Sometimes years. It depends on how bad it is at the time you are examend and they do blood work checking for inflamation markers. My lower back has hurt off and on since I was 20yrs. I was hit head on by a drunk driver. So they would tell me your getting older and your raising children its going to get worse as you get older. Really? I had sevier pain in both elbows and could not pick anything up with right hand, brush my teeth, trun a door knob. Had to do it all left handed. That was 7 yrs ago. 1-1/2 yrs ago my first knuckle on my index finger swelled up and was red. Told my PCP I need to see a Rhumo asap. He did blood work, exrays of hips and pelvis and thorasic spine. My blood work lit up like a christmas tree. I don't have rhomotoid arthritis. He confirmed Psoriatic Arthritis with ultra sounds of my hands. There was inflamation in the sheaths that cover your ligaments and that doesn't happen in other arthritis. So PsA. psoriasis, Sjogrens, Sponyloarthitis.