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Updated August 4, 2020

Ask anyone with rheumatoid arthritis (RA) to tell you about their biggest frustration and chances are they’ll mention the misperception that it is similar to osteoarthritis (OA). You know the moment — you explain that you have RA and they say, “oh yes, I know exactly what you mean. My knee twinges when it’s going to rain.”

No. Actually, that’s not like it at all. RA is a very different condition in a multitude of ways and it can feel very dismissive to have someone equate it with osteoarthritis, which for many people can be quite mild. Here, I do want to mention that in no way am I suggesting that OA can’t be severe, leading to limited function, even severely so, and needing joint replacement and other types of surgery. But although we may be able to create some common ground — and may even have both at the same time — RA and OA are two unique and separate conditions.

So, what are these differences between RA and OA? Let me count (some of) the ways.

What is rheumatoid arthritis?

Rheumatoid arthritis is a chronic autoimmune disease. In autoimmune diseases, the immune system mistakenly attacks healthy tissue. In RA, this causes inflammation all over the body, but the most well-known areas are the joints. It can affect any joint, including the top joint in the neck and even the vocal cords. However, RA is a systemic disease, meaning inflammation also affects other systems in the body, such as organs, the vascular system, eyes and tendons. If left untreated, systemic inflammation can put you at a higher risk for heart disease and diabetes.

RA is very much still a mystery, but we do know that it is caused by an interaction of genetic predisposition and external triggers. Triggers that may be implicated in initiating the immune response that leads to the development of RA include gingivitis, smoking and a particular bacteria in the gut. RA can develop, become quite severe and, if left untreated, disabling in a relatively short time. Although there currently is no cure for RA, there are a number of treatments available that may lead to remission.

What is ostearthritis?

Osteaoarthritis is a slowly progressive condition resulting from wear and tear on the structures of joints, including cartilage, bone, joint lining and ligaments. OA tends to affect larger weight-bearing joints, such as knees or hips, but can also affect hands, fingers and the spine. OA only affects joints. Because it is a result of wear and tear, it usually starts in one joint on one side of the body and spreads to other joints as more wear and tear happens.

OA appears to be caused by a combination of factors, including genetic predisposition and joint injury or overuse. There is no cure for OA, but you can get treated for the symptoms.

Who gets RA and OA?

RA usually develops between the ages of 30-50. Approximately 1% of the population has this condition, that is 300,000 people in Canada and 1.3 million people in the US. As in many autoimmune diseases, RA tends to affect women more than men, with almost 3 times as many women as men having the condition. You can develop RA at any time of your life, but in women, the disease usually starts between the ages of 30-60, while men tend to get it later in life. On average, men also have more severe cases of RA.

OA usually appears after age 45 and the older you get, the more likely it is that you have some form of osteoarthritis. However, OA can also happen to younger people after an injury or related to obesity. OA also happens more often in women than in men, especially in cases where the person is older than 45. It happens more often in men below the age of 45. By 2030, 67 million Americans are projected to have OA, about 25% of the population. In Canada, the current rate of osteoarthritis is one in six people and it is expected to increase at the same rate. In another 10-15 years, one third of people who live with OA will be between the ages of 45-65.

What are the symptoms of OA and RA?

Common rheumatoid arthritis symptoms include inflammation, swelling, tenderness and stiffness in joints. These often occur symmetrically, on both sides of the body. Other symptoms include flu-like symptoms, fevers, nausea, and nodules, firm lumps under the skin usually near an affected joint. Morning stiffness is a classic RA symptom, lasting more than 30 minutes after getting up in the morning or moving around after being inactive. Approximately 80% of people with RA experience fatigue.

OA symptoms include joint pain that eases after rest, as well as stiffness, swelling, and creaking in the joint. Bone spurs around the affected joint can also happen. OA usually starts in one joint on one side of the body, slowly progressing to others. People with osteoarthritis also often experience stiffness after getting out of bed or becoming active after a period of being still, but it usually lasts less than 30 minutes. OA usually does not affect a person’s energy levels, except in severe cases.

How do you treat rheumatoid arthritis and osteoarthritis?

RA is treated with several different kinds of medication. To treat the condition itself, rheumatologists may prescribe DMARDs (disease modifying antirheumatic drugs), including steroids (tablets and injections in the joint), methotrexate and immunosuppressant medications, such as the Biologics, a class of drugs derived from living cells. Other medications can be used to treat symptoms of inflammation and pain, such as NSAIDs (nonsteroidal anti-inflammatory drugs) and opioid painkillers. RA remission is very possible, especially with early and aggressive treatment.

Unfortunately, treatment for OA is usually limited to symptom relief using over-the-counter painkillers, prescription anti-inflammatories, opioid painkillers, and steroid injections in the joint. Fairly recently, other types of treatment have been developed to replace fluid in the joint, such as hyaluronan injections in the joint. Weight loss and exercise are also important in managing the condition.

Both RA and OA can cause damage to joints, requiring different kinds of surgeries, including joint replacements.

This was a very general overview of some of the most common differences between rheumatoid arthritis and osteoarthritis. I hope it will be useful in helping you educate people in your lives and create a better understanding of what you going through.

What are some of the things you would like people to know about rheumatoid arthritis or osteoarthritis?

 

Check my Sources:

the Fatigue of RA. (2017, August 02). Retrieved August 04, 2020, from http://blog.arthritis.org/rheumatoid-arthritis/fighting-ra-fatigue/

Hootman, J. M., & Helmick, C. G. (2005). Projections of US prevalence of arthritis and associated activity limitations. Arthritis & Rheumatism, 54(1), 226-229. doi:10.1002/art.21562

Jackson-Cannady, Ayren, Senior Editor. Rheumatoid Arthritis Symptoms, Causes, Treatments, and More. Retrieved August 04, 2020, from https://www.healthcentral.com/condition/rheumatoid-arthritis/?ap=420

Osteoarthritis. (n.d.). Retrieved August 04, 2020, from https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Osteoarthritis

Osteoarthritis: Arthritis Society. (n.d.). Retrieved August 04, 2020, from https://arthritis.ca/about-arthritis/arthritis-types-(a-z)/types/osteoarthritis

Rheumatoid Arthritis: Arthritis Society. (n.d.). Retrieved August 04, 2020, from https://arthritis.ca/about-arthritis/arthritis-types-(a-z)/types/rheumatoid-arthritis

Rheumatoid nodules: Symptoms, causes, and pictures. (n.d.). Retrieved August 04, 2020, from https://www.medicalnewstoday.com/articles/319839

What is Osteoarthritis? (2020, February 25). Retrieved August 04, 2020, from https://curearthritis.org/osteoarthritis/