Quick answer: Different types of arthritis tend to affect different joints. Osteoarthritis commonly affects knees, hips, the base of the thumb, finger end joints and the spine. Rheumatoid arthritis often starts in the small joints of the hands and feet on both sides. Gout often affects the big toe. A pain map is a guide only; your GP can confirm the cause.
Where your pain is can say a lot. Different types of arthritis have favourite joints and typical patterns, and other common problems such as tendon pain, bursitis or trapped nerves can mimic them. This pain map walks through the body joint by joint, explaining what is common, what else it could be, and when to get checked. It is for understanding, not self-diagnosis: only a clinician who examines you, sometimes with tests, can tell you what is causing your pain.
How to use this pain map
- Find the joint or area that hurts in the sections below.
- Note the pattern: which side, whether it is one joint or many, whether both sides are affected equally, how long morning stiffness lasts, and whether there is swelling.
- Read the "could also be" notes. Many joint-area pains come from tendons, muscles or nerves rather than the joint itself.
- Write it down and take it to your GP or physiotherapist. A simple record helps them a lot. Our pain tracking journal includes a joint map you can tick.
The big picture: patterns that point to different types
| Pattern | Often seen in |
|---|---|
| Weight-bearing joints (knees, hips), base of thumb, end finger joints, spine; pain worse with use, short morning stiffness | Osteoarthritis |
| Small joints of hands (knuckles, middle finger joints) and feet, wrists, often both sides; swelling; morning stiffness over 30 minutes | Rheumatoid arthritis |
| Sudden, very painful, hot, swollen single joint, often the big toe | Gout (but infection must be ruled out) |
| Finger or toe end joints, a whole swollen "sausage" finger or toe, heel pain, often with psoriasis | Psoriatic arthritis |
| Lower back and buttock pain and stiffness, worse with rest and at night, better with exercise, usually starting before 45 | Axial spondyloarthritis, including ankylosing spondylitis |
| Aching and stiffness in both shoulders and hips, usually over 50, coming on over days to weeks | Polymyalgia rheumatica |
| Widespread pain, tiredness, poor sleep, tender areas rather than swollen joints | Fibromyalgia (can occur alongside arthritis) |
Hands and wrists
Base of the thumb
Aching at the base of the thumb, where it meets the wrist, especially when gripping, turning keys or opening jars, is a very common site for osteoarthritis. The base of the thumb may look slightly squared off over time.
Could also be: de Quervain's tenosynovitis, a tendon problem causing pain on the thumb side of the wrist, often with pain when moving the thumb.
Finger end joints and middle joints
Hard, bony lumps on the end joints of the fingers (Heberden's nodes) or the middle joints (Bouchard's nodes) are typical of hand osteoarthritis. They can be red and sore when they first form, then often settle. Psoriatic arthritis can also affect the end joints, sometimes with nail changes.
Knuckles and middle finger joints with swelling
Soft, puffy swelling of the knuckles or middle finger joints, often on both hands, with stiffness lasting more than 30 minutes in the morning, is a typical pattern in rheumatoid arthritis. The NHS lists the hands, feet and wrists as commonly affected first.
Wrist
Rheumatoid arthritis often affects the wrists. Osteoarthritis of the wrist is less common and often follows an old injury.
Could also be: carpal tunnel syndrome, which causes tingling, numbness or pain in the thumb, index and middle fingers, often worse at night. The NHS notes it can be linked to arthritis.
See our hand arthritis guide and hand exercises.
Elbows
Elbow arthritis is less common. It can occur in rheumatoid arthritis, after an old injury, or in people who have done heavy manual work. Signs include stiffness, difficulty fully straightening the arm, and sometimes locking.
Could also be: tennis elbow or golfer's elbow (tendon pain on the outer or inner elbow), or olecranon bursitis, a soft swelling over the point of the elbow. A hot, red bursa with fever needs urgent assessment for infection.
Shoulders
Deep ache and stiffness in the shoulder joint
Osteoarthritis of the main shoulder joint can cause a deep ache, stiffness and grinding, and difficulty lifting the arm or reaching behind you. It is less common than knee or hip osteoarthritis.
Top of the shoulder
Pain on the top of the shoulder, at the bony point where the collarbone meets the shoulder blade, can come from osteoarthritis of that smaller joint, often worse when reaching across the body.
Both shoulders, with hip stiffness, over 50
Aching and stiffness in both shoulders and often both hips, worse in the morning, coming on over a short time, can be polymyalgia rheumatica. See a GP promptly. If you also have headache, scalp tenderness, jaw pain when chewing or vision changes, get same-day help.
Could also be: rotator cuff problems (pain on the outer upper arm when lifting), or frozen shoulder (severe stiffness in all directions). See our shoulder arthritis guide.
Neck and back
Neck
Age-related changes in the neck joints and discs, sometimes called cervical spondylosis, are very common and often cause stiffness and aching. Pain can spread to the shoulders or between the shoulder blades. In long-standing rheumatoid arthritis, the top of the neck can be affected, so new neck pain with tingling in the hands or feet should be checked promptly.
Lower back
Osteoarthritis of the small spinal joints is a common cause of stiffness and aching, often worse after sitting or first thing, and better after moving around. Inflammatory back pain from axial spondyloarthritis is different: it usually starts before age 45, comes on gradually, is worse with rest and in the second half of the night, and improves with exercise. The NHS notes that ankylosing spondylitis symptoms often improve with exercise and worsen with rest.
Could also be: muscle strain, a disc problem, or sciatica, which causes pain shooting down the leg.
Hips and groin
Groin and front of the hip
Hip osteoarthritis most often causes pain in the groin or front of the thigh, sometimes spreading to the knee. People often notice difficulty putting on socks and shoes, getting in and out of cars and walking longer distances.
Outer side of the hip
Pain on the outside of the hip, often worse lying on that side or climbing stairs, is commonly due to tendon or bursa irritation (greater trochanteric pain syndrome) rather than the hip joint itself.
Buttock
Buttock pain can come from the lower back or the sacroiliac joints, which are commonly affected in axial spondyloarthritis.
See our hip arthritis guide.
Knees
Inner side of the knee
The inner part of the knee is the most common site of knee osteoarthritis, causing pain on walking, stairs and getting up from chairs, with stiffness after rest that usually eases within 30 minutes.
Front of the knee and behind the kneecap
Pain around or behind the kneecap, worse on stairs, kneeling or squatting, can come from osteoarthritis behind the kneecap or from irritation of the tissues around it.
Swollen knee
Knee swelling can happen in osteoarthritis, especially after a busy day. A large, warm, swollen knee can also occur in inflammatory arthritis, gout or pseudogout. A sudden hot, swollen, very painful knee with fever needs urgent help.
Could also be: a meniscus (cartilage) tear, especially after a twist, or a Baker's cyst, a swelling behind the knee. See our knee arthritis guide.
Ankles and feet
Big toe
Two common causes: gout, which the NHS describes as sudden severe pain, often in the big toe, with a hot, swollen, red joint; and osteoarthritis of the big toe joint (hallux rigidus), which causes stiffness and pain when pushing off to walk, sometimes with a bony lump on top.
Ball of the foot and toes
Pain and swelling across the balls of the feet, sometimes feeling like walking on pebbles, is a common early sign of rheumatoid arthritis. Psoriatic arthritis can cause a whole toe to swell.
Midfoot and ankle
Osteoarthritis of the midfoot causes aching across the top of the foot, often with a bony bump. Ankle osteoarthritis usually follows an old injury or fracture.
Heel
Heel pain is usually plantar fasciitis, but in psoriatic arthritis and axial spondyloarthritis, inflammation where the tendons attach to the heel is common.
See our foot and ankle arthritis guide.
Jaw
The jaw joint can be affected by osteoarthritis and inflammatory arthritis, causing pain when chewing, clicking or difficulty opening the mouth. Jaw pain when chewing in someone over 50, especially with headache or scalp tenderness, needs same-day medical advice because it can be a sign of giant cell arteritis.
What to do with your pain map
- Book a GP appointment if you have joint pain that has lasted more than a few weeks, or has no diagnosis yet. In many areas you can also self-refer to NHS physiotherapy for joint and muscle problems.
- Bring your notes: which joints, when the pain started, morning stiffness time, swelling, and what makes it better or worse.
- Do not wait for tests to start helping yourself. NICE's osteoarthritis guideline (NG226) says osteoarthritis can usually be diagnosed clinically, without X-rays or blood tests, in people over 45 with typical symptoms. Exercise, weight management where relevant, and the right information are core treatments.
- Do not self-diagnose from a chart. Patterns overlap, and some people have more than one condition.
When to get medical help
- Call NHS 111 or go to A&E for a suddenly hot, red, swollen, very painful joint, especially with fever or feeling unwell, or if you cannot weight-bear after a fall.
- Go to A&E or call 999 for back pain with new numbness around the bottom or genitals, problems controlling your bladder or bowel, or weakness in both legs.
- Get same-day help if you are over 50 with a new headache, scalp tenderness, jaw pain on chewing or vision changes. Call 999 or go to A&E for any loss of vision.
- See your GP soon for swollen joints, morning stiffness over 30 minutes most days, new stiffness in both shoulders or hips if you are over 50, or joint pain with unexplained weight loss, fevers or night sweats.
- Call 999 for chest pain, severe breathlessness or signs of a stroke.
Which joints does osteoarthritis usually affect?
Osteoarthritis most commonly affects the knees, hips, the base of the thumb, the end and middle finger joints, the big toe and the spine. Pain is usually worse with use and stiffness after rest tends to ease within about 30 minutes.
Which joints does rheumatoid arthritis affect first?
Rheumatoid arthritis often starts in the small joints of the hands and feet and the wrists, usually on both sides of the body. Joints may be swollen, warm and tender, with morning stiffness lasting longer than 30 minutes.
Is pain on the outside of my hip arthritis?
Often not. Pain on the outer hip, worse lying on that side or on stairs, is commonly from tendons or a bursa around the hip. Hip joint arthritis more often causes pain in the groin or front of the thigh. A GP or physiotherapist can tell the difference.
Can arthritis in the hip cause knee pain?
Yes. Hip arthritis can cause pain felt in the thigh or knee, which is called referred pain. If you have knee pain but your knee looks and feels normal when examined, your clinician may check your hip.
What does gout in the big toe feel like?
The NHS describes sudden, severe pain in a joint, often the big toe, with the joint becoming hot, swollen and red, and the skin shiny. Attacks often start at night. Because joint infection can look similar, get urgent advice if you have a fever or feel unwell.
Do I need an X-ray to find out which type of arthritis I have?
Not always. NICE says osteoarthritis can usually be diagnosed from your symptoms and an examination in people over 45. Blood tests, X-rays or scans may be used if inflammatory arthritis, gout or another cause is suspected.
Sources and further reading
- NHS: Osteoarthritis
- NHS: Rheumatoid arthritis
- NHS: Gout
- NHS: Psoriatic arthritis
- NHS: Ankylosing spondylitis
- NHS: Polymyalgia rheumatica
- NHS: Carpal tunnel syndrome
- NICE NG226: Osteoarthritis in over 16s
Educational information for people in the United Kingdom — not a diagnosis or personal medical advice. Charity no. 1218461. Pending clinical review. Everyone's situation is different, so always follow the advice of your own GP, pharmacist or rheumatology team. If you feel very unwell, call 999 or go to A&E. For urgent advice, contact NHS 111.
Continue with related help
- Knee arthritis — symptoms and self-help
- Hip arthritis — symptoms and treatment
- Hand arthritis — thumb and finger joints
- Foot and ankle arthritis — toes, midfoot and ankle
- Shoulder arthritis — deep shoulder pain
- Symptom checker — educational next steps