What Is The Difference Between Rheumatoid Arthritis and Osteoarthritis?
The symptoms of rheumatoid arthritis and osteoarthritis have distinct characteristics, and to clarify things a bit I will give an overview of each type so that you may have a better understanding.
An accurate diagnosis will determine the form of arthritis you have, which entails a series of diagnostic tests… and the results are interpreted by your Doctor or Rheumatologist.
Rheumatoid arthritis is a chronic inflammatory autoimmune disease, which affects joints and can extend to internal organs of the body, as well. Autoimmune is defined as, the body attacking healthy tissues for unknown reasons. Rheumatoid arthritis is the 2nd most common type of arthritis and affects approximately 2.1 million Americans. It is a disease more common in women than men and can develop in anyone, including children, teenagers, and young adults… but more likely to occur between the ages of 30 to 50 years. Studies have shown RA to develop in any culture, but have an extremely low rate in people of African descent.
Rheumatoid arthritis is a more severe disorder due to systemic involvement, which may produce complications such as, pericarditis… pleuritis… vasculitis, etc., causing a shorter life expectancy if not diagnosed and treated properly.
The cause of RA has not been determined, although some research studies have linked rheumatoid arthritis with dietary intake of foods that are considered to be inflammatory and acidic.
Rheumatoid arthritis is characterized by:
- Early morning stiffness lasting for 1 hour or more upon awakening
- Painful and swollen joints (pain usually subsides when joints are in motion)
- Warmth at the site of swelling
- Redness or discoloration around swollen joints
- Nodules (rheumatoid nodules) just underneath the skin near joints of the elbows… forearms… and metacarpophalangeal joints
- Loss of appetite
- Inflammation – In comparison, inflammation in rheumatoid arthritis vs osteoarthritis, can migrate from joints into various internal organs creating new disorders. In osteoarthritis, the inflammation affects only the joints.
Rheumatoid arthritis symptoms can appear and disappear (flare-up…remission), throughout disease progression, and once established there is a bilateral display of symptoms on the right and left. This means if the left hand is stiff and swollen the right hand will also be stiff and swollen.
Osteoarthritis (OA), also known as a degenerative joint disease (DJD), affects approximately 27 million Americans, making it the most common type of arthritis and predominantly widespread. Osteoarthritis can involve any joint of the body, but more commonly affect the knees… feet… hips… spine (mainly cervical and lumbar spines)… and fingers. OA affects women 2 times greater than men. Hand osteoarthritis is more prevalent in women than men and knee OA is the most common site for osteoarthritis in women.
The main cause of osteoarthritis
Cartilage is a firm rubbery substance that covers the end of two bones that join. The primary function of cartilage is to provide protection for joints and reduce friction between bones by creating a shock-absorbing cushion at the site of articulation (where the ends of bone join to form a joint).
Osteoarthritis is caused by the breakdown of cartilage in the joints. Cartilage may stiffen and deteriorate, losing the shock-absorbing quality over time. Once cartilage degenerates, the bone began to rub together producing pain, swelling… inflammation… and limited mobility.
Contributing factors to the cause of osteoarthritis are:
Primary OA – generally relates to aging or genetics.
Secondary OA – a result of trauma, surgery… infection… or metabolic process (a chemical process that occurs in the body).
- Aging – Research has shown aging as a direct link to the loss of the binding protein HMGB2 found in the surface layer of cartilage, which leads to increased deterioration of joint cartilage… and is the precursor to OA.
- Heredity – A previous research study conducted by Darwin J. Prockop and his colleagues, of the Jefferson Medical College in Philadelphia, discovered a mutated gene to be the cause of primary osteoarthritis. Primary osteoarthritis sometimes develops within 20-30 years of age. Researchers believe the gene weakens collagen, which is a vital component of cartilage, causing vulnerability to deterioration after a few years of normal wear and tear. The genetic study involved 19 family members of 3 generations. Nine family members were affected with OA. The mutated gene was found in the affected members only. Unaffected family members and 57 unrelated individuals did not possess the mutated gene.
- Injury (physical trauma) – Osteoarthritis can develop in the younger population from injury, but on average, usually occur after the age of 40 years.
- Obesity – A controlled study demonstrated a direct correlation with weight loss and the improvement of symptoms in knee OA. Obesity causes stress on cartilage and is the most forceful reason for knee OA.
- Joint Overuse (wear and tear) – People, especially athletes who have participated in high-impact activities over the years are at a higher risk for developing OA.
- Acetabular Dysplasia (abnormal tissue development) – A chief contributor of hip osteoarthritis and cause of secondary osteoarthritis. It occurs in 25%-50% of people by the age of 50 years. Acetabular dysplasia can manifest before the onset of OA and is also known as “acetabular rim syndrome.”
- Uric Acid – A research study conducted by Dr. Virginia Byers Kraus, Ph.D., M.D. of Duke University, Division of Rheumatology and Immunology… involving 159 people reported the amount of uric acid in the knees directly correlated to the severity of OA of the knees. The amount of uric acid in your joints increases the risk of severe osteoarthritis, according to researchers at Duke University Medical Center.
Signs and Symptoms of osteoarthritis appear gradually and usually began to manifest around the age of 45 years or older. Symptoms may include:
- Joint pain – during routine activities such as opening a jar… twisting a doorknob… writing… driving or pain after repetitive joint use. Joint pain can come and go in some people and generally dissipates upon rest.
- Morning stiffness lasting 30 minutes… and stiffness from sitting
- Crepitus (grating sound of two ends of bone rubbing together) on motion
- Joint swelling
- Limited range of motion or loss of use of the joint
- Muscle weakness – mainly in the knees
Not everyone who has OA will show signs of pain or stiffness. It has been stated that one-third of people with osteoarthritis show radiographic evidence with no symptoms.
Diagnostic changes may show:
- Radiographic narrowing of joint spaces
- Bone spurs
No matter which type of arthritis you may think you have, early detection is key in slowing disease progression and minimizing or eliminating pain.
Wishing you an enjoyable and pain-free life!