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Rheumatoid arthritis vs Osteoarthritis - What's the difference?

What is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation, pain, and stiffness in the joints. Being a long-term condition, it can deplete energy levels that also leaves people feeling unwell. Other associated effects include sporadic inflammation of the eyes or lungs, exterior skin nodules around the elbows, hands, or feet, and even anemia.

Caption: The illustration shows the progress of rheumatoid arthritis in the joint
Caption: The illustration shows the progress of rheumatoid arthritis in the joint

Being an autoimmune disease, RA is a result of the body’s immune system attacking the joints, particularly in the wrists, feet, and hands. It targets the synovial membrane, which is the soft tissue lining the joints and tendons. Because this membrane is subjected to constant swelling, the joint becomes stretched and unstable. This in turn causes pain and stiffness that can be disabling when it comes to managing daily activities.


The symptoms of RA may appear intermittently with the onset generally being a gradual process over months. It affects people differently and for some, the disease can develop rapidly within weeks. Usually, the joints start becoming tender or uncomfortable and will occur symmetrically, which means symptoms appear on both sides of the body in the same joints.

While the direct cause is not yet fully understood, there are factors that can increase the risk of getting RA. Having a family history of the condition, women between the ages of 20 and 40, and smoking are possible contributors. There is no single test to make a clinical diagnosis, so doctors will need to do a physical examination along with blood tests, immunologic tests, or use imaging methods to fully investigate the symptoms.

Early identification of rheumatoid arthritis symptoms and treatment applications can help slow the progression of RA, minimize potential joint damage, and possibly lead to complete remission. Effective treatment would include prescribed medications, healthy lifestyle choices, and rehabilitation exercises like occupational and physiotherapy.

What is Osteoarthritis?

Osteoarthritis is the most common type of arthritis and typically associated with aging. It occurs in all areas of the joints in the knee, hip, hands, or spine and causes swelling and pain and inhibits mobility. The cartilage softens and eventually wears away from the bone ends, the joint linings become inflamed and thicker, muscles surrounding the joints get weaker and sensitivity increases in the nerves.

Caption: Illustration shows the difference between healthy and osteoarthritis knee
Caption: Illustration shows the difference between healthy and osteoarthritis knee

The progression of osteoarthritis is slow and over time the following symptoms may develop and worsen in the joints: stiffness, persistent pain, swelling, creaking sensations during movement, bony growths (spurs), and muscle weakness. Living with these indications can make simple tasks difficult, cause anxiety, sleeping problems, and depression.

While osteoarthritis is characteristically related to the aging process, there are other factors that can increase a person’s risk. Long-term obesity, joint damage from a torn cartilage or facture, or infections in the joint or bone can all play a part in triggering the onset of the condition.

When people start experiencing these symptoms, it is important to seek medical advice from a rheumatologist. So, what can a rheumatologist do for osteoarthritis that a general practitioner cannot? A general physician doctor can manage conditions associated with arthritis, however, a specialist is more knowledgeable on advances in diagnosis and treatment options, as well as new procedures and medications.

Treatment for osteoarthritis does not cure the condition, but rather helps with managing pain to enable people to continue with carrying out work and daily activities, and to also prevent increased joint damage. Over and above medical treatment, there are important self-care options that people can apply to minimize effects and progression, such as maintaining a healthy weight and not smoking.

What's the difference between RA and OA?

There are common misconceptions when it comes to understanding what's the difference between osteoarthritis and rheumatoid arthritis. The major differences are that osteoarthritis is associated with age and presents degenerative changes, while rheumatoid arthritis is an autoimmune disease and commonly affects younger people specifically women under the age of 40.

Because one is linked to aging and the other to an autoimmune disease, the treatment between the two will differ. For rheumatoid arthritis, the medication prescribed will focus on suppressing the immune system, but in osteoarthritis, treatment mainly concentrates on managing the pain.

There are also differences in the pattern of symptoms and affected joints. In rheumatoid arthritis, the small and large joints are affected on both sides of the body, for example both hands or both wrists. In osteoarthritis, the symptoms typically start on one side of the body and may or may not spread. The symptoms are gradual and commonly restricted to one specific set of joints, for example the finger joints or, the weight-bearing joints such as the knees or hips.

Additionally, people suffering from rheumatoid arthritis will experience unusual stiffness in the morning that lasts longer than an hour. They will also notice regular feelings of fatigue and a general sense of unwellness. In osteoarthritis, this stiffness will be short-lived in the morning but returns after inactivity or later in the day, and other symptoms affecting the whole body will not be as noticeable, if at all present.

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