When joint pain is more than ‘wear and tear’
Early Clues of Inflammatory Arthritis
Many people assume that joint pain, especially as we get older, must be due to “wear and tear” — ageing of cartilage that leads to osteoarthritis.
But not all joint pain fits this pattern. When pain and stiffness are caused by inflammation rather than mechanical strain, it could point towards an inflammatory arthritis, such as rheumatoid arthritis, psoriatic arthritis, or axial spondyloarthritis.
Recognising the difference early is important. With modern treatments, most people with inflammatory arthritis can live full, active lives — but early diagnosis is key.
A Patient’s Story: When Pain & Stiffness Wasn’t “Just wear and tear”
“I visited Dr Singh today after experiencing excruciating pain for a number of weeks and feeling extremely crestfallen. He was very kind and patient, took care to listen carefully before then diagnosing me and making a considered plan for next steps. I found him via a Google review and am so glad I did!”
— Patient diagnosed with new psoriatic arthritis
This patient came to clinic after several weeks of severe joint pain, swelling and fatigue, initially assuming it might be age-related (even though she was only 40!) or due to overuse. Careful assessment — taking into account their symptoms, pattern of joint involvement, and history of skin psoriasis — confirmed a diagnosis of psoriatic arthritis, an autoimmune condition where the immune system mistakenly causes inflammation in the joints and tendons.
Once the diagnosis was clear, an evidence-based treatment plan was started promptly. Within weeks, their pain and stiffness had significantly improved — a reminder that recognition and early intervention can completely change the outlook for patients with inflammatory arthritis.
How Inflammatory Arthritis Differs from Osteoarthritis
Osteoarthritis:
Develops gradually, often over years
Stiffness lasts only a few minutes in the morning
Joints may feel bony or mildly swollen
Usually affects one or two weight-bearing joints (knees, hips)
No general symptoms like fatigue or fever
Inflammatory arthritis:
Can develop over weeks or months
Morning stiffness lasting more than 30 minutes
Joints feel warm, soft or puffy due to inflammation
Often affects multiple small joints symmetrically (hands, wrists, feet)
May cause fatigue, low mood, or other systemic symptoms
Early Signs You Shouldn’t Ignore
Persistent morning stiffness that lasts longer than 30 minutes
Swelling or warmth in joints, particularly fingers, wrists, or toes
Pain that improves with gentle movement but worsens with rest
Fatigue or feeling generally unwell
A history of psoriasis, even if mild or only affecting nails
If these symptoms sound familiar, it’s worth seeking an early rheumatology assessment.
Why Early Diagnosis Matters
Inflammatory arthritis can cause joint damage within months if left untreated. Modern diagnostic tools — including ultrasound and MRI — can detect inflammation even before X-ray changes appear.
Blood tests can be helpful but do not tell the entire story. They can often be normal especially in some inflammatory arthritis disorders such as psoriatic arthritis and there may be no ‘autoantibodies’.
Early treatment can:
Reduce inflammation and pain
Prevent long-term joint damage
Maintain mobility and function
Restore quality of life
With conditions like rheumatoid or psoriatic arthritis, early and tailored treatment often means patients can continue their normal routines with minimal disruption.
A No-Fuss, Reassuring Approach
My consultations focus on careful listening, clear diagnosis, and practical next steps — avoiding unnecessary delay or jargon. Many patients describe feeling reassured after their first appointment, understanding not just what is happening, but why and how to move forward.
If you’re experiencing joint pain that doesn’t feel like simple wear and tear — especially if it’s accompanied by stiffness, swelling, or fatigue — it’s important to seek expert advice. Early recognition and treatment can make all the difference.
Dr Animesh Singh, Consultant Rheumatologist. GMC: 6130215
Please note, these posts are for general information only and do not constitute medical advice. Dr Singh would encourage you to speak to your healthcare professional to be assessed and managed for your specific symptoms.