An Atypical Presentation of Seronegative Rheumatoid Arthritis
8 Early Signs Of Arthritis You Should Never Ignore
GRAND RAPIDS, Mich. (ABC 4)- It's not unusual to experience pain in your joints on occasion, especially if you're active and participate in high-impact activities such as running. That unwanted ouch can be caused by injured muscles, tendons and ligaments around the joint — or by tendonitis, a sprain or a strain.
But if you start experiencing aching, pain and stiffness on a routine basis — and particularly if the pain is right at the joint — you may be developing arthritis, says rheumatologist Uzma Haque, M.D., codirector of clinical operations at the Johns Hopkins Arthritis Center in Baltimore.
Your risk of arthritis increases as you age, and it's a leading cause of disability in the U.S., affecting around 58.5 million people, according to the Centers for Disease Control and Prevention (CDC).
Inflammatory arthritis vs. OsteoarthritisArthritis actually describes over 100 different conditions that affect joints and the surrounding tissue. They fall into two main categories: inflammatory arthritis and osteoarthritis (OA).
Inflammatory arthritis is a systemic disease in which the mechanisms that normally protect your body attack your own joints and tissues instead. The most well-known example is rheumatoid arthritis (RA), which tends to be symmetrical, meaning you'll have problems in the same joints on both sides of your body, like both wrists or both knees.
The second type of arthritis — and the most common form — is osteoarthritis. A degenerative disorder, it's caused by trauma or age-related wear and tear on your joints over time. OA is most likely to affect weight-bearing joints such as the knees, hip, lower spine or big toe, but it can also cause pain and stiffness in your thumb or finger joints.
Here are some early arthritis symptoms that should prompt you to see a medical provider.
1. Pain in a joint. Pain or aching in a joint that gradually becomes worse over time is a classic symptom of arthritis, says Lisa Cannada, M.D., an orthopedic trauma surgeon at Novant Health in Charlotte, North Carolina. The pain may be triggered by activity, or it may set in after activity or at the end of a long day.
2. Joint swelling and tenderness. As arthritis gets worse, it can cause joints to be swollen and tender. It may hurt when you press down on the joint.
3. Joint stiffness, especially in the morning. Stiffness may occur after prolonged sitting, after activity or when you wake up. "It's a feeling that you need lubrication to do something," Cannada explains. Morning stiffness that lasts more than 30 minutes is a hallmark of RA.
4. Grating sound or sensation. Grinding or grating as a joint moves is a sign the cartilage in your joint has worn down and can indicate arthritis, Cannada says. It's most common in the knee and hip but can affect other joints as well.
5. Pain in a joint that was previously injured. Many cases of osteoarthritis occur in a part of the body that suffered a prior injury or trauma. "If a football player had a knee injury back in high school, then they're likely to get knee osteoarthritis later," Haque says.
6. Groin pain. Many people don't realize pain from hip arthritis radiates to the groin, not the outside of the hip, Cannada says. Hip arthritis can also cause pain in your thigh or buttocks.
7. Symmetrical joint pain. Rheumatoid arthritis often causes problems in the same joints on both sides of your body, like both wrists or both knees.
8. Pain or stiffness in your hands and feet. Rheumatoid and other types of inflammatory arthritis often develop first in the small joints of your hands, wrists and feet, Haque says. "Somebody with inflammatory arthritis may say, 'In the morning when I wake up, my feet are very stiff, I can barely move them, and it's painful to bend my toes. Then the day goes on and I feel better.
Photo courtesy of Getty images. Arthritis treatment Arthritis has no cure, but there are steps you can take to minimize pain and stiffness, says Rochelle Rosian, M.D., a rheumatologist with the Cleveland Clinic Department of Rheumatologic and Immunologic Diseases. "There is a lot we can do to help you feel better," she says. "You can live a long and healthy life with arthritis."
Your primary care doctor may be able to treat your symptoms if they're mild, or he or she may refer you to a rheumatologist, a sports medicine doctor, an orthopedist or a podiatrist, depending on your symptoms and where your problem is located.
Expect your doctor to ask you what makes the pain better and what makes it worse, how long you've had the pain and stiffness and whether you have had any trauma to the area. It's not unusual for a high school sports injury to manifest as arthritis in a joint decades later, Rosian says.
Here are some steps your doctor may recommend to help ease your pain.
Weight loss: You may not want to hear it, but the extra pounds you're carrying are putting stress on your joints. "For every pound you carry, the force on your knee is multiplied by three," Rosian says. "If you gain 10 pounds, your knee feels 30 pounds of pressure. Maintaining an ideal body weight is critical for managing arthritis."
Exercise: If you are in pain, you may be tempted to move less, but studies show physical activity helps reduce pain and improve movement in arthritis patients. "Keeping the muscles around your joint active and strong is key in protecting and stabilizing the joint," Haque says. Low-impact activities like cycling or swimming will be easier on the joints.
Physical therapy: A physical therapist can teach you specific exercises to do to strengthen the muscles around your joint, Haque says. He or she can also work with you to correct any gait abnormalities that are putting extra stress on your knees, feet or hips.
Medication: If you have osteoarthritis, acetaminophen (brand name, Tylenol) is the safest over-the-counter pain reliever for long-term use, Rosian says, but NSAIDs (nonsteroidal anti-inflammatory drugs) like Advil or Motrin may be more effective if your joints are swollen and feel warm to the touch. Some NSAIDs are also available as liquids or gels, which can be rubbed on joints. For rheumatoid arthritis patients, early treatment with specific drugs can improve the long-term outcome.
Topical treatments: Over-the-counter or prescription creams and sports ointments can help relieve pain. Some patients have also reported success with cannabidiol (CBD) oils and creams, Rosian says.
Joint supports or splints: A splint or brace can help support and protect a damaged joint. Some immobilize and rest the joint in the ideal position to minimize stress. Others provide support while you perform a task. Examples include wrist splints, knee braces and orthotics.
Injections: If you are still experiencing pain despite trying other therapies, your doctor may suggest injections of cortisone (or hyaluronic acid) for short-term relief. However, two recent studies suggest that repeated cortisone injections may lead to more joint damage and pain. Some doctors have started offering platelet-rich plasma (PRP) or stem cells as an alternative, but their effectiveness has not been proven.
Surgery: Eventually, your doctor may recommend surgery to replace or stabilize your joint. There are many different surgical options, depending on where you have pain and how bad it is. For severe cases, you may need a total joint replacement.
(Sponsored by AARP Michigan)
What Is Osteoarthritis?
Medically reviewed by Anita C. Chandrasekaran, MDOsteoarthritis is the most common joint condition that occurs when the cartilage (the connective tissue surrounding the bones) around a joint gradually breaks down over time. When the cartilage breaks down, the remaining cartilage and bones rub together, causing symptoms such as joint pain, swelling, and stiffness in the knees, hips, neck, and hands.
Researchers don't know what exactly causes osteoarthritis, but risk factors like age, previous joint injury, and joint overuse may increase your risk of developing the condition. At this time, there is no cure for osteoarthritis. But, drug and non-drug treatment options are available to help you better manage your symptoms. Your exact treatment plan will depend on the severity of your condition and the symptoms you are experiencing.
SymptomsOsteoarthritis is a degenerative (progressively declining) joint condition that often begins slowly, affecting one or a few joints at first. Most people living with osteoarthritis start having symptoms after 40 years old. Although symptoms may vary person to person, common symptoms include:
Symptoms of osteoarthritis commonly appear in the fingers, feet, knees, hip, and spine. Joints that are less likely to be affected by osteoarthritis symptoms are the elbows, wrists, shoulders, and ankles.
CausesYour cartilage is a firm, rubbery tissue that cushions and protects your bones at the joints. A joint is where two bones meet or make contact. When a person develops osteoarthritis, the cartilage breaks down and wears away over time. As a result, the remaining pieces of cartilage or bones rub together, leading to painful symptoms.
Researchers aren't sure what exactly causes osteoarthritis. But, they have found that some factors increase your risk of developing the condition. Most people with osteoarthritis have one or more of the following risk factors:
Related:Can You Get Osteoarthritis as a Young Adult?
DiagnosisThere is no single test that can diagnose osteoarthritis alone. That said, your healthcare provider will take a thorough medical history to learn about your symptoms and order a number of tests to help confirm a diagnosis.
During your appointment, you can expect your provider to ask you questions such as:
The information from these questions can help your provider guide the next steps. In this case, they may order one or more of the following tests to confirm a diagnosis or rule out other health conditions:
There is no cure for osteoarthritis, but drugs and non-drug therapies can help you manage your condition. Your healthcare provider will create a treatment plan based on your medical history, the severity of your symptoms, and your specific needs. The goals of treatment are to:
Non-drug therapies are the first treatments that your provider will recommend. These therapies include:
Generally, your provider will prescribe medication in conjunction with non-drug therapies. They may recommend one of the following drug therapies:
If you have severe joint damage because of your condition, surgery may be an option for you. This is especially true if drug and non-drug therapies have not improved your symptoms and your joint damage is limiting your daily activities. Surgery options include:
Related:Gentle Exercises for People With Arthritis
How to Prevent Osteoarthritis FlaresIf you are living with osteoarthritis, you may experience a period of time when your symptoms are more intense. These moments of increased pain, stiffness, and swelling are known as flares or flare-ups.
It's not possible to prevent osteoarthritis altogether. However, there are some things you can do to reduce the pain associated with osteoarthritis flare-ups, such as:
People living with osteoarthritis may experience complications as their condition progresses. In addition to ongoing pain, other complications may include:
Complications caused by osteoarthritis can lead to challenges with everyday activities like completing household chores or keeping up with personal hygiene. With treatment, your ability to complete everyday tasks can improve over time.
Living With OsteoarthritisOsteoarthritis is a progressive joint disorder that affects everyone differently based on which joints are affected and the severity of your symptoms. Some people with mild osteoarthritis may not be affected by their symptoms at all, while others may experience severe disability. That's why treatment options for osteoarthritis can vary.
Living with osteoarthritis can feel limiting, difficult, and draining. It's important to follow your treatment plan and implement lifestyle changes when you can, such as:
Can anything reverse osteoarthritis?
No, damage done by osteoarthritis cannot be reversed. However, drug and non-drug treatments can help slow disease progression.
What climate is worst for osteoarthritis?
Some people living with osteoarthritis may experience worsening symptoms with colder or frigid temperatures.
What causes osteoarthritis flare-ups?
Repetitive movements such as frequent bending or overdoing activity without adequate rest can aggravate your joints and cause an osteoarthritis flare-up.
What time of day is osteoarthritis worse?
Osteoarthritis joint pain tends to be worse in the morning. This is known as morning stiffness.
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A Very, Very Serious Investigation Into Why King Charles Has Sausage Fingers
King Charles is pretty inescapable at the minute. But it's not for the reasons you might think. It's not because he was officially crowned as monarch at the weekend in a ceremony which brought London to a standstill and was watched by more than 18 million people around the country. No, far more importantly, it's about his fingers.
Keen royalists have known for years about the state of Charles' swollen fingers.
In fact, the Queen commented on the state of Charles' fingers as soon as he was born. Writing to her former music teacher in November 1948 just after Charles' birth, the Queen described his "interesting pair of hands", adding "they are rather large".
But there's nothing like a coronation to shine a spotlight on their grandiose appearance. TikTok has erupted this weekend as the usual suspects of clout chasers and TikTok 'detectives' sleuth through old footage to share theories and ideas about the mystery.
Why are King Charles' swollen fingers referred to as 'sausage fingers'Admittedly it's not the nicest comparison in the world. Of all the meats to be compared to, I'm not sure having your fingers and Cumberland sausages in the same sentence is ideal.
But it's a phrase that Charles himself has endorsed. Quoted in a 2007 biography, Charles said about the birth of Prince William: "I can't tell you how excited and proud I am. He really does look surprisingly appetising and has sausage fingers just like mine."
In 2018, William got in on the joke. At Charles' 70th birthday celebration, he quipped he wished Charles' "sausage fingers" would stop writing so many letters and instead spend more time with his grandchildren.
But beyond all the references, what's the cause behind their strange appearance? Here's a very serious investigation into why King Charles has such swollen fingers and what on earth caused it.
Theory one: OedemaNot so much suggested by actual doctors but one that has been all over Twitter and TikTok this weekend and worth investigating all the same.
Oedema is the (rather fancy) medical term for the build up of fluid which leaves legs, ankles and feet swollen.
The NHS website lists numerous causes for the condition. Among them are "standing or sitting in the same position for too long", "eating too much salty food", "being overweight" or a whole list of specific medicines including blood pressure medicines, contraceptive pills, hormone therapy, steroids and antidepressants.
Even the most outlandish TikTok detective is going to have a hard time convincing viewers some of these symptoms are related to King Charles.
Arguments for: Just take a look at King Charles' feetAdmittedly not something you are prone to Google every day but in the name of investigating, it's important to look at King Charles' feet.
This video which has gone viral on TikTok shows then Prince Charles on a visit to a Sikh temple in New Dehli in 2019. Taking off his shoes and socks to enter the temple barefoot, he revealed swollen feet that certainly rival the state of his hands.
The images of his feet have strong similarities to NHS images which show people who suffer from oedema.
There are however numerous holes in this theory. While the NHS lists 10 different causes of the condition, so many of them have nothing to do with Charles. He's not pregnant, equally he's not overweight and it's highly unlikely – given he's had the condition for years – that it's caused by an insect bite or sting.
While the other listed causes could apply to Charles, the condition focuses heavily on swollen ankles, feet or legs and the NHS website has absolutely zero mention of swollen fingers.
The NHS also advises sufferers to visit a GP if the swelling hasn't improved after a few days or gets worse.
The Palace has never commented on King Charles' fingers or suggested the issue is a serious condition. As such numerous doctors have suggested different theories.
Theory two: Travelling and hot weatherThe second theory has been around the longest. For at least the last decade, there has been an ever-present cycle: Charles goes on a foreign tour to a Commonwealth country; he's then photographed taking part in a local tradition; and then news sites speculate about the condition of his hands.
via SWNS
In 2019, Metro suggested the condition could be caused by water retention due to travelling and hot weather.
Arguments for: The worst pictures always come abroadWhile travelling is almost certainly a more boring cause than oedema, it seems a lot more credible. The theory goes as you travel for long periods of time, you move a lot less and in some people, this lack of movement allows fluid to build up. After a few days the swelling then disappears as you go about your daily life.
via Shutterstock
The picture of Charles visiting a Sikh temple in 2019 came straight off the back of a non-stop nine hour flight to India which would be prime time to have swollen fingers.
Equally important to consider is Charles' fingers are not always pictured looking red and swollen. Swelling due to travelling and hot weather helps explain when his hands look far more normal when taking part in engagements in the UK.
Charles pictured with no swollen fingers via SWNS
Theory three: ArthritisGareth Nye is a senior lecturer at the University of Chester. The physiology lecturer argued the condition could be a sign of arthritis.
He pointed out arthritis is common for people over the age of 60 and "often affects three main areas in the hand – the thumb joint or either joins in the fingers".
He added: "Fingers usually become stiff, painful and swollen and although medication can help with the pain, the swelling can remain."
In recent years, Charles has been photographed with his hands in his jacket pocket. Via SWNS
These thoughts were echoed by another doctor. Dr Chun Tang, who has worked in the NHS for almost 20 years, told MailOnline: "There are numerous reasons a person may suffer with "sausage" fingers.
"Often puffy fingers are a symptom of water retention which can be caused by numerous health conditions. Sausage fingers are officially known as dactylitis.
"This condition arises due to inflammation and can be a result of arthritis, multiple bacterial infections or even TB."
Arguments for: Backed up by the most medical expertsAway from social media, most doctors have pointed the swollen fingers point towards a form of arthritis. Unlike oedema, the condition is very common especially for people of Charles' age.
ConclusionThe Palace has never explained the medical condition being King Charles sausage fingers. However, we know the Queen has spoken about his "interesting hands", Charles himself referred to his own fingers as "sausage fingers" in a biography written about him and Prince William equally joked about them in a 2018 speech marking his 70th birthday.
All of this points to the idea the condition is unlikely to be very medically serious. And while he continues to not address the subject, medical experts will continue to speculate between whether it's caused by travelling and climate or is a sign of arthritis. However, given Charles' intention to modernise the Royal Family and make the firm seem more approachable, perhaps it won't be long before he answers a Royal fan's question on the topic.
Related stories recommended by this writer:• Erm, are Katy Perry and King Charles mates? An investigation into their bizarre friendship
• This is exactly what King Charles was like when he was a Cambridge University student
• Debunked: The creepy and real identity of the mystery Grim Reaper at the Coronation
Featured image before edits via Shutterstock/Madhuram Paliwal
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