The difference between osteoarthritis and rheumatoid arthritis

December 10, 2014 By Yousong Wang, M.D., FACR, Ph.D.

It is a common to confuse osteoarthritis (OA) and rheumatoid arthritis (RA); the words are similar.

Besides being the two predominant types of arthritis, OA and RA have very little in common except pain and the limitations they impose on life. The triggers are unclear, though there is evidence that genetics may play a role. With RA, the risk doubles if a person has a first-degree relative with the disease.

When people hear the word “arthritis,” it is often osteoarthritis that they might be thinking of. OA is a degenerative joint disease that usually affects the knees, hips, lower back, small joints in the hands, and the neck. Causes can be strenuous occupations, playing sports, carrying excess weight and repetitive motions. Over time, the cartilage on the ends of the bones wears away leaving bone grating on bone at the joints – a very painful condition. This condition primarily impacts older people, equally in both sexes.

RA, an autoimmune disease, causes antibodies to attack the body's tissues, inflaming and eventually destroying the lining of the joints. This disease can impact people of any age, even children. Research shows that three times more women than men develop RA and females experience greater pain and depression.

With OA, the pain and stiffness is usually worse toward the end of the day. People who have RA experience similar symptoms but pain is mostly in the morning and in greater intensity for several hours. The inflammation can also produce fatigue, low-grade fevers, weakness, anemia and other complications throughout the body. RA can impact as many as 30 different joints while OA affects a limited number.

RA often leads to greater medical problems including heart, lung and eye damage and, most seriously, cardiovascular disease. Studies indicate RA can shorten a person's lifespan by as much as three years due to its impact on the heart. It can also cause lymphoma.

The diagnosis of RA can be difficult because it often flares up and then subsides, particularly in the early stages. OA develops gradually over time. With both, patient history is important in addition to a physical examination, testing and other assessments.

Neither disease is curable; however RA patients can be treated so as to maintain full functionality. There are treatments that slow RA progression, and the earlier it is diagnosed the better. Exercise is recommended for both conditions to improve function and mobility. OA treatment includes cold/heat compression, braces, physical therapy, non-steroidal anti-inflammatory drugs and/or surgery. Steroids can quickly alleviate the symptoms of RA; however patients with RA need more extensive therapies called disease modification therapies.

Understanding these diseases and learning coping and managing strategies can help ease the pain and be instrumental in resuming a more normal life.

Rheumatologist Yousong Wang, M.D., is a member of The Hospital of Central Connecticut (HOCC) medical staff. He practices at Grove Hill Medical Center, 300 Kensington Ave., New Britain, 860.612.0485. For referrals to HOCC physicians, please contact our free Need-A-Physician referral service by phone at 800.321.6244.