Rheumatoid Arthritis vs. Osteoarthritis: What’s the Difference?

Medically Reviewed
Key Takeaways

Rheumatoid arthritis and osteoarthritis are two of the most common types of arthritis and share many symptoms; however, the underlying causes for the diseases are different.

Rheumatoid arthritis is an inflammatory autoimmune disease, where the body’s immune system attacks the cells surrounding joints, leading to inflammation and pain. 

Osteoarthritis is an inflammatory disease that is commonly caused by overuse of the joints. The cartilage — the smooth, tough tissue that surrounds and protects the joints — begins to wear down, leading to friction between the bones.

Medically Reviewed By
Dr. Anshul Gupta
Written By
WellTheory Team

When we think of arthritis, what often comes to mind are problems with our bones and joints. However, there are actually several different types of arthritis, each with their own unique set of causes. It is important to differentiate between these forms, as it will also dictate courses of treatment and rehabilitation. In this article, we will be breaking down the similarities and differences between the two most common forms of arthritis: rheumatoid arthritis vs. osteoarthritis. 

What Is Rheumatoid Arthritis vs. Osteoarthritis?

Rheumatoid Arthritis (RA)

Rheumatoid arthritis is an inflammatory autoimmune disease where the body’s immune system mistakenly attacks healthy cells around the joints. If left unchecked, this can lead to the deterioration of healthy tissues that are necessary for proper joint movement. It is also one of the most common types of inflammatory arthritis. Prevalence, or the proportion of a population with the disease, varies from 0.3% to 1% of the world population. As with other autoimmune diseases, RA affects women more often than men. (Source)

Osteoarthritis (OA)

On the other hand, OA is an inflammatory disease that specifically breaks down cartilage. Osteoarthritis is not an autoimmune disease; instead, the most common causes are age and overuse of the joints. This causes the cartilage between the bones to wear down, exposing the bones so they rub against one another, causing pain and restricting movement. The number of new cases of OA is expected to rise in many countries with aging populations. (Source, Source

For both RA and OA, the most commonly affected joints include knees, hips, spine, ankles, and the small joints of the hands and wrists. (Source

Symptoms of Rheumatoid Arthritis vs. Osteoarthritis

Since RA and OA are both diseases that affect the joints, there are many overlapping symptoms. Some of the most common ones include: 

  • pain and stiffness in joints 
  • joint swelling 
  • decreased range of movement 

How to Tell the Difference

Despite these similarities, RA has unique symptoms that might make it easier to differentiate between the two.

  • Symmetry of symptoms is often observed in patients diagnosed with RA. For example, they will have pain in both hips, as opposed to just one. On the other hand, OA symptoms will most likely only affect one side of the body.
  • Warmth in joints might be difficult to perceive on your own, but is something a health care provider will look for when diagnosing RA. 
  • Because RA is an autoimmune disease, it can cause symptoms in the body as a whole, such as anemia, fatigue, and fever. Osteoarthritis symptoms are limited to the affected joints. 
  • Morning stiffness will take much longer to subside for RA than it does for OA.

(Source, Source)

Why Are Women More Affected Than Men? 

As mentioned earlier, women are more often affected by arthritis than men. Although the results are conflicting, there is a growing body of literature to suggest that hormones and different body mechanics might play a significant role. (Source)

Hormones May Play a Role

Researchers have observed an increase in OA in women after menopause, leading some to suggest that perhaps estrogen (and other hormones) might be important in preventing cartilage inflammation. Further, when hormone levels are high during pregnancy, most women with RA will go into remission, but then experience flare ups after giving birth. (Source, Source)

Physiological Differences Factor In

It may also seem that women are more affected than men simply because of the different types of measures that are used to clinically diagnose arthritis. There is no single perfect test to determine whether someone suffers from RA or OA, but several proinflammatory markers in the blood have been identified that might signal the presence of arthritis. Due to physiological differences between men and women, testing for these markers without taking gender differences into account may skew the results.

For example, women are known to have higher average erythrocyte sedimentation rate (ESR) levels. High ESR levels are an indication of inflammation, and this test is used to determine whether a person with RA has achieved remission. A study published in Arthritis Care & Research found that differences in remission rates among men and women were similar when gender differences in ESR levels were taken into account. (Source, Source)

Foods That Can Help With RA and OA

Omega-3 Fatty Acids

The healthy omega-3 fatty acids that can be found in fish have been shown to reduce inflammation and boost the immune system. Another healthy option would be to opt for walnut oil, which has 10 times the omega-3 content of olive oil. (Source, Source

Vitamin D

Research has suggested vitamin D deficiency is associated with an increased risk of developing RA, although study results have been mixed. In some studies, the degree of vitamin D deficiency has been linked with the severity of the disease. Vitamin D is also a nutrient that is known to be very important for healthy bone development. Our bodies can create vitamin D when the skin is directly exposed to sunlight, but when we don’t receive enough, it can also be found in foods such as fish and mushrooms. (Source, Source, Source)

Polyphenols

Polyphenols are compounds that are naturally produced by plants, and have significant antioxidant and anti-inflammatory properties. Research has shown they may specifically be beneficial in reducing RA symptoms. Polyphenols can be found in many fruits and vegetables, including berries of all types, olives, and artichokes. They are also found in dark chocolate. (Source)

When to Seek Medical Care for Arthritis

Arthritis by itself is not a diagnosis, but a term that covers many different kinds of diseases. Therefore, it’s important to listen to your body and know when to see a health care professional to receive the right treatment. If you begin to experience any of the following symptoms, it is probably time to seek medical evaluation: 

  • joint symptoms that last for three or more days, such as
  • pain
  • swelling
  • stiffness
  • redness
  • difficulty with movement
  • several episodes of joint symptoms within a month

(Source)

What Kind of Treatment to Expect 

Rheumatoid arthritis and osteoarthritis are both chronic diseases. This means that as of now there are no cures, and most treatment plans are focused on preventing and managing symptoms. 

First Comes Diagnosis

To determine if you have RA or OA, your health care provider may:

  • ask you about your symptoms
  • examine you physically
  • order labs and imaging tests (X-rays, MRI, etc.)
  • perform arthrocentesis (draw fluid from a joint to reduce pain or send it for lab studies)

(Source)

Osteoarthritis Treatment Options

Treatment for OA generally includes pain relievers and anti-inflammatory medications, along with lifestyle changes and supportive measures. Often recommended are:

  • weight loss if needed
  • increased physical activity
  • physical therapy
  • strength training

(Source)

Rheumatoid Arthritis Treatment Options

Because RA can take such a severe toll on health and quality of life, treatment is more aggressive than with OA. In addition to NSAIDs, corticosteroids, and the lifestyle recommendations listed above, RA treatment options include disease modifying anti-rheumatic drugs (DMARDs) intended to prevent or limit joint destruction. Examples of DMARDs currently in use include:

  • methotrexate
  • etanercept (Enbrel®)
  • adalimumab (Humira®)
  • anakinra (Kineret®)

 (Source)

What to Expect for Recovery

RA and OA are both chronic conditions for which we currently have no cure. However, with the right treatments, most people can continue to live healthy and active lives. In rare cases of severe pain, the option for bone realignment surgery or even total joint replacements are available as well, although nonsurgical treatment options are most often recommended. (Source, Source)

The Bottom Line on Rheumatoid Arthritis vs. Osteoarthritis

Many factors can influence the progress of RA and OA, but among them the most influential is early diagnosis. Advancements in understanding how these diseases affect the human body are offering opportunities for earlier, more effective treatments. So should you experience pain in your joints, or the other symptoms we’ve discussed, seek medical attention as soon as possible. (Source)


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