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The Differences Between RA and Other Types of Arthritis

Rheumatoid arthritis is one of over 100 types of arthritis. This article outlines the differences and overlaps in RA vs. arthritis vs. OA. Arthritis refers to any disorder that affects the joints. Arthritis affects nearly 25% of the U.S. population and, along with related rheumatological conditions, it is suspected to be the leading cause of disability among U.S. adults. The most

  • Posted on 26th May, 2022 20:40 PM
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Arthritis refers to any disorder that affects the joints. Arthritis affects nearly 25% of the U.S. population and, along with related rheumatological conditions, it is suspected to be the leading cause of disability among U.S. adults. The most common forms include osteoarthritis (OA), rheumatoid arthritis (RA), lupus, and gout.

This article focuses on how to identify the differences between the many forms of arthritis, including OA and RA.

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Terms to Know

When discussing different forms of arthritis, it's important to have an understanding of some of the more commonly used terms and phrases.

Inflammation

Inflammation refers to the body's immune system response to injury, trauma, or disease. Most commonly, inflammation leads to the development of redness, swelling, warmth, and sometimes pain in the affected area.

Inflammation can either be acute or chronic. Acute inflammation occurs suddenly, perhaps after an injury or overuse of a joint or muscle group, and tends to heal more rapidly. Chronic (longstanding) inflammation tends to be present in poorly or uncontrolled systemic diseases, such as rheumatoid arthritis or lupus.

Autoimmune

The term autoimmune disease refers to diseases and conditions in which a person's own immune system mistakenly attacks its own organs or tissues.

Typically, the immune system is tasked with identifying and destroying viruses, bacteria, or any other perceived threat to the body's overall health. In people with autoimmune disorders, the immune system perceives their own healthy tissues as unwanted visitors and aims to eliminate the perceived threat by launching an inflammatory response.

An autoimmune attack on healthy tissue can lead to serious complications. When inflammation affects the joints in diseases like rheumatoid arthritis or lupus, joint pain and permanent joint deformities can occur.

Rheumatology

Rheumatology refers to the study of diseases which affect the muscles, bones, joints, ligaments, and tendons.

Healthcare providers who specialize in the diagnosis and treatment of such diseases are known as rheumatologists. Rheumatologists are specifically trained in the treatment of inflammatory diseases, which include muscle, bone, and joint diseases but also involve autoimmune disorders.

Previously, diseases that caused joint pain, stiffness, and deformities were labeled with the broad term "rheumatism." Thanks in large part to modern advancements in disease diagnosis, management, and treatment, healthcare providers are now able to more specifically diagnose and treat rheumatological conditions.

Degenerative

When discussing various forms of arthritis, the term degenerative refers to the deterioration of the joint spaces and breakdown of the surrounding cartilage.

Osteoarthritis can also be referred to as degenerative arthritis as the joint spaces narrow and cartilage wears down over time, leading to joint pain, stiffness, and even swelling.

RA vs. Osteoarthritis: One and the Same?

While rheumatoid arthritis and osteoarthritis are both diseases that affect the joints, it's important to understand they are actually quite different diseases.

RA is a systemic, autoimmune illness, which means the body's own immune system mistakenly targets joint tissue and organs, such as the heart and lungs. RA more commonly leads to the development of joint swelling when compared to OA.

OA is not an autoimmune illness, but rather a form of degenerative disease. People may naturally develop OA as they age due to:

  • Reduced activity levels
  • Previous injuries or surgeries
  • Obesity and other lifestyle factors

While OA can cause joint swelling in later-stage disease, it's more commonly associated with joint pain, stiffness, and changes in mobility.

Through specific laboratory testing and imaging studies, a healthcare provider will be able to differentiate between the two forms of arthritis. This is an important step in ensuring the proper treatment options are used, as early treatment can provide symptom relief as well as potentially slow disease progression.

RA and Osteoarthritis Pain Location

While both RA and OA can affect any of the joints throughout the body, there are specific patterns that can help differentiate between RA and OA. Both diseases can cause joint pain, stiffness, and swelling, but locations can vary.

Smaller joints tend to be more commonly affected in RA. Common sites of pain in RA include but are not limited to:

  • Proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joints of the hands
  • Wrists
  • Elbows
  • Knees
  • Ankles
  • Feet

While some small joints may be affected by OA, it more commonly affects larger, weight-bearing joints. These joints include:

  • Carpometacarpal (CMC) joints
  • Hips
  • Knees
  • Neck and lower back

Common Types of Arthritis and Treatment

There are over 100 different types of arthritis. Osteoarthritis and rheumatoid arthritis are the two most common forms of arthritis seen today.

While various forms of arthritis may have overlapping symptoms and treatment options, there are some distinct differences.

RA vs. OA

Rheumatoid and osteoarthritis may present with similar symptoms in early stages, but there are a few key differences that can help differentiate the two.

Verywell / Alexandra Gordon

Osteoarthritis
  • Degenerative "wear and tear"

  • Asymmetrical pattern

  • Morning stiffness lasting less than 60 minutes

  • Larger joints most commonly affected (shoulders, hips, knees)

  • More common in people over 65

  • Less discriminate by gender

Rheumatoid Arthritis
  • Autoimmune, inflammatory

  • Symmetrical pattern

  • Morning stiffness lasting greater than 60 minutes

  • Smaller joints most affected (PIP joints, elbows, ankles, feet)

  • Commonly diagnosed between 30-60 years old

  • Stronger female prevelance

Additionally, treatment of OA and RA differs, as the root of both diseases is different.

While nonsteroidal anti-inflammatories (NSAIDs), physical therapy, and weight loss can be used to manage both conditions, medications aiming to reduce systemic inflammation, such as disease-modifying antirheumatic drugs (DMARDs) and biologics, will be beneficial only for RA and not OA.

Can You Have Both?

Since RA is a systemic autoimmune illness and OA is a degenerative form of arthritis, it is entirely possible for these conditions to occur simultaneously. They are most often observed together in the older population.

There is currently an overlap in certain treatment options for both RA and OA which can help provide symptom relief.

If You Suspect You Have Arthritis

If you have developed joint pain, swelling, tenderness, or a change in normal range of motion, seek a rheumatological evaluation. A rheumatology specialist will be able to differentiate between the numerous different forms of arthritis. They can determine the proper treatment and therapies necessary to minimize the potential for any long-term deformities or disabilities.

Summary

Joint stiffness, swelling, and pain can be symptoms of different forms of arthritis. Osteoarthritis is the most common form of arthritis and typically affects larger joints, like the shoulders, hips, and knees. Overuse, obesity, and older age are just some of the risk factors for developing OA.

Rheumatoid arthritis is a systemic, autoimmune illness associated with chronic inflammation throughout the body. RA tends to affect smaller joints, like the fingers, wrists, ankles, and feet. It usually presents in a symmetrical pattern.

Physical therapy, NSAIDs, and weight loss can be used for symptom relief in both conditions, though RA will require more extensive treatment and management.

A Word From Verywell

If you are experiencing new joint issues and think you may have some form of arthritis, it's important to speak with a rheumatologist or healthcare provider. They will be able to properly diagnose your condition and make sure the proper treatment options are offered and utilized. Effective and timely treatment will help decrease the possibility of long-term complications and disability associated with arthritis.

Frequently Asked Questions

  • Is RA or OA worse?

    Both RA and OA can lead to permanent joint deformities and disabilities over time. However, both diseases are treatable with therapies aimed at relieving symptoms and halting disease progression.

  • How does RA progress?

    Since RA is a systemic inflammatory condition, disease progression occurs when inflammation is not properly controlled. Uncontrolled, systemic inflammation in RA can affect not only the joints, but the heart, lungs, and other organs as well. That is why it's important to see a healthcare provider if you believe you may have RA.

  • How do you know which arthritis you have?

    Seeking an evaluation from a board-certified rheumatologist is the best way to determine what form of arthritis you may have. Through a thorough history and physical examination, along with specific laboratory testing and imaging studies, a specialist will be able to diagnose which form of arthritis a person has.

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