Joint Pain and Swelling: Rheumatoid Arthritis, Gout, or an Injury, and When to Get Seen

Joint pain usually comes from one of four things: wear-and-tear arthritis (osteoarthritis), an inflammatory condition such as rheumatoid arthritis (RA), gout, or an injury or overuse problem like a sprain, bursitis or tendonitis. RA tends to affect the same joints on both sides of the body, with morning stiffness that lasts more than half an hour. A single joint that suddenly becomes hot, red, swollen and very painful needs a same-day look, and with a fever, the ER.

Rheumatoid arthritis

RA is an autoimmune disease, where the immune system attacks the lining of the joints. It usually:

• Affects small joints of the hands, wrists and feet first, on both sides
• Causes stiffness that lasts more than 30 minutes in the morning
• Makes joints swollen, warm and tender
• Comes with tiredness and sometimes a low fever

RA is managed long term by a rheumatologist, and early treatment helps protect the joints. If you have these symptoms and haven't been diagnosed, a primary care provider can start the workup with blood tests.

Osteoarthritis

The most common kind of arthritis comes from wear on the cartilage over time. It usually affects knees, hips, hands and the spine, hurts more with use and later in the day, and causes stiffness that eases within a few minutes of moving.

Gout

Gout causes sudden, severe pain, redness and swelling in one joint, very often the big toe, and often starts at night. It's caused by uric acid crystals in the joint. Flares can be set off by alcohol, red meat, shellfish, sugary drinks and dehydration. Treatment started early in a flare works best.

Bursitis, tendonitis and injuries

Pain around a joint, rather than in it, often comes from bursitis or tendonitis, usually from overuse. Pain that started with a fall, twist or impact is more likely a sprain or fracture. See our posts on sprains and carpal tunnel and wrist pain.

What helps during a flare

• Rest the joint, but keep up gentle movement so it doesn't stiffen
• Use ice for a hot, swollen joint, or heat for stiffness
• Try anti-inflammatory pain relievers, if they're safe for you
• Keep taking your prescribed arthritis medicine, and call your specialist about a flare
• Drink plenty of water, especially during a gout flare

What urgent care can do

A clinician can examine the joint, check for infection, injury or gout, and may order an X-ray or lab tests. Treatment can include anti-inflammatory or steroid medicine, a splint or brace, and a plan to follow up with your primary care provider or specialist.

When to get seen

Come in the same day for a joint that suddenly becomes painful, swollen or red, for a gout flare, or for joint pain after an injury. At an AfterOurs clinic, a standard self-pay visit is $175, a visit with one moderate service such as an X-ray is $250, and a self-pay in-clinic visit never costs more than $330. We contract with all major commercial and government plans, including Colorado Medicaid and Medicare. See our bursitis and tendonitis page and the cost and insurance page.

Go to the ER if a joint is hot, red and swollen and you have a fever or chills, which can be a joint infection; if you can't move the joint or bear weight; if a joint looks deformed after an injury; or if a swollen leg comes with chest pain or shortness of breath.

Where to find us

Four clinics across metro Denver, all ages welcome, se habla español:

• Hampden (Southeast Denver): 8 AM–11 PM daily
• Littleton: 8 AM–11 PM daily
• Thornton: 8 AM–11 PM daily
• Highlands: Mon–Fri 5–11 PM, Sat–Sun 8 AM–11 PM

Walk in, or book online.