History and Physical Examination
Your healthcare provider may ask about:
- When your symptoms started and how severe they are
- How your symptoms change with rest or activity
- Past episodes of similar pain
- Medications you take, including prescription and over-the-counter drugs
- Your exercise habits, daily activities, and lifestyle
- Other symptoms, such as weight or appetite loss, sleep problems, rash, fever, muscle weakness, feeling unwell, or depression
- Whether symptoms interfere with sleep, walking, or daily activities
- Family history of joint or autoimmune diseases
Your healthcare provider will also perform a physical exam. This may include:
- Identifying where the pain is coming from and which joints are affected
- Checking for redness, swelling, warmth, weakness, or bony changes
- Looking for signs of tendon injury or nerve problems
- Watching how you walk, sit, stand, and move
Lab Tests
A healthcare provider may order tests, including:
- Blood and urine tests
- Testing fluid taken from the affected joint (joint aspiration)
- Imaging tests, such as X-rays or other scans, to look for joint damage
- Arthroscopy, a procedure that uses a small camera to look inside the joint
Specific testing to diagnose common musculoskeletal problems
Osteoarthritis
Usually diagnosed based on your medical history and physical exam. X-rays may show narrowing of the joint space, bone spurs, or thickening of the bone. However, X-ray changes do not always match how much pain a person feels. Imaging tests are not always needed unless symptoms are unusual or severe.
Rheumatoid Arthritis
Diagnosis is based on medical history, physical exam findings (such as warm, swollen joints), and blood tests. Blood tests may look for signs of inflammation or autoimmune disease. Imaging tests can show joint damage in later stages. Referral to a rheumatologist is often recommended.
Gout / Pseudogout (CPPD)
The best way to diagnose these conditions is by removing fluid from the joint (joint aspiration) and looking for crystals under a microscope. Imaging may show calcium buildup in pseudogout (CPPD). Blood tests that measure uric acid can support the diagnosis of gout but cannot confirm it alone.
Specific Testing for Mechanical / Soft-Tissue Problems
Fibromyalgia
Diagnosis is based on medical history and physical exam. The healthcare provider must rule out other conditions that can cause similar symptoms.
Tendinitis
Diagnosed when there is pain with movement against resistance in the affected tendon. Imaging tests, such as ultrasound or MRI, are usually not needed unless symptoms continue.
Rotator Cuff Tendinopathy
Diagnosis is mainly based on the physical exam. Limited shoulder movement and pain with certain motions support this diagnosis.
Frozen Shoulder (Adhesive Capsulitis)
Diagnosed by physical exam showing limited active (you move it) and passive (someone else moves it) range of motion. Imaging tests are usually normal.
Bursitis
Usually diagnosed by physical exam. Common findings include swelling and tenderness in one area. Joint aspiration may be needed if infection or crystal disease is suspected.
Special Note on Low Back Pain
Most nonspecific low back pain improves within a few weeks.
Imaging is not needed early unless warning signs are present, such as weight loss, weakness, loss of bladder or bowel control, or trouble walking.
Older adults should talk with their healthcare provider if pain is severe or does not improve.
Last Updated April 2026