Osteoarthritis vs Rheumatoid Arthritis

What is arthritis?

When people face difficulty with everyday tasks such as opening jars or climbing stairs due to joint pain, the word "arthritis" is usually the first to come to mind. Arthritis is characterised by joint pain and inflammation.

The two most common forms of arthritis are osteoarthritis (OA) and rheumatoid arthritis (RA)

What are the differences between Osteoarthritis and Rheumatoid Arthritis?

Osteoarthritis (OA)

Osteoarthritis (OA) is a degenerative disease and the most common type of arthritis. It occurs due to the ‘wear-and-tear’ that affects the joints over time, particularly the weight-bearing joints in the spine, hip, and knee.

It narrows the joint space and destroys the cartilage lining of the joint. This makes mobility more difficult than usual, resulting in pain and stiffness.

When the cartilage lining begins to roughen and weaken, the tendons and ligaments must exert tremendous effort. This can lead to the development of osteophytes (bone spurs). Severe loss of cartilage can cause bone-to-bone friction and alter the shape of the joint.

Symptoms may occur intermittently, depending on your activity levels and weather. The symptoms may be persistent in severe cases.

Symptoms include:

Joint pain and stiffness
Joint tenderness
Limited range of motion in your joints
Crackling sound (crepitus) in your joints
Joint swelling, which may appear in later stages of osteoarthritis

Although osteoarthritis can affect any joint, it mostly affects the knees, hips, and small joints in the hands.

Rheumatoid Arthritis (RA)

Rheumatoid arthritis (RA) is a chronic, autoimmune condition that primarily affects the joints. This condition occurs when the immune system, which typically helps protect the body from diseases and infections, attacks healthy tissue.

In most cases, the symptoms of rheumatoid arthritis develop gradually over several weeks; however, in certain cases, the condition can progress rapidly over several days.

Symptoms can vary from person to person. When the condition deteriorates and symptoms worse, you may experience flares.

Typically, rheumatoid arthritis affects the joints symmetrically (both sides of the body simultaneously and to the same degree). Nevertheless, this may not be the same for every patient.

Symptoms include:

Morning stiffness of the joint that does not improve after an hour
Joint pain that is worse in the morning
Swelling, redness and warm joint
Joint deformities and contractures
Fatigue
Poor appetite
Weight loss
Fever

Although rheumatoid arthritis can affect any joint, the small joints in the hands and feet are usually affected at first.

What are the risk factors for Osteoarthritis and Rheumatoid Arthritis?

Risk factors include:

Age: Likelihood increases with age
Gender: Commonly seen in women
Family history
Genetics
Being overweight or obese
Smoking
Joint injury or overuse of joint may cause joint damage and increases the likelihood of osteoarthritis

How are Osteoarthritis and Rheumatoid Arthritis diagnosed?

Your doctor would first question your general health and symptoms before conducting a thorough physical examination. Diagnosis is made based on your reported symptoms, physical examination, and investigations.

Blood tests
Blood tests for osteoarthritis may not be necessary in most cases but can be done to rule out other causes, such as rheumatoid arthritis.
Blood tests for rheumatoid arthritis include:
- Erythrocyte sedimentation rate (ESR): To assess levels of inflammation in the body
- Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) test: To help diagnose rheumatoid arthritis
- Full blood count (FBC): As an indicator of your general health or to rule out causes of your symptoms
Imaging tests:X-rays and magnetic resonance imaging (MRI) scans: To check for joint inflammation and damage as well as disease progression

How are Osteoarthritis and Rheumatoid Arthritis treated?

Although osteoarthritis and rheumatoid arthritis have no known cure, early treatment and support can decrease the likelihood of joint damage.

Osteoarthritis	Rheumatoid arthritis
Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation. Opioids such as codeine to relieve pain. Capsaicin cream to apply locally on your hands and knees if topical NSAIDs were ineffective. Steroid injections if other medications did not relieve symptoms. Hot or cold packs to relieve pain and symptoms. Assistive devices: Special footwear or insoles Walking aid if it affects your mobility	Medications: Disease-modifying anti-rheumatic drugs (DMARDs): Used to slow down the progress of the disease and ease symptoms. Methotrexate Sulfasalazine Biological treatments such as Adalimumab and Etanercept. JAK inhibitors: For adults with moderate to severe rheumatoid arthritis. It is mostly offered for those who cannot take DMARDs or biologicals. NSAIDs such as ibuprofen or naproxen for pain relief. Steroids to reduce pain, inflammation, and stiffness.
Physiotherapy to improve muscle strength and make your joints more flexible.
Surgery may be recommended if symptoms persist despite medications. You may require surgery to help restore the ability to use your joint if your joint is damaged.

Osteoarthritis

Rheumatoid arthritis

Medications:

Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation.
Opioids such as codeine to relieve pain.
Capsaicin cream to apply locally on your hands and knees if topical NSAIDs were ineffective.
Steroid injections if other medications did not relieve symptoms.

Hot or cold packs to relieve pain and symptoms.

Assistive devices:

Special footwear or insoles
Walking aid if it affects your mobility

Medications:

Disease-modifying anti-rheumatic drugs (DMARDs): Used to slow down the progress of the disease and ease symptoms.
- Methotrexate
- Sulfasalazine
Biological treatments such as Adalimumab and Etanercept.
JAK inhibitors: For adults with moderate to severe rheumatoid arthritis. It is mostly offered for those who cannot take DMARDs or biologicals.
NSAIDs such as ibuprofen or naproxen for pain relief.
Steroids to reduce pain, inflammation, and stiffness.

Physiotherapy to improve muscle strength and make your joints more flexible.

Surgery may be recommended if symptoms persist despite medications. You may require surgery to help restore the ability to use your joint if your joint is damaged.

Book an appointment at Pantai Hospitals

Early detection of Osteoarthritis and Rheumatoid arthritis makes it easier to treat the condition with effective and appropriate treatment. A dedicated and expert team of Orthopaedic specialists at Pantai Hospital is available for consultation to provide the best care possible.

Get in touch with us to book an appointment today if you have concerns or questions regarding arthritis.

Pantai Hospital has been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.