Joint and back pain: is it arthritis?

Written by: Dr Anshuman Malaviya
Published: | Updated: 03/04/2023
Edited by: Robert Smith

Joint and back pain remain amongst the most common symptoms that result in GP and hospital visits. The aim of this article is for you to understand the various conditions that are collectively called 'arthritis'.

back pain


What are the main causes of joint pain?

The most common cause of joint pain is mechanical. By this I mean, the pain experienced when joints are excessively stressed or strained. For example, the pain that you might get after unaccustomed exercise. Patients with joint hypermobility often have mechanical joint pain. The other form of joint pain is inflammatory joint pain. Inflammatory joint and back pain are usually (but not always) a symptom of inflammatory arthritis.

What are the different types of arthritis?

As rheumatologists, we spend a lot of our time trying to distinguish between mechanical and inflammatory joint pain. Unfortunately, in my opinion, patients are often wrongly labelled as having either osteoarthritis or inflammatory arthritis based on the presence or absence of blood test markers. In actual fact, you could have completely normal markers of inflammation and still have inflammatory arthritis. The opposite is also true.

Are there ways I can distinguish between mechanical and inflammatory joint pain?

Typically, patients with inflammatory joint pain are able to go to sleep, but are woken in the early hours of the morning with pain and stiffness in their joints. There is considerable early morning pain and stiffness. This is usually less by 10-11am.


Symptoms often recur after periods of rest, such as long car journeys. If the pattern of your joint pain is as above, you could have inflammatory arthritis and this may need further investigation.

Mechanical joint pain (osteoarthritis) is associated with pain that eases at night and is generally worse after activity. Symptoms generally improve after periods of rest and most patients have no trouble with long car or train journeys.

Not all inflammatory arthritis is rheumatoid arthritis and there are a number of different conditions that are associated with inflammation in the peripheral joints and spine, some with normal inflammatory markers.

By Dr Anshuman Malaviya

Dr Anshuman Malaviya is a Consultant Rheumatologist and is Clinical Lead of the rheumatology department at Addenbrooke’s Hospital in Cambridge. He specialises in the diagnosis and management of rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, cancer immunotherapy-associated arthritis and manages patients with osteoporosisvasculitisfibromyalgia, and lupus .

Dr Malaviya qualified in 1998. Having done an MD and trained in general medicine as a junior doctor, he went on to do specialist training in rheumatology in the East of England. During this time, he spent 2 years in Cambridge and gained considerable clinical trial experience. He completed his specialist training in rheumatology and general medicine in 2012. He subsequently became a substantive NHS consultant at Mid Essex Hospital Trust in Chelmsford in 2012. Since 2017 he has been a consultant rheumatologist at Addenbrooke’s Hospital in Cambridge, where in addition to general clinics he also runs an Early Arthritis Clinic.

Dr Malaviya has gained considerable clinical experience during his time as a consultant, managing complex musculoskeletal disease and has developed an appreciation of the psychosocial impact chronic disease and pain has on the lives of both patients and their families. There is growing evidence that many autoimmune diseases present in clusters across various body systems such as the gut, the spine and the joints. Therefore, he takes a holistic approach - taking into account the body as a whole - when making his diagnoses and offering treatments. He strongly believes that appropriate early intervention can prevent long term chronic disease and disability.

Dr Malaviya is currently Clinical Lead of the Department of Rheumatology at Addenbrooke's Hospital. Over his career, he has won various awards including the Clinical Excellence Award Trust in 2014 and his rheumatology research team in Chelmsford won the CLRN Award for Best Research Team.   He also routinely publishes in peer-reviewed journals.

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