It’s likely when most people hear or read the word “arthritis” that they are picturing classic osteoarthritis – they picture an older person suffering from joint pain brought about by wear and tear, complaining of their “bad knee” or their “bad hip”. But there’s another kind of arthritis, rheumatoid arthritis which can strike at any age and comes with its own set of associated symptoms.
*Photo from Creaky Joints
So what is the difference between osteoarthritis and rheumatoid arthritis?
Osteoarthritis is the most common form of arthritis, and it commonly occurs later in life. In osteoarthritis, the cartilage in a joint has worn away, resulting in stiffness and pain when using the affected body parts. The onset is generally slow, building with age and usually affecting an isolated joint or set of joints (for example, the knuckles of one hand) before other joints gradually become affected as they are also subject to wear and tear over time. X-Rays and MRIs are generally used to diagnose osteoarthritis and blood tests may be performed in order to rule out other causes of joint pain (for example, rheumatoid arthritis!).
Rheumatoid arthritis is rarer, affecting about one tenth as many people. It can strike at any age. It is an autoimmune disease in which the immune system of the affected person attacks the synovial membrane which enclose and protect the joints. The onset can be very sudden, and is often identifiable by the symmetrical pattern of joint issues – for example the affected person might suddenly experience pain in both hips or both hands. In rheumatoid arthritis the affected joints may appear swollen, a symptom not present in osteoarthritis. Anemia, fatigue, fevers and a general whole body feeling of being unwell are other common symptoms. To diagnose rheumatoid arthritis imaging tests and blood work are performed. Your doctors may also look at family medical history as there is strong evidence for genetics playing a role as a risk factor for developing rheumatoid arthritis.
How are osteoarthritis and rheumatoid arthritis treated?
Osteoarthritis is treated most simply through the use of painkillers such as acetaminophen and NSAIDs. You can work with a physical therapist who will lead you through exercises that strengthen the muscles around your joints to provide them with more support and help keep them mobile. Occupational therapy can help you figure out how to perform the activities of daily life without putting additional strain on your affected joints.
In more severe cases, corticosteroid injections at the site of the arthritis symptoms may be used to provide more lasting pain relief. Alternatively, injections of joint lubricants such as hyaluronic acid may be used to restore some of the “cushion” in your joints to provide enhanced mobility and reduce pain. However, there is some debate about the efficacy of this treatment.
Finally, in cases of osteoarthritis which are especially problematic, joint replacements (for example, total hip and knee replacements) may be required in order to restore the proper range of motion to your joint.
Rheumatoid arthritis is treated through anti-inflammatory and pain relieving medications to reduce swelling and pain. Special medications known as DMARDs (Disease-Modifying AntiRheumatic Drugs) help to interrupt the disordered immune response which is attacking the affected joints. Additional classes of DMARDs, biological response modifiers and Janus kinase (JAK) inhibitors may also be used if your rheumatoid arthritis doesn’t respond to initial therapies.
Similarly to osteoarthritis, physical therapy can help you to strengthen the affected joints and maintain their mobility as part of your overall treatment regimen, and occupational therapy can also be used to help you make adjustments to your daily routines that will reduce stress on your joints. In rarer cases where your rheumatoid arthritis has caused severe damage to an affected joint, surgery may be used to correct the damage and restore function. What to Look Out For
As you can see, osteoarthritis and rheumatoid arthritis share a lot of similarities, but there are key differences to keep an eye out for that can help you reach a diagnosis (and treatment) more quickly. If you’re experiencing joint pain, ask yourself:
Is my joint pain symmetrical on both sides of my body?
What is my family’s history of arthritis?
Am I experiencing symptoms aside from the joint pain?
Has this come on suddenly or gradually?
With the answers to those questions, you’ll be armed to help your doctors find the root cause of your joint pain much more quickly and hopefully reduce the amount of time you spend in pain and save your joints from experiencing additional damage.