Arthritis is, without a doubt, a leading cause of pain and disability across the world and it is surprisingly common. A recent report estimated that approximately 24 million people in America alone suffer from severe immobility due to some form of arthritis.[1] The term ‘arthritis’ refers to joint inflammation and encompasses over 100 joint conditions however, the most common types are osteoarthritis and rheumatoid arthritis. Although these two conditions have some symptomatic similarities, their underlying causes are quite different which is why it is important to gain the correct diagnosis and associated treatment.

Osteoarthritis Overview

This form of arthritis falls into the category of degenerative or mechanical arthritis and the primary cause is damage to the cartilage on the articulating surfaces due to inflammation and wear and tear of weight-bearing joints or from a previous trauma in that area. It is more prevalent in women than men and onset is usually age-related with those over 65 most affected.

Rheumatoid Arthritis Overview

The root cause of this type of arthritis is abnormal inflammation, usually in the feet and hands, due to an autoimmune disorder. This immune response causes the joint surfaces and tissues around the joints to become damaged causing pain, stiffness and swelling. This condition is not related to age and is also more common in women but, when found in men, it is often more severe.

Osteoarthritis = Cartilage Loss

Normally joint cartilage gets constantly remodeled after joint movement but in those with osteoarthritis this function is altered resulting in abnormal joint cartilage. Over time osteoarthritis causes progressive cartilage loss and a thickening on the subchondral plate.[2] Bony spurs can occur along the joints as well as bone cysts which are fluid-filled holes within the bone. Knees, hips, lower back and hands are common areas affected. Pain often occurs during joint usage and sometimes there is a grating or cracking sensation due to friction between bone and cartilage. Inflammation does occur around the joint tissues and also aids the cartilage degradation process but it is less severe than in those with Rheumatoid Arthritis.

Rheumatoid Arthritis = Joint Damage

The symptoms of this condition can develop gradually or suddenly and it is characterized by severe inflammation of synovium – the soft tissue that lines joints. This leads to joint damage, pain, stiffness and loss of physical function. [3] It is triggered by an excessive immune response in which antibodies normally deployed to fight foreign substances begin to be directed against tissues within the body. This can affect not only the joints but other organs of the body as well and associated fatigue and fever can result. The immune response causes swelling around the joint that begins to erode the bone and marrow and destroy the surrounding structures. Left untreated, the joint loses its shape and eventually becomes completely immobile and low bone density and osteoporosis can result. [2] 

Comparing the Symptoms

Though there is an overlap in some symptoms, these signs that can assist with differentiating between osteoarthritis (OA) and rheumatoid arthritis (RA).

  • Swelling and inflammation around the joints is usually associated with RA.
  • Pain, restricted joint mobility and joint grating is common in advanced OA.
  • OA tends to be unilateral (on one side) while RA is usually bilateral (affecting the same joint on both sides of the body).
  • Generally, RA affects multiple joints while OA is experienced in only a few sites.
  • Morning stiffness can be an indicator as it is much more prolonged in those with RA – sometimes over an hour in duration.
  • Joint movement may bring on OA pain while moving the painful joint may relieve RA stiffness.
  • RA patients tend to have other symptoms including tiredness, depression, loss of appetite, weight loss, anaemia, dry eyes and occasional low-grade fever. However, it is important note that these may be caused by other simultaneous conditions. [4]

Arthritis Treatment

Diagnosis of a specific type of arthritis is not a simple task and if the above symptoms are experienced it is important to get a thorough assessment from a medical professional. Pinpointing and treating arthritis early is critical to minimizing the impact of the disease in order to prolong ease of movement and decrease the need for surgery. Unfortunately, arthritis is currently considered incurable but these conditions can be controlled through a treatment plan that focuses on relieving pain, reducing inflammation and slowing joint damage for improved quality of life.[4]

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References:

  1. http://www.medscape.com/viewarticle/880472
  2. Kori A. Dewing, DNP, FNP, ARNP; Stephen M. Setter, PharmD, DVM, CDE,CGP, FASCP; Barbara A. Slusher, MSW, PA-C. October 31, 2012. Osteoarthritis and Rheumatoid ¬Arthritis 2012: Pathophysiology, Diagnosis, and Treatment
  3. Centre for Disease Control and Prevention. Arthritis Basics http://www.cdc.gov/arthritis/basics.htm Accessed 24 April 2014.
  4. South African Rheumatism and Arthritis Association. “Rheumatoid Arthritis”. http://www.saraa.co.za/C_TeauOverview.asp accessed 22 April 2014