Why pay attention: Sudden, excruciating pain, especially in the large toe, is likely an attack of gout, the second-most common form of arthritis and the most common type of inflammatory arthritis. Gout occurs when uric acid, a natural waste product that circulates in the blood, builds up in body tissue as needle-shaped crystals. This happens either because the body produces too much uric acid or doesn't dispose of it well through the urine.

Men in their 40s and 50s are affected most by gout, though by the 60s, it affects both genders equally. Left unmanaged, attacks of gout can strike more often.

More early warning signs of arthritis

Warning sign #4: Fatigue, flu-like symptoms

Look for: Chronic tiredness, loss of appetite, weight loss, anemia, and/or fever that persists for weeks (longer than a bout of flu). Some combination of these symptoms usually appears, along with stiffness and pain. You might even notice changes in nonjoint tissue, such as eyes that feel dry and sore and may be red. These symptoms can come on gradually or suddenly.

Why pay attention: Having these mild, flu-like, across-the-body symptoms, along with stiffness and pain, points to rheumatoid arthritis. RA is a disorder of systemic inflammation, meaning the entire body is affected (as opposed to the problem being isolated in a particular joint). "You shouldn't just take two Tylenol and sleep the discomfort off," Putterman says. These symptoms warrant a physical exam soon.

Warning sign #5: Odd-looking bumps on fingers

Look for: Bony spurs (small enlargements) on the joint of fingers. One may appear on the last joint, where it's known as a Heberden's node, or on the middle joint, where it's called a Bouchard's node. Sometimes the knobby bump appears at the base of the thumb (though this bump wasn't named after the doctor who studied it).

The joint is probably also stiff to move, although not necessarily painful. To the touch, the bump feels more like a bone than like a sponge. Some toes can also be affected.

Why pay attention: Doctors use this visual information to help diagnose arthritis, along with the rest of a physical exam, a history, and, sometimes, X-rays and lab tests. Heberden's nodes and Bouchard's nodes, seen in osteoarthritis, tend to run in families, especially through women, White says. Farmers and others who engage in a lot of manual labor are especially prone to OA of the lower extremities.

Warning sign #6: Pain that interferes with sleep or pleasure

Look for: Being unable to fall asleep because you're so focused on joint pain, or being awakened in the middle of the night by joint pain. Some sufferers begin to avoid family and other activities they enjoy because they feel ground down by chronic pain; the very prospect of visiting grandchildren or going to a social outing feels overwhelming.

Why pay attention: Osteoarthritis pain is caused by eroding cartilage, which eventually causes bone to rub against bone -- and yes, it can really hurt. Everyone has a different threshold for pain. But pain that interferes with your ability to enjoy the most basic, restful activities of life like sleep or enjoying your family? That's a different animal. "It shows that what you've been doing before is not adequate and that the pain should be taken care of," Putterman says.

What's more, when chronic pain saps your joie de vivre, depression can evolve.

Warning sign #7: Achy, hard-to-use hands

Look for: Trouble managing fine-motor skills: buttoning a shirt, tying shoelaces, using a fork and knife, turning a key in a lock, grasping a doorknob, snapping fingers.

Affected joints can be redder than surrounding skin, warm to the touch, and tender.

Why pay attention: "Trouble with these activities of daily living all suggest something worrisome is going on," Putterman says. Many different joints in the hands and wrists tend to be involved with rheumatoid arthritis, making these hand and finger tasks so frustrating. Rheumatoid arthritis is also a symmetrical disease, meaning both sides of the body (and hands as well as feet) tend to be affected simultaneously. (In osteoarthritis, the joints affected usually aren't symmetrical.)

Notice which part of the hand is affected. Rheumatoid arthritis tends to afflict the knuckles and the next joint up, White says. In osteoarthritis, the top joints and the base of the thumb are more affected, and not necessarily all of the digits at once.

Paula Spencer Scott

Paula Spencer Scott is the author of Surviving Alzheimer's: Practical Tips and Soul-Saving Wisdom for Caregivers and much of the Alzheimer's and caregiving content on Caring. See full bio

almost 2 years, said...

I just found out that I have "early onset arthritis (literally minutes ago)!!! Reading this explains a lot.... ( I have an EXTENDED LIST of symptoms.) Thanks for the information (oh and I am only a 27 year male).

over 2 years, said...

Great article - very informative. I'm a 42 yr old male and have been suffering mild pain in the knees and feet for the last 5 years but the past year has been a step-change in pain level. The pain is so unpredictable. I'm fine one day and then the next it is literally an excruciating struggle to climb one flight of stairs. I've been told from xrays that some osteoarthritis is evident in my knees and back, but after reading this article the signs of rheumatoid are screaming out at me. I will be pushing for testing. Thank you for writing such a concise and informative article.

over 2 years, said...

I found out last week my local hospital has no notes on all the scans axrays and bloods that I had done that confirmed my osto and ruhmoid arthritis. I claim DLA which I didnt claim as my pride wouldnt let me but because of losing one wage I had to put my pride in my pocket. This gp who I have never met gave me a copy of the letter of the above and I felt devestated as the pain over the last six months has become so much worse where some days walking is so difficult. House work is restricted as I try and do the most important jobs knowing after a short time Icant carry on. Now my hands are ggoing and the only thing left is my crafting. When I applied for DLA I had to give all the hospital consultants named xrays scans and bloods. So why do I feel like a victim. Can anyone help with advice because im at a loss to what to do

over 5 years, said...

I was recently diagnosed with osteoarthritis after being seen by several doctors over the last 4 years of coming up empty of why I am in such pain. After reading your article I now know that what I have been feeling really does have a name. You did an excellant job of writing your article. Thank you for sharing.

over 5 years, said...

Hi, More information about this condition and treatment for it is included on Caring.com here: http://www.caring.com/rheumatoid-arthritis Please also consult your doctor. Thanks!

over 5 years, said...

I want to know about the succefull treatment of this chronic disease ( rheumatoid arthritis )

over 5 years, said...

The comparison of osteo- to rheumatoid arthritis was helpful.

over 5 years, said...

It seems I have osteo and not rheumatoid arthritis - whew! I do not have insurance so will look further on websites for things to alleviate the disease and symptoms. Thanks!

over 5 years, said...

All of it, little things/signs of a possible problem.

almost 6 years, said...

Thanks for this post. I keep periodically having very fine bumps taht come up on the side of the fingers of my left hand that are hard. They itch like crazy. They don't ripen and burst but they stay there a couple of days and go away. They arein the vicinity of the joint. I am wodering if that is a sign of arthritis that runs in my family. The 2nd to last vertebrae in my lower back is showing signs of it, my leeft big toe sometimes pains for no apparent reason for a few seconds and wears of, so squatting and bending the toe is sometimes aargh! The morning stiffness is there sometimes but wears off as I walk around. Left knee is a problem. I think I may be an arthritis candidate.I am 54

almost 6 years, said...

no comment, but I thank you for your services, better than all my doctors here in Kauai !!

almost 6 years, said...

I gained a lot of information about hands, which is my problem. My thumbs are so painful that I do wake up, or cannot go to sleep. I find ordinary duties in my home harder and harder without experincing pain. Marquita

almost 6 years, said...

Hi Sooner! Thanks for acknowledging my comments and accompanying info. AND your most welcome! Very Truly Yours, Ron_in_PA

almost 6 years, said...

wow..thanks Ron in PA for the information.

almost 6 years, said...

will try and eat the recommended foods, and make a doctors appointment.

almost 6 years, said...

Hi folks! I never posted on this site before. When I was working on the post I thought it was going to appear as I typed it. Unfortunately it appears as one BIG run-together paragraph. Will you please accept my apology? Thank you very much. VTY, Ron_in_PA.

almost 6 years, said...

I'm 65 years young. Honestly - and without holding anything back, I can tell everyone reading my post I don't have any of the symptoms described in the article. I never did. I don't think I ever will. Its not genetic. My fantastic Grandpop told my terricic Dad. AND Dad told me THE number one natural preventive for arthritis is cod liver oil. At one time or another I used the cherry-flavored, orange-flavored or natural -flavored cod liver oil. The flavor I opted for didn't make any diffeence. I experienced the same benefits. Even the flavored oil doesn't taste very good, BUT in due time you should begin to feel the results. I was taught: When you buy it, keep it in the refrigerator. It doesn't matter if you keep it in the door or on a shelf. Keep it refrigerated. As soon as you wake up, take two (2) tablespoons - on an empty stomach. In the event you're someone who likes to work-out A] at a gym or club B] or you prefer walking, jogging and/or running C] or exercising in the comfort of your apartment or home, DO your normal routine on an empty stomach. The cod liver oil seems to get where it should go better on an empty stomach. Don't eat or drink anything for at least one (1) hour. In the event you prefer not doing any exercise, please allow about one and a half (1 1/2) to two (2) hours prior to eating. You will not really experience any significant changes for at least 30 to 60 days - maybe longer. I never noticed a difference any earlier than that time period. Don't get discouraged or disappointed. Keep it up and keep taking the cod liver oil. OR I recently discovered CLO is also marketed in softgels by a nationwide vitamin and mineral supplement store. I keep these in my room at room temperature. Along with my medications, vitamins and other supplements, I take three softgels in the morning - immediately after breakfast. AND the same in the evening immediately after dinner or my late-night snack. So far, so good. VTY, Ron_in_PA

almost 6 years, said...

Very helpful

almost 6 years, said...

There is now a cure for arthritis in the joint of the fingers its called Regjoint, its been done with success in Germany after many trials in Finland.going to try to put a link here . http://www.dailymail.co.uk/health/article-2114008/Need-new-joint-Now-grow-own.html and also see http://www.tut.fi/en/current/researchers-develop-world-s-first-biodegradable-joint-implant-p025876c2 I,d love to have the top joints of my little fingers done as the are swollen and hurt ,especially in the winter. Greeting from the Rock of Gibraltar to all members here . Ken

almost 6 years, said...

It describes some of the conditions I have had for some time, especially in my hands, I'm assuming its Rheumatoid arthritis. Are there any remedies to aleviate the condition?

almost 6 years, said...

very interesting article ,thanks for posting it.

almost 6 years, said...

Are you serious? Most doctors, including my own just fluff off early complaints of symptoms of arthritis. All they say is, "I'm sure it's just the beginnings of arthritis", ergo, the patients just think, "Oh, arthritis, just a sign of normal aging." My fingers were misshapen and painful before my pcp suggested I go. The rheumatologist then told me I'd waited much too long. Now we're just trying to slow progression. I can't even talk my younger sister, who's in considerable pain, into seeing a rheumatologist even though my own rheumatologist (thirty miles away from my sister) said he'd examine her and, if necessary, send a report with recommendations to her pcp and then her pcp could then recommend someone closer. This is a great article if only it was realistic.

almost 6 years, said...

This article clearly pointed out where and when the pain will occur. It describes which kind of arthritis is most likely the cause of the pain.

almost 6 years, said...

It has given me a better and clearer understanding about arthritis!