Rheumatoid arthritis versus osteoarthritis: What’s the difference?
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Published on 21 December 2022
Rheumatoid arthritis is not just a joint problem. Understand the facts and causes of this disease, and learn how to avoid triggers and manage flare-ups.
Creaky, stiff and painful joints are typical of both rheumatoid arthritis (RA) and osteoarthritis. Beyond these symptoms, these two types of arthritis are actually quite different.
Rheumatoid arthritis
Osteoarthritis
Causes
An autoimmune disease where the body's immune system attacks the joints. The cause is unknown, though genes play a part and smoking increases the risk.
Caused by many factors that contribute to wear and tear, including but not limited to genes and being overweight.
What happens to the joints?
The immune system attacks the synovial membrane that protects and lubricates joints, causing inflammation, pain and swelling. Joint erosion may follow.
The cartilage that lines and cushions the joints wears away. Bony outgrowths may occur. All this causes pain and swelling.
Onset occurs
Can happen at any age, though typically in the forties and fifties.
Usually develops gradually and later in life after years of mechanical wear and tear.
Symptoms
Pain and stiffness in the joints are often accompanied by ‘flu-like’ symptoms, such as tiredness. Pain is more prolonged and functionally limiting, and especially worse in the morning or after inactivity.
The symptoms are limited to pain in and around the joints. It is often worse during activity, such as walking, and gets better with rest. However, there may also be a few minutes of ‘gelling’ after inactivity.
Diagnosis
Clinical diagnosis, based on history and physical examination
X-rays may be done to check for joint damage
Blood tests are usually done to test for the presence of inflammation factors and other parameters
Timely diagnosis is important as permanent joint damage can start within weeks of disease onset
Clinical diagnosis, based on history and physical examination
X-rays are usually done to check for joint damage
Blood tests are usually not necessary
Diagnosis helps to empower and educate patients on how to manage symptoms
Treatment
Disease Modifying Anti-Rheumatic Drugs (DMARDs) are the cornerstone of treatment. Other adjunctive treatments may include:
Pain medicine
Steroid injections
Heat therapy
Exercise
Lifestyle changes
Weight loss, strengthening low-impact exercises, and lifestyle changes are the cornerstone of treatment. Other adjunctive treatments may include:
Pain medicine
Steroid injections
Heat therapy
Will I need surgery?
Surgery is rarely needed nowadays as effective medical treatment options are available to help prevent joint damage and tendon rupture.
If medication, weight loss, and lifestyle changes do not adequately relieve the pain in a joint and the damage becomes too extensive, surgery may be recommended to replace the joint.
Called Treat to Target, this framework comprises close monitoring, blood tests, and adjustment of DMARDs as necessary to achieve and maintain a state of remission. Achieving remission allows patients to live normal, active lives.
