The difference between osteoarthritis and rheumatoid arthritis

Overview

Matthew Piff Regional Physiotherapy Lead

Arthritis is a widespread condition that often leads to joint pain and reduced mobility. Although osteoarthritis and rheumatoid arthritis share some similar symptoms, it's crucial to understand that they are two distinct types of arthritis, each requiring their own unique treatment.

Keep reading to learn more about the key differences between osteoarthritis and rheumatoid arthritis, and how to identify the signs and symptoms of each condition.

What’s the difference?

Osteoarthritis (OA) is often referred to as ‘wear-and-tear’ arthritis because it’s primarily caused by the gradual breakdown of joint cartilage and repetitive motion.

Rheumatoid arthritis (RA) is an autoimmune condition where our immune system mistakenly attacks the joint lining, causing inflammation and damage.

Are the symptoms different?

Another factor that distinguishes these conditions is their symptoms.

Osteoarthritis tends to cause stiffness and pain in specific joints (that usually gets worse with activity), while rheumatoid arthritis typically affects multiple joints at the same time.

Some symptoms that overlap both conditions include:

Joint pain
Joint stiffness
Immobility and reduced flexibility
Persistent pain
A reduced range of motion
‘Warmth’ around the joints
Swelling around the joints

Is one ‘worse’ than the other?

Both osteoarthritis and rheumatoid arthritis can become debilitating over time. How manageable or painful either condition is for you depends on a variety of factors, including:

How long you’ve had arthritis
How well you manage your pain
Which joints are affected
Whether you have another physical health condition
Your lifestyle habits

OA is typically localised to one or two joints, and while it can severely limit movement, its progression is usually slower than RA.

Because RA is an autoimmune condition, it affects multiple joints at once and can even cause damage to other organs like the lungs and heart. RA flare-ups can come and go suddenly and are often more aggressive because of the significant inflammation they’re capable of causing.

Though both conditions are persistent and painful, RA is considered more problematic and painful. Without the right treatment, it can damage our joints quicker than OA, making it more it more dangerous and disabling in the long run.

Can you have both at the same time?

It’s not common but it is possible.

For example, someone with autoimmune arthritis will experience flare-ups that attack their joints in multiple areas of the body, resulting in excess inflammation. This can force other joints into bearing more weight and overcompensating, which are two leading causes of osteoarthritis.

Do they affect different areas of the body?

Yes, osteoarthritis and rheumatoid arthritis often affect different parts of the body.

OA usually affects our weight-bearing joints like the knees, hips, and spine first, as well as joints in the wrist and hands that regularly experience overuse.

RA on the other hand usually attacks smaller joints first, particularly in the hands, wrists, and feet, before progressing to larger joints if left untreated. A unique element of RA is that it also tends to affect joints symmetrically, meaning if one wrist is affected, the other will likely be as well.

Can osteoarthritis turn into rheumatoid arthritis?

This is a common question. Many people think that osteoarthritis can eventually gravitate into rheumatoid arthritis because the latter is seen as the ‘more severe’ form of the condition.

This isn’t the case and while both conditions can exist simultaneously, they are entirely separate from one another.

If you’re experiencing symptoms of either, it’s important to consult a healthcare professional for an accurate diagnosis and proper treatment plan.

Does treatment look different?

Yes, treatment for osteoarthritis and rheumatoid arthritis differs significantly because of the underlying causes of each condition.

Osteoarthritis treatment focuses on pain management and improving joint function through lifestyle changes like exercise, weight management, and possibly taking medications like nonsteroidal anti-inflammatory drugs (NSAIDs). Physical therapy and, in severe cases, surgery may also be recommended.

For rheumatoid arthritis, the goal is to reduce the immune system’s ability to attack the joints. This may involve disease-modifying antirheumatic drugs (DMARDs), biologics, and corticosteroids. Early intervention with RA is crucial for preventing long-term joint damage and other complications.

Last updated Friday 20 September 2024

First published on Friday 20 September 2024