We often have a way of brushing off the little things our bodies tell us — a stiff knee after getting out of bed, fingers that take a while to loosen up, or a familiar ache that returns every few days. ‘It’s just age,’ many tell themselves, or blame it on a long walk, too many stairs or a busy day. But when these everyday aches begin to repeat themselves, linger longer or quietly interfere with things we do without thinking, they may be worth paying attention to. Ahead of World Arthritis Day on October 12, doctors explain the early signs of arthritis that are often mistaken for normal ageing, and when an ordinary ache deserves a closer look.
“One of the commonest things people tend to overlook is a gradual change in how a joint feels or functions,” says Dr Aruna S Malipeddi, senior consultant, rheumatology, KIMS-Arete Hospital. Stiff fingers in the morning, knee pain while getting up from a chair or climbing stairs, or a joint that does not move as freely as it used to can all be subtle changes. Recurrent swelling or tenderness, she adds, may also be attributed to age, overuse or lack of exercise.
Dr Behera Sanjib Kumar, clinical director and head of department - CARE Bone and Joint Institute, CARE Hospitals, Banjara Hills, shares that the pattern of pain can give doctors useful clues. “Pain that gradually increases with activity and improves with rest is commonly seen with wear-and-tear conditions such as osteoarthritis. On the other hand, prolonged morning stiffness or stiffness after sitting or resting for a long time can sometimes point towards an inflammatory form of arthritis,” he says.
However, he cautions that these patterns are not enough to diagnose the condition on their own. “A doctor’s examination, and sometimes blood tests or imaging, may be needed to understand the actual cause.”
Morning stiffness is another symptom people can easily dismiss. Dr Aruna says it is an important clue, particularly when it is persistent. She notes, “The duration and what happens to the stiffness after getting up can help us understand whether the problem is more likely to be inflammatory or mechanical. If someone is regularly waking up with significant stiffness, particularly if it is accompanied by swelling, pain in several joints or difficulty making a fist or walking normally, it is worth getting assessed rather than assuming it is simply age-related.”
Dr Behera also highlights, “Prolonged stiffness after periods of rest as a pattern worth noticing. But neither the duration nor the pattern alone establishes a diagnosis.”
Clicking and cracking sounds can be alarming, but they do not automatically indicate arthritis. “Clicking or cracking by itself does not necessarily mean that a joint is damaged or that a person has arthritis. It can occur in otherwise healthy joints,” says Dr Aruna.
Dr Behera further explains that such sounds can occur due to changes in pressure within the joint or movement of tendons and ligaments. He adds, “However, if the sounds are persistent and are accompanied by pain, swelling, stiffness, locking of the joint or difficulty moving it, they should be evaluated. A sudden change in the joint after an injury should also not be ignored.”
One of the clearest signs that joint pain may be more than a routine ache is when it begins interfering with normal life.
Dr Behera explains, “If someone finds it difficult to climb stairs, walk for their usual distance, squat, open a bottle, get dressed or perform other routine activities, it suggests that the problem may be affecting joint function. When pain is persistent and gradually limits movement, it is better to seek medical advice rather than simply adjusting one’s daily activities around the pain,” he adds.
Mild pain which is clearly related to unusual activity and settles with rest may be managed with a short period of self-care. “But recurring pain or pain that does not settle should not be repeatedly self-managed. If swelling keeps recurring, morning stiffness lasts beyond 30 minutes, several joints hurt, or movement is becoming difficult, it is time to see a doctor,” shares Dr Aruna. The same applies if the pain is affecting sleep or day-to-day activities.
Both doctors point to ignoring persistent symptoms as a common mistake. “A common mistake is assuming that joint pain is simply a normal part of ageing and continuing to ignore it,” explains Dr Behera. Repeatedly relying on painkillers or home remedies without finding out what is causing the pain is another.
“Some people also stop physical activity completely because they are worried about making the pain worse,” he adds.
Dr Aruna stresses the importance of not waiting until symptoms become severe. “The important point is not to wait until the pain becomes severe or the joint is significantly restricted,” she concludes.
Early diagnosis is important because the cause of joint pain can vary widely, and treatment depends on the condition.
