What's the difference between rheumatoid disease and osteoarthritis?

arthritis autoimmune disorder chronic pain joint pain osteoarthritis rheumatoid arthritis rheumatoid diagnosis rheumatoid disease

doctor in white jacket holding the arthritic hands of a woman in a white blouse

When people say 'arthritis' they usually mean any condition that causes painful joints. 

But not all arthritis is the same.

There over 100 forms of arthritis. The word 'arthritis' means 'swollen joint'. Arthritis conditions are all linked by this one common symptom, but they may have very different causes, outcomes, and treatments.

The two most well-known types of arthritis are osteoarthritis (OA) and rheumatoid disease (aka rheumatoid arthritis or RD or RA).

Osteoarthritis affects over 27 million Americans, whereas rheumatoid affects around 1.3 million. Some unlucky patients may develop both rheumatoid and osteoarthritis as they age.

Despite the word arthritis, these conditions are quite different from one another. 


Osteoarthritis - a degenerative disease linked to aging

Osteoarthritis can occur as we age,  the result of years of wear and tear on the body.

Developing slowly over many years, as natural cartilage wears down, OA could be caused by a combination of factors. These could include your age, genetic makeup, hormones, joint injury, obesity and muscle weakness.

Athletes are more prone to osteoarthritis due to their higher level of activity and the strain this places on joints.

People with OA experience pain and discomfort from cartilage damage which can eventually lead to bone spurs and bone-on-bone rubbing, typically in larger weight-bearing joints, such as your knees and hips.

People with OA may also wake up in the mornings with stiffness that usually subsides within a half hour. Symptoms of discomfort and stiffness may also return after physical activity.

Usually confined to the joints, OA can be treated with steroid injections into the joint, and oral NSAID drugs such as ibuprofen for pain. In severe cases, surgery may be necessary.

Rheumatoid disease (aka rheumatoid arthritis): an autoimmune disease that can be diagnosed at any age

Rheumatoid disease is an autoimmune disease in which the body’s immune system mistakenly attacks the body’s joints. It can occur at any age.

Most often diagnosed between the ages of 30 and 50 years, RA can affect even children. 

This disorder may be caused by genetics, hormones, smoking, viral or bacterial infections or other environmental factors. The cause of RD and the destructive path within the body’s immune system is still unknown.

RD typically attacks smaller joints first, such as the hands, causing them to become painfully swollen. Symptoms often appear in matching sets on both sides of the body. It can also occur throughout the body to as many as 30 separate joints.

Some RD patients develop firm lumps under the skin, called nodules. These lumps range in size from a pea to a golf ball and can be extremely painful.

RD patients often wake in the morning with soreness and stiffness, which can continue for hours. Unlike OA, RD is not limited to just the joints. It is a systemic illness that affects the whole body. Other symptoms include fever, fatigue, muscle pain and even cause nerve damage.

When left untreated, RA can damage other internal organs, and people with RA have an increased risk of heart disease and cancer. This can result in a shortened lifespan.

Treatments include steroid injections, and oral NSAID drugs, like Diclofenac and Ibruprofen. RD patients are often also prescribed oral steroids like prednisone, which can cause bone thinning, as well as DMARDS like Methotrexate (also used in chemotherapy).

Biologic drugs - including Humira, Enbrel and Remicade - are becoming more widely prescribed and are administered by IV infusion or self-injection.

While osteoarthritis and rheumatoid disease are both diseases that can result in joint pain and loss of mobility, they have different causes, symptoms and treatments. 

It can be frustrating for people when the two diseases are confused, so it’s important to understand the difference.

If you think that you may have osteoarthritis or rheumatoid disease, you should seek medical help. Visit your doctor to get a clear diagnosis as soon as possible. 

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