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Is It Really Arthritis?

New aches, pains, and twinges in the joints naturally make adults of a certain age wonder, "Is it arthritis?" Often, the answer is yes: Arthritis is the leading cause of disability in people over age 55. Arthritis is a blanket name for more than 100 different conditions causing joint damage. The most common are osteoarthritis (or OA, caused by wear and tear) and rheumatoid arthritis (RA, an immune disorder).

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But some aches are neither OA nor RA, but a distant relative in the arthritis family -- or not arthritis at all. How can you tell?

Is it arthritis -- or tendinitis?

How they're the same: Like some types of arthritis, tendinitis is caused by damaging overuse of the joint -- usually the shoulders, elbows ("tennis elbow"), knees, hips, wrists, heels.

Both arthritis and tendinitis can cause pain that worsens with overuse. The inflammation both conditions can create makes the affected area tender and painful to move.

How they're different: Tendinitis is a specific kind of injury to the tendons, tough cords of tissue that connect muscles and bones. It tends to cause pain over a wider area than arthritis, which is limited to the joint.

Also, tendinitis can heal relatively quickly with simple measures such as rest, ice, pain medication, and physical therapy, because it's an injury. Arthritis doesn't go away with treatment or time; it's a chronic (ongoing) condition that you learn to minimize and live with.

Is it arthritis -- or carpal tunnel syndrome?

How they're the same: Carpal tunnel syndrome (CTS) often shows up at the same time as osteoarthritis -- the midlife years of 45 to 55. There really is a carpal "tunnel" -- a narrow passage in the wrist formed by wrist bones and a ligament along the palm. If the passageway narrows, constricting a key nerve called the median nerve, the result is burning pain, tingling, and numbness.

Both CTS and osteoarthritis can be caused by repetitive use, such as typing or hobbies that require the hands to be in an awkward position. Women, smokers, and people with rheumatoid arthritis are at higher risk.

How they're different: Carpal tunnel pain develops gradually but tends to create a more intense pain. A doctor can diagnose carpal tunnel using simple tests that may involve bending the wrist and timing how long it takes for a tingling sensation to appear. Wearing a special splint can relieve symptoms.

Is it arthritis -- or fibromyalgia?

How they're the same: Like arthritis, fibromyalgia is a pain syndrome, although its cause is unknown. Pain may cluster on certain tender points -- the neck, shoulder, back, hips, arms, legs -- where the joint pain of arthritis also exists. (People with rheumatoid arthritis sometimes develop fibromyalgia.)

How they're different: Fibromyalgia pain (often described as a generalized achiness) eventually extends beyond just the joints. And it tends to cause extreme chronic fatigue not necessarily seen in arthritis. Other symptoms of fibromyalgia include sleep disruption, mental "fog," headaches, and sensitivity to noise.

Because its causes are little understood, treatments are far less advanced for fibromyalgia than for arthritis.

Is it arthritis -- or gout?

How they're the same: The word gout may conjure up images of fat, Colonial-era old men, but it's a modern problem, too -- and technically a type of arthritis. It causes painful inflammation, swelling, and pain in the joints, often the big toe.

How they're different: Unlike osteoarthritis, gout attacks tend to come and go. One day you're fine, and the next day a joint is swollen, shiny red or purple, and extremely painful.

Gout isn't caused by wear and tear or an immune disorder but by a build-up of uric acid in the blood. (Sometimes too much uric acid is produced; sometimes one's kidneys can't rid the body of it fast enough.) Seafood, organ meats, and beer are among foods that raise uric acid levels; so can diuretics.

Doctors can diagnose gout by examining joint fluid under a microscope. Future attacks are preventable by managing diet and other factors.

Is it arthritis -- or flu?

How they're the same: Both arthritis and influenza involve a creeping, generalized achiness, especially around the joints. Both kinds of muscular pain can be eased with over-the-counter pain relievers. People with rheumatoid arthritis are at higher risk of developing complications such as pneumonia from flu, as are those who take steroids, prednisone, and certain other arthritis treatments.

How they're different: Flu is caused by a virus, not a degenerative or autoimmune disorder. When muscle-ache symptoms are accompanied by a fever, cough, chills, or headache, it's a pretty good bet that a virus like flu is at fault. The good news: Though flu makes you more miserable in the short run, it's a shorter run. Arthritis is a chronic condition you learn to live with.

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