Osteoarthritis Vs Rheumatoid Arthritis: Know the Difference

Arthritis encompasses various conditions characterised by joint inflammation, pain, and stiffness. Among the most prevalent forms of arthritis are osteoarthritis and rheumatoid arthritis. While both conditions affect the joints, they have distinct underlying causes, symptoms, and treatment approaches. Understanding the differences between these two types of arthritis is crucial for proper diagnosis and management.

Difference Between Osteoarthritis and Rheumatoid Arthritis

• Cause: Osteoarthritis, or degenerative joint disease, primarily results from the gradual breakdown of cartilage, the protective cushion between bones in the joints. This breakdown can result from ageing, injury, or excessive wear and tear on the joints over time. On the other hand, rheumatoid arthritis is an autoimmune disorder in which the body's immunity mistakenly attacks the synovial membrane (the lining of the joints), leading to inflammation and joint damage.
• Age of Onset: Osteoarthritis is more commonly associated with ageing, as the risk of developing the condition increases. It typically affects individuals over 50, although it may occur earlier due to injury or other factors. On the other hand, rheumatoid arthritis can happen at any age, with the peak onset occurring between the ages of 30 and 60.
• Joint Involvement: Osteoarthritis often affects weight-bearing joints (knees, hips, and spine) and the joints in the hands. The joint involvement is typically asymmetrical, meaning that one joint may be affected more severely than its counterpart on the opposite side of the body. Rheumatoid arthritis affects multiple joints simultaneously and symmetrically, meaning that both sides of the body are affected similarly.
• Inflammation: While both conditions involve inflammation, the nature and severity of inflammation differ. In osteoarthritis, inflammation is typically mild and localised to the affected joints. In rheumatoid arthritis, however, the inflammation is more severe and systemic, meaning it can affect the entire body and various organs, including the heart, lungs, and eyes.
• Stiffness Duration: Individuals with osteoarthritis often experience stiffness in the affected joints after periods of inactivity (waking in the morning or sitting for an extended period). This stiffness typically subsides after a few minutes of movement. In contrast, the stiffness associated with rheumatoid arthritis is more persistent and can last for hours or even all day.

Difference Between Osteoarthritis and Rheumatoid Arthritis Symptoms

Osteoarthritis is primarily localised, with symptoms typically limited to the affected joints. Rheumatoid arthritis, however, can cause systemic symptoms such as fatigue, fever, loss of appetite, and general malaise, reflecting the body's overall inflammatory response.

• Progression: Osteoarthritis is a progressive condition, with joint damage occurring gradually over time. The progression rate can vary depending on age, weight, and joint injury. Rheumatoid arthritis (RA) can progress more rapidly, with periods of flare-ups and remissions. Without proper treatment, it may progress to severe joint damage and disability within a few years.
• Joint Deformity: In advanced stages of osteoarthritis, joint deformities may occur due to the breakdown of cartilage and the formation of bone spurs. However, these deformities are typically less severe than those in rheumatoid arthritis. In rheumatoid arthritis, joint deformities, including swollen, distorted, and twisted joints, can be more pronounced, particularly in the hands and feet.
• Extra-articular Involvement: Osteoarthritis primarily affects the joints, with little to no other organs or systems involvement. Rheumatoid arthritis can have extra-articular manifestations, affecting organs and tissues outside the joints. These can include:
  • Rheumatoid nodules (firm lumps under the skin)
  • Lung inflammation (pleurisy or interstitial lung disease)
  • Eye inflammation (scleritis or Sjögren's syndrome)
  • Cardiovascular complications (elevated risk of heart disease and stroke)
• Treatment Approach: The treatment approaches for osteoarthritis and rheumatoid arthritis differ significantly. For osteoarthritis, the primary focus is on managing symptoms, reducing joint stress, and improving joint function through a combination of:
  • Pain medication (over-the-counter or prescription)
  • Physical therapy and exercise
  • Weight management
  • Assistive devices (canes, braces, or orthotics)
  • Joint replacement surgery may be considered if conservative methods fail.
• For rheumatoid arthritis, the treatment goals are to decrease inflammation, slow disease progression, and prevent joint damage. The treatment approach typically involves:
  • Disease-modifying antirheumatic drugs (DMARDs)
  • Biologic response modifiers (biologics)
  • Corticosteroids (for short-term inflammation control)
  • Physical therapy & exercise
  • In severe cases, joint replacement surgery 

Conclusion

While osteoarthritis and rheumatoid arthritis share some common symptoms, including but not limited to joint pain and stiffness, they are distinct conditions with different underlying causes, progression patterns and treatment modalities. Understanding the difference between rheumatoid and osteoarthritis is essential for accurate diagnosis & effective management of each condition.