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Osteoarthritis vs. rheumatoid arthritis: Which one do I have?

Osteoarthritis vs. rheumatoid arthritis causes | Prevalence | Symptoms | Diagnosis | Treatments | Risk factors | Prevention | When to see a doctor | FAQs | Resources

Most people know of arthritis as a condition that causes joint pain and inflammation, but there are actually different types of arthritis that people can develop. Osteoarthritis and rheumatoid arthritis are two of the most common types of arthritis, and they affect people in different ways. Osteoarthritis affects the hands, knees, spine, and hips, while rheumatoid arthritis mainly affects the wrists, hands, and knees. Let’s take a look at the difference between osteoarthritis and rheumatoid arthritis.   

Causes 

Osteoarthritis

Osteoarthritis is the most common form of arthritis, according to the Centers for Disease Control and Prevention (CDC). Sometimes osteoarthritis is called degenerative joint disease because it causes joint cartilage on the ends of bones to wear down over time. Inflammation or injury causes the cartilage to wear down, and eventually, the underlying bones start to change. This process causes pain and swelling in the finger joints, knees, hips, spine, or toes.  

Rheumatoid arthritis 

Rheumatoid arthritis (RA) is an autoimmune disease that causes the body’s immune system to attack the synovial membrane that protects healthy joints. When the immune system attacks this protective membrane, joints can become inflamed and get damaged. Rheumatoid arthritis mainly affects the hands, wrists, and knees, and it can target numerous joints at one time. In some cases, rheumatoid arthritis can even affect the heart, lungs, and eyes.  

Osteoarthritis vs. rheumatoid arthritis causes
Osteoarthritis Rheumatoid arthritis
  • Inflammation
  • Injury
  • Cartilage on bones in the hands, hips, spine, knees, and toes are affected 
  • Inflammation
  • Autoimmune disease
  • Healthy joints of the hands, knees, and wrists are affected

Prevalence

Osteoarthritis

Osteoarthritis affects over 32 million adults in the United States, and about 80% of adults over the age of 55 show evidence of osteoarthritis on their X-rays. More than 240 million adults worldwide are estimated to have osteoarthritis. In the U.S., symptomatic knee osteoarthritis is prevalent in about 10% of men and 13% of women older than 60. 

Rheumatoid arthritis

Rheumatoid arthritis is one of the most common types of arthritis. It affects about 1% of the global population and over 1.3 million Americans. Women are nearly three times more likely to get rheumatoid arthritis than men are, and they’re also more likely to develop it at a younger age. 

Osteoarthritis vs. rheumatoid arthritis prevalence
Osteoarthritis Rheumatoid arthritis
  • Most common type of arthritis
  • 32 million adults in the U.S. are diagnosed with OA
  • 240 million adults worldwide are diagnosed with OA
  • 80% of adults older than 55 show signs of OA 
  • One of the most common types of arthritis
  • 1.3 million adults in the U.S. are diagnosed with RA
  • 1% of adults worldwide are diagnosed with RA
  • RA affects more women than men

Symptoms

Osteoarthritis

Osteoarthritis can cause pain, swelling, inflammation, stiffness, and decreased flexibility. Many people will find that symptoms of OA get worse over time as the cartilage between bones continues to deteriorate. 

Rheumatoid arthritis

Rheumatoid arthritis mainly causes pain, aching, swelling, tenderness, and joint stiffness in the hands, knees, and wrists. It tends to affect large and small joints on both sides of the body, so it may affect both hands, wrists, or knees at the same time. Because it’s an autoimmune disorder, it can also cause other symptoms like fatigue, weakness, weight loss, and fevers.  

Osteoarthritis vs. rheumatoid arthritis symptoms
Osteoarthritis Rheumatoid arthritis
  • Pain
  • Swelling
  • Stiffness
  • Inflammation
  • Decreased flexibility 
  • Pain
  • Swelling
  • Stiffness
  • Aching
  • Tenderness
  • Fatigue
  • Weakness
  • Fever
  • Weight loss 
  • Loss of appetite 

Diagnosis 

Osteoarthritis

To diagnose osteoarthritis, a doctor or orthopedist will need to do a physical exam, get someone’s complete medical history, and run blood tests. X-rays can detect joint and bone damage, while MRIs can give doctors a better look at joints and cartilage. Sometimes it may be necessary to take fluid out of a joint (a process called joint aspiration) to see if a joint is infected. 

Rheumatoid arthritis 

Rheumatoid arthritis is diagnosed in a similar way to osteoarthritis. A doctor or rheumatologist will do a complete physical examination, ask the patient for their medical history, and potentially do some blood tests, X-rays, ultrasounds, or MRIs. According to the CDC, it’s best to diagnose rheumatoid arthritis within the first six months so that patients can begin treatment to slow down the disease’s progression.   

Osteoarthritis vs. rheumatoid arthritis diagnosis
Osteoarthritis Rheumatoid arthritis
  • Physical exam
  • Medical history
  • Lab tests
  • X-rays
  • MRI
  • Joint aspiration
  • Physical exam
  • Medical history
  • Lab tests
  • X-rays
  • MRI
  • Ultrasound 

Treatments

Osteoarthritis

There’s currently no cure for osteoarthritis. Even though the damage done by the condition can’t be reversed, it’s possible to treat symptoms and keep them from getting worse. Osteoarthritis treatment plans will likely involve one or more of the following:

Medications

Over-the-counter pain medications and certain prescription drugs can help reduce symptoms of pain, aching, and swelling. 

RELATED: FDA approves topical arthritis medication Voltaren for OTC use

Therapy

Physical therapy and occupational therapy can help those with osteoarthritis reduce pain, increase their flexibility, and strengthen muscles surrounding weight-bearing joints.  

Surgery

Some people with osteoarthritis may end up needing surgery. Here are some of the most common procedures for osteoarthritis: 

  • Joint replacement surgery to replace the affected joint 
  • Cortisone injections
  • Realigning joints 

Rheumatoid arthritis

There’s currently no cure for rheumatoid arthritis, but proper treatment can manage symptoms. Here are some of the most common treatments for rheumatoid arthritis:  

Medications

Medications for rheumatoid arthritis focus on treating pain, slowing the disease, and preventing joint deformities. These medications may include:

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Therapy

A physical or occupational therapist may help people with rheumatoid arthritis increase their range of motion and reduce everyday pain. 

Surgery

People with severe rheumatoid arthritis may need to have a procedure done to help eliminate pain and increase their range of motion: 

  • Joint replacement surgery
  • Tendon repair surgery
  • Joint fusion
  • Synovectomy 
Osteoarthritis vs. rheumatoid arthritis treatments
Osteoarthritis Rheumatoid arthritis
  • NSAIDs
  • Cymbalta (duloxetine)
  • Acetaminophen 
  • Physical therapy
  • Occupational therapy
  • Joint replacement surgery
  • Cortisone injections
  • Realigning joints 
  • NSAIDs
  • Celebrex (celecoxib)
  • Disease-modifying antirheumatic drugs (DMARDs) 
    • Methotrexate
    • Sulfasalazine
  • Biological response modifiers
  • Steroids 
  • Physical therapy
  • Occupational therapy
  • Joint replacement surgery
  • Tendon repair surgery
  • Joint fusion
  • Synovectomy 

RELATED: Arthritis treatments and medications

Risk factors

Osteoarthritis

Some people are more likely to get osteoarthritis than others. Here are the top risk factors for osteoarthritis:

  • Being obese
  • Being a woman
  • Aging
  • Joint injuries or overusing joints
  • Family history of osteoarthritis
  • Bone deformities
  • Diabetes 

Rheumatoid arthritis

Some people have a higher chance of getting rheumatoid arthritis. Here are the top risk factors for the condition:

  • Being obese
  • Being a woman
  • Aging
  • Smoking
  • Family history of rheumatoid arthritis
  • Environmental exposures (asbestos, dust, second-hand smoke, etc.) 
Osteoarthritis vs. rheumatoid arthritis risk factors
Osteoarthritis Rheumatoid arthritis
  • Obesity
  • Age
  • Female
  • Joint injuries
  • Overuse of joints
  • Family history
  • Bone deformities
  • Diabetes 
  • Obesity
  • Age
  • Female
  • Smoking
  • Family history
  • Environmental exposures 

Prevention

Osteoarthritis

Osteoarthritis can’t be 100% prevented, but you can decrease the chances of getting it. According to the University of Rochester Medical Center, doing the following things can reduce the probability of getting osteoarthritis: 

  • Exercising regularly
  • Preventing injury to your joints
  • Maintaining a healthy body weight
  • Controlling your blood sugar 

Rheumatoid arthritis

You can’t entirely prevent rheumatoid arthritis, but there are some ways to decrease the probability of getting it and lessen the severity of symptoms for those who have it. Here are some of the best ways to do so:

  • Quitting smoking
  • Maintaining a healthy body weight
  • Limiting exposure to environmental toxins and pollutants 
How to prevent osteoarthritis vs. rheumatoid arthritis
Osteoarthritis Rheumatoid arthritis
  • Exercising regularly
  • Maintaining a healthy body weight
  • Controlling blood sugar levels
  • Preventing injury to joints 
  • Quitting smoking
  • Maintaining a healthy body weight
  • Limiting exposure to toxins and pollutants 

When to see a doctor for osteoarthritis or rheumatoid arthritis

If you have pain, discomfort, stiffness, or swelling in your joints that isn’t going away, it’s best to see a doctor as soon as you can. These symptoms may indicate that you have either osteoarthritis or rheumatoid arthritis. Getting an early diagnosis for either of these conditions is vital to help slow down their progression. A primary care physician will likely be able to diagnose you, or you may be referred to a rheumatologist or orthopaedist.  

Frequently asked questions about osteoarthritis and rheumatoid arthritis

How do I know if I have osteoarthritis or rheumatoid arthritis?

Osteoarthritis pain tends to develop more steadily over time, while rheumatoid arthritis causes pain that worsens over several weeks or months. The only way to know for sure what type of arthritis you have is to get an official diagnosis from a medical professional. 

Can an X-ray show the difference between osteoarthritis and rheumatoid arthritis?

X-rays can help detect joint and bone damage, but they won’t be able to tell a doctor exactly what type of arthritis someone has. It’s also possible for X-rays to show no joint damage, but for someone to still have arthritis. 

Can you have rheumatoid arthritis and osteoarthritis?

Although it’s rare, it is possible to have rheumatoid arthritis and osteoarthritis at the same time. An injury may lead to both types of arthritis, and as a person ages, they may develop multiple types of arthritis. 

What are the different symptoms between osteoarthritis and rheumatoid arthritis?

Osteoarthritis causes pain, stiffness, swelling, and decreased flexibility mainly in the knees, hands, and hips. Rheumatoid arthritis causes pain, stiffness, swelling, tenderness, and aching in the hands, wrists, and knees. It can also cause fatigue, weight loss, and weakness. One of the most significant differences in the symptoms of RA and OA is that rheumatoid arthritis causes morning stiffness that takes about an hour to wear off.

Resources