Rheumatoid Arthritis vs Osteoarthritis

Having recently been diagnosed with rheumatoid arthritis, many people have asked me, what is the difference between rheumatoid and osteoarthritis.

Rheumatoid arthritis (RA) affects about 0.5% of the population and is an autoimmune disorder causing chronic inflammation. The body stops recognizing the lining of the joint as being normal and starts to attack it as it thinks it’s a foreign invader. Rheumatoid arthritis doesn’t just affect the joints, it can also affect the lungs and cardiovascular system as a result of chronic inflammation. It affects joints bilaterally (left and right side of the body) and most commonly starts with pain and swelling in the hands and feet. Morning pain and stiffness lasts from 30mins up to several hours and affects women 2-3 times more than men. Ra can occur at any age and symptoms can develop relatively rapidly.

Osteoarthritis (OA) symptoms more commonly affect people over the age of 60 and can be visible by x-ray in people as young as 20. The articular cartilage in the joint degenerates and is usually accompanied by osteophyte formation, this occurs slowly over years. The cause of OA is not well understood, however normal use of the joints does not increase your risk of developing OA. The biggest risk factors for developing OA include: being female, genetic factors, excess weight, joint misalignment, muscle weakness, and joint injury or trauma. OA most commonly affects knees, hips, spine, hands and ankles. It is characterized by joint pain, reduced movement, crepitus, joint swelling and deformity.

Comparatively, RA will usually have more clinically active joints (sore joints), increased length of time of morning stiffness, decreased grip strength, and decreased mobility and social activity as a result of the symptoms.  As RA is a systemic (whole body) disease, fatigue and a general feeling of illness are common which is not present in people with OA.

Rheumatoid and osteoarthritis sufferers can benefit from the use of non-steroidal anti-inflammatories and corticosteroids. Those with RA typically take disease-modifying antirheumatic drugs (DMARDs) which suppress the immune system to reduce damage to the joints and slows the progress of the disease. It is important to remember that there can be side effects of all medications and currently there is no medication that can cure either OA or RA.

Both RA and OA benefit from exercise. The type of exercise for each condition may vary but pool-based exercise and walking both have good evidence for being beneficial. Exercise for OA is important and can reduce pain and decrease the need for joint replacements. It is important to make sure you are exercising with correct joint alignment. Commonly, people with reported knee OA have difficulty of completing a sit to stand exercise due to knee pain, with correct knee alignment and engagement of the gluteal muscles, this pain can usually be significantly reduced. Exercise for RA is slightly different as it can be harder to exercise during a pain flare. Exercises should be chosen based on what can be completed on the day so as not to stress the inflamed joints.

If you are experiencing pain from either RA or OA, its always good to come and speak to a physiotherapist to find out what exercises are best for you.

Sophie Hellings

Sophie is a senior physiotherapist at BodyWise Physiotherapy. She has completed a Masters of musculoskeletal physiotherapy at Curtin University, and has many years experience managing a wide range of pain and musculoskeletal conditions. Her particular interests incoude chronic and persistent pain, headache management and complex conditions such as vertigo. Having been diagnosed with Rheumatoid arthritis herself, she does also have a special interest in arthritic conditions.