Not Every Ache Is Just Getting Older: When Joint Pain Deserves a Second Look

Written by: Anjani Pillarisetty, M.D.

Every week, I meet patients who tell me the same thing- “I thought this was just part of getting older.” Often, they’ve been living with symptoms for months or even years before seeking help. While some aches are a normal part of aging, others are not, and recognizing the difference can make a tremendous difference in quality of life.

What “normal aging” joint pain usually feels like

Osteoarthritis is the most common form of arthritis. It is a degenerative arthritis that occurs due to gradual deterioration of the protective cartilage at the ends of your bones. This type of pain usually develops gradually over many years. Many people can manage osteoarthritis successfully with a combination of exercise, weight management, physical therapy, and, when needed, medications or joint injections. The following are symptoms suggestive of osteoarthritis:

• Pain that worsens with activity (walking, standing, repetitive use)
• Improvement with rest
• Brief stiffness after sitting or waking up
• Achy, localized discomfort (commonly knees, hips, hands, lower back)
• Symptoms that flare after overuse rather than staying constantly inflamed

Signs your joint pain may need a closer look

These symptoms don’t necessarily mean you have an autoimmune disease, but they are signs that shouldn’t be ignored. Early evaluation allows your healthcare provider to determine whether further testing is needed. For many inflammatory forms of arthritis, early diagnosis and treatment can help prevent permanent joint damage and preserve long-term function. The following are symptoms that could be suggestive of inflammatory arthritis:

• Morning stiffness lasting longer than 30–60 minutes
• Visible joint swelling (puffy, warm, or tender joints) that lasts for several days at a time
• Pain that persists even at rest
• Symptoms affecting multiple joints, often in a symmetrical pattern (both hands, wrists, or feet)
• Fatigue that feels out of proportion to daily activity
• A general sense of feeling unwell along with joint symptoms

Conditions I commonly see in older adults

Polymyalgia rheumatica (PMR)

• Typically affects adults over 60
• Causes marked stiffness and aching in shoulders and hips
• Difficulty getting out of bed, standing from a chair, or lifting arms
• Often responds very well to treatment once diagnosed

Rheumatoid arthritis (RA)

• Autoimmune disease causing joint inflammation
• Commonly affects small joints (hands, wrists, feet)
• Prolonged morning stiffness is a key feature
• Joints may become swollen, tender, and progressively harder to use
• Early treatment significantly improves long-term outcomes

Gout

• Sudden, severe joint pain (often big toe, but not always)
• Red, hot, swollen joints during flares
• Episodes that can recur and become chronic
• Very effective long-term treatments are available

How to Support Healthy Joints

Movement is medicine: Regular movement reduces stiffness and helps maintain range of motion, whereas long periods of immobility tend to worsen stiffness. Walking, swimming, cycling, and water aerobics are especially joint-friendly.

Strength training: Strong muscles act like shock absorbers for joints. Focus on legs, hips, core, and upper back. Even light resistance training a few times a week can improve function and balance.

Healthy weight: Even modest weight loss can reduce stress on knees, hips and back thus improving symptoms.

Protect your joints: Use larger joints when possible, break up repetitive tasks, use ergonomic tools, and avoid repeatedly pushing through pain.

Maintain flexibility: Gentle stretching, yoga, or tai chi can improve flexibility, balance, and morning stiffness.

Sleep and recovery: Good sleep reduces pain sensitivity and fatigue. Rest is important, but prolonged inactivity often worsens stiffness.

Overall health: Regular exercise, a balanced diet, and avoiding smoking all support long-term joint health.

The Bottom Line

Persistent pain, swelling, prolonged morning stiffness, or loss of function in your joints should not be ignored. Many inflammatory conditions, including rheumatoid arthritis, respond well to treatment when diagnosed early.

One of the most rewarding parts of my job is seeing patients return to activities they thought they had lost forever. With the advances in treatment in the modern day and a proactive approach to joint health, many people with arthritis continue to live active, fulfilling lives.

Anjani Pillarisetty, M.D., is a board-certified rheumatologist with Carson Tahoe Medical Group. For an appointment, please call (775) 445-5500.