Joint and back pain: is it arthritis?
Written by:
Rheumatologist
Published: 07/06/2021
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'.
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.