Signs and Symptoms of Arthritis

Warning signs of arthritis can be vague and confusing, You should see a healthcare provider if you are experiencing joint pain, stiffness, tenderness, or swelling. There are many types of arthritis, and different joints can be affected with varying levels of severity. While certain symptoms are common to most types of arthritis, you can also experience effects that are specific to the form of arthritis that you have.

Frequent Symptoms

Arthritis typically affects the joints, and most types of arthritis can also cause systemic (throughout the body) symptoms that can make you feel like you have the flu. Some people have arthritis symptoms almost all the time, while many people only have occasional symptoms.

Whether your symptoms are always present or rarely occur, you can also have flare-ups of your arthritis from time to time, with worsening symptoms.

The following symptoms occur in most types of arthritis and rheumatic diseases:

• Joint pain
• Joint stiffness
• Tenderness in and around the joint
• Joint swelling
• Limited range of motion in one or more affected joints
• Redness and ​warmth around the affected joints
• Fever
• Fatigue
• Malaise
• Lumps and bumps

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an autoimmune, inflammatory type of arthritis. While it primarily affects the joints, it can cause systemic effects as well.

Symptoms and characteristics of RA include:

• Morning stiffness lasting more than an hour
• Involvement of the small bones of the hands and feet
• Extreme fatigue
• Rheumatoid nodules (bumps on the joints)
• Symmetrical joint involvement (e.g., both knees are affected, not just one)

Osteoarthritis

Osteoarthritis (OA) primarily affects the joints without systemic effects. Pain in the affected joint is the most common symptom associated with osteoarthritis. The pain often worsens with use. The affected joint can also swell, feel warm, and become stiff if you don't use it for several hours.

Bone spurs and bony enlargements are also characteristic of osteoarthritis.

Psoriatic Arthritis

Psoriatic arthritis is a type of arthritis that's associated with psoriasis (a skin condition characterized by red, patchy, raised, or scaly areas) and chronic joint symptoms. The symptoms of psoriasis and joint inflammation often develop separately.

Symptoms associated with psoriatic arthritis vary in how they occur (symmetrical or asymmetrical pattern) and which joints are affected; it can involve any joint in the body.

When psoriasis causes pitting and thickened or discolored fingernails, the joints nearest the fingertips are likely to become arthritic. Enthesitis (inflammation where tendons and ligaments attach to bone) can develop, with resorption of phalangeal (finger) bones.

Ankylosing Spondylitis

Ankylosing spondylitis (AS) is commonly associated with inflammation that involves the spine and sacroiliac joints. The earliest symptoms are often chronic pain and stiffness in the lower back region and hips.

Typical ankylosing spondylitis pain in the back worsens following rest or inactivity of the affected joint. As symptoms of pain and stiffness progress up the spine to the neck, possibly including the rib cage area, bones may fuse.

Lupus

Lupus can affect the joints, nervous system, skin, kidneys, lungs, heart, and other organs of the body. It can take months or longer to be diagnosed with lupus because it sometimes mimics other types of arthritis and rheumatic diseases.

A butterfly-shaped rash appearing on the cheeks and over the bridge of the nose (malar rash) is just one of the many distinguishing characteristics of lupus.

Gout

Gout is considered one of the most intensely painful types of arthritis. It is characterized by sudden onset of severe pain, tenderness, warmth, redness, and swelling from inflammation of the affected joint.

Gout usually affects a single joint, often the big toe, though the knee, ankle, foot, hand, wrist, and elbow may be involved as well. The shoulders, hips, and spine may rarely become affected by gout. Often, someone's first gout attack occurs at night.

Rare Symptoms

Each type of arthritis can also cause less common symptoms, particularly as the condition worsens over time.

Ankylosing Spondylitis

While it's not common, AS may affect the heart, lung, or kidney. Heart failure and heart conduction defects may occur. Lung problems can develop due to limited chest wall and spine movement or from lung fibrosis. Kidney problems such as IgA nephropathy can also occur. Some of these problems may become life-threatening.

Psoriatic Arthritis

Psoriatic arthritis can cause serious effects—5% of cases of psoriatic arthritis are of the painful and destructive arthritis mutilans type.

Lupus

Some uncommon effects of lupus include:

• Dizziness
• Depression
• Confusion
• Seizures

Complications/Sub-Group Indications

The complications of arthritis vary depending on the type of arthritis.

Juvenile Arthritis

About 1 in 1000 children under age 16 have one of the forms of arthritis. The symptoms are similar to the adult symptoms seen for each type.

For children who have arthritis, bone loss can develop because the inflammatory process and corticosteroid treatment can inhibit bone formation. This can lead to early osteoporosis or bone fractures.

Osteoarthritis

Being overweight increases the risk of osteoarthritis in the weight-bearing joints and in the hands. Losing excess weight can be beneficial.

Osteoarthritis is common in older adults, earning the nickname "wear-and-tear" arthritis. Painful joints can inhibit physical activity, impair your basic activities of daily living, and keep you from getting a good night's sleep.

Rheumatoid Arthritis

With rheumatoid arthritis, the disease progression can destroy joints, leading to deformity in the fingers and wrist.

Serious complications can arise in organ systems throughout the body, including:

• Rheumatoid nodules
• Sjögren's syndrome
• Pericarditis
• Vasculitis
• Pleuritis
• Chronic obstructive pulmonary disease (COPD)
• Scleritis

Obesity and smoking can exacerbate the lung and heart complications of rheumatoid arthritis. Cardiovascular disease is the leading cause of death with this condition.

Females who have rheumatoid arthritis can have difficulty conceiving. It's recommended that the condition be well-controlled for three to six months before attempting to get pregnant.

Methotrexate must be discontinued for a minimum of three months before pregnancy due to the risk of associated birth defects. And it's important to get prenatal care because uncontrolled rheumatoid arthritis during pregnancy also raises the risk of preterm birth and low birth weight.

Ankylosing Spondylitis

People with AS have an increased risk of vertebral fracture, which could injure the spinal cord and lead to a variety of neurological symptoms like weakness, numbness, or even paralysis. Severe misalignment of the spine from AS can also cause spinal cord compression, which is a neurological emergency.

People with AS are more likely to have inflammatory bowel disease and psoriasis. These are not thought to be direct complications of the disease, but they can occur together due to shared genetic factors.

Lupus

Complications from the inflammation caused by lupus can affect any number of areas in your body, including your skin, heart, lungs, kidneys, blood, and brain.

If you get pregnant while you have lupus, you're more likely to have a miscarriage, high blood pressure during your pregnancy, and preterm birth. Having your disease under control before you get pregnant helps reduce these risks.

Gout

The high uric acid levels in long-term, untreated gout can lead to kidney stones. If your kidney function is impaired, you are also at risk of acute uric acid nephropathy (AUAN) with a rapid deterioration of renal function.

When to See a Healthcare Provider

Arthritis that interferes with your quality of life in any way—whether from pain or loss of range of motion or both—should, and can, be treated. See your healthcare provider or an orthopedic specialist if you:

• Experience symptoms for three days or more in a row
• Have several episodes of symptoms within a month
• Find yourself avoiding normal activities
• Do not get relief with rest, OTC pain medication, and other conservative measures
• Notice changes in symptoms that are unusual—for example, a stiff joint that normally improves after 15 minutes of exercise becomes swollen and red-hot

After diagnosis, be sure to contact your healthcare provider if you have any symptoms that are not typical of your usual symptoms, such as increased joint redness or swelling. This is especially true if you develop a fever at the same time.

If you are having an arthritis flare-up that doesn't clear up in a week with conservative therapy and rest, you should see your healthcare provider.

A Word From Verywell

Joint symptoms can come on suddenly or develop slowly over time. The diagnosis of arthritis is not always quick, but early diagnosis and management is the best way to prevent joint damage and to preserve your quality of life.