Although they share a few common characteristics, Osteoarthritis and Rheumatoid Arthritis are actually two different diseases. Most people who have been diagnosed with arthritis have osteoarthritis, which commonly occurs as we age. Rheumatoid arthritis (RA) is a serious autoimmune disease, and the two are often confused, which can be a real problem for people suffering from RA.
Below are some guidelines for understanding the difference between Rheumatoid Arthritis and Osteoarthritis:
Age. Osteoarthritis generally occurs in older people, the result of years of wear and tear on the body. Rheumatoid Arthritis can occur quickly at any age, from childhood through adulthood. Known as juvenile RA when it occurs in children under age 16, RA onset generally occurs between the ages of 40 and 50 while Osteoarthritis surfaces in most adults later in life.
Deformities. People who suffer from RA are more likely to experience joint deformities than OA sufferers. RA deformities can eventually cause joint erosion and displacement, and the hands of RA patients can become severely deformed with fingers appearing to be pulled out to the side.
Painful, bony lumps are more likely to surface in the fingers, elbows, knees, hips, shoulders or ankles of Osteoarthritis patients. With either form of arthritis, joint replacement surgery may become necessary.
Joints. Both OA and RA attack the joints, but the difference between the two is in the where and how the trouble erupts.
RA commonly targets smaller joints first, causing them to become painfully red, warm, and swollen. Usually joints show symptoms in matching sets on both sides of the body. Rheumatoid arthritis can spread from one hand to the other, and it can spread throughout the body to as many as 30 separate joints.
Osteoarthritis attacks the larger weight-bearing joints like knees and hips, which usually bear the worst damage. With OA, the problematic joint may be limited to one side of the body. OA affects a very limited number of joints.
Longevity. People who suffer from Rheumatoid arthritis may have a shortened lifespan by about three years, in part because of the increased risk of heart disease. Current treatments to target inflammation and immune response are helping many RA sufferers.
Osteoarthritis can inhibit activity in sufferers, but other than that it has no direct impact on longevity.
Medication. Osteoarthritis can be treated with steroid injections into the joint, as well as oral NSAID drugs such as ibuprofen and naproxen (Aleve) for pain. These same medications are used to treat RA, in addition to stronger oral steroids like prednisone, which can result in bone thinning. RA sufferers also need drugs to prevent joint destruction. Some of these RA medications, called disease-modifying ant rheumatic drugs (DMARDS) are lower doses of the same drugs used in chemotherapy for cancer patients.
Morning symptoms. Rheumatoid Arthritis sufferers often wake in the morning with stiffness that lasts for hours, while Osteoarthritis sufferers wake with stiffness that usually subsides within a half hour. Osteoarthritis symptoms can return after physical activity.
Nodules. Between 20 and 30 percent of RA patients develop firm nodules under the skin, most often on the elbows. These nodules, or lumps, can vary in size from a pea to a golf ball. Nodules can be very painful, and signify a more severe disease. OA sufferers do not experience nodules.
Numbers. Of the approximately 50 million Americans with arthritis, half of whom are over the age of 65, about 27 million suffer from Osteoarthritis and 1.3 million suffer from Rheumatoid Arthritis.
Many people believe that Osteoarthritis provides a blanket description for both forms of arthritis, and may be surprised to meet a child or young person with RA – not everyone realizes that Grandma’s OA is not the same disease anyone else’s RA.
Non-joint symptoms. A patient with RA may suffer from symptoms of all-over ill heath, including a low-grade fever, fatigue, and muscle pain. RA can also cause nerve damage, and dryness of the eyes and mouth. Untreated RA can spread to other organs in the body, leaving sufferers at an increased risk of heart disease and even certain cancers. Osteoarthritis, on the other, is usually confined to the joints.
Onset and progression. RA can flare up and then subside in an unpredictable pattern that can inhibit diagnosis, especially in the early stages. can make diagnosis difficult, especially in its early stages. The manner in which RA flares and progresses can vary from one patient to the next. Rheumatoid Arthritis causes the immune system to attack and fight the joint, as if it were a foreign object that needs to be destroyed, which is the nature of autoimmune diseases.
Osteoarthritis usually develops slowly over many years, as natural cartilage wears down and eventually the sufferer experiences bone-on-bone rubbing.
Source of the pain. With Osteoarthritis, cartilage within the joints that cushions the bones wears away over time, leaving bone to rub against bone. This is OA’s source of pain.
With RA, the immune system cells mistakenly “recognize” an invader and target the lining of the joint (synovium). Cell-signaling molecules such as tumor necrosis factor and interleukins pour into the blood stream, causing fever, swelling, and other symptoms not seen in osteoarthritis. Inflammation caused by RA can lead to heart, lung, and eye damage. RA affects approximately three times more women than men, and evidence suggests that women with RA may endure more severe pain, depression and other problems due to the disease than male sufferers.
Osteoarthritis hits males and females equally, although distribution depends on age. OA sufferers under age 55 are more commonly men, while women tend to dominate the disease in later life.
Triggers. The cause of both OA and RA is often unclear. Since RA is an autoimmune disorder that causes inflammation in the lining of the joints, researchers believe that genetics, hormones, smoking, and other environmental factors such as viral or bacterial infections may play a role in triggering a destructive path within the the immune system.
Osteoarthritis sufferers experience no immune involvement in their joint deterioration. OA appears to be caused by a combination of factors – age, genetics, hormones, joint injury and overuse, obesity, and muscle weakness are assumed culprits.
If you are experiencing any symptoms of OA or RA, talk to your physician about determining exactly which type of arthritis you may be suffering from, and establish a treatment plan to help you live a long and active life.