Rheumatoid arthritis and osteoarthritis are two different types of arthritis. They have different symptoms and each requires a specific treatment, although they may have some similar characteristics. An accurate diagnosis early on is important to ensure the most effective course of treatment is prescribed.

Rheumatoid arthritis affects far fewer people than osteoarthritis, the most common form of arthritis. Only about one-tenth as many people have rheumatoid arthritis in comparison with osteoarthritis. The main difference between the two conditions is the cause behind the joint problems.

Autoimmune disease

While osteoarthritis occurs due to general wear and tear on the joints, rheumatoid arthritis is an autoimmune disease. It is caused by an overactive immune system, which leads to the body’s own immune system attacking the joints.

The immune system usually fights infection, but instead, it mistakenly attacks the cells that line the joints. This is what causes the swollen, painful, stiff joints. Over a period of time, this not only damages the affected joints, but also the cartilage and nearby bones.

Rheumatoid arthritis can begin at any time in life, with the onset of symptoms occurring relatively quickly, in a period ranging from weeks to months. Osteoarthritis usually begins in later life and the onset of symptoms can be slow. While both conditions involve joint pain, there are specific differences.

Different symptoms

The symptoms of rheumatoid arthritis include joint swelling, while they also feel painful and stiff. The condition often affects both small and large joints in a symmetrical pattern on both sides of the body, such as both wrists, hands, or elbows and even the balls of both feet.

With osteoarthritis, the joints ache and may feel tender, but they will have little or no swelling. The symptoms frequently begin on one side of the body, but may spread to the other side.

They begin gradually and are commonly limited to one set of joints, such as large weight-bearing joints like the hips and knees, the spine, the finger joints closest to the fingernails, or the thumbs.

Rheumatoid arthritis can damage other parts of the body and not just the joints. The symptoms can affect the whole body, causing frequent fatigue and a general feeling of being ill continually.

There are times when the symptoms are worse. These periods are known as flare-ups. It can be difficult to predict when this is going to happen, so it is important for sufferers to manage the condition with the appropriate treatment.

Diagnosis

It is crucial to investigate and diagnose rheumatoid arthritis early and this can be achieved by seeing a specialist as soon as possible. It can be a difficult condition to diagnose, as some of the symptoms can also occur with other conditions, so it’s a case of ruling out other problems to reach the correct diagnosis.

The specialist will ask questions relating to where the pain is experienced and will also carry out a physical examination. The sufferer’s level of mobility and affected joints will be tested. In order to confirm the diagnosis, the patient may also need blood tests and imaging tests, including X-rays and ultrasound scans.

Currently, there is no cure for rheumatoid arthritis. However, diagnosing the condition early and a suitable treatment plan can help many people to have periods of months – or even years – without any flare-ups. They can lead a full life and have a regular job, without the condition drastically affecting their day-to-day activities.

Treatments

The main treatments include taking long-term medication to slow the progress of the condition and relieve the symptoms. This can be combined with supportive treatment, such as occupational therapy and physiotherapy, to keep the patient mobile and manage any challenges they experience with daily activities.

The initial treatment is normally a combination of medications that modulate the immune system called Disease Modifying Anti-Rheumatic Drugs (DMARDS). These medicines will slow down the progression of rheumatoid arthritis and ease the symptoms. They work by blocking the effects of the chemicals that are released when the body’s immune system attacks the joints.

The most commonly used DMARDs include methotrexate, sulfasalazine, hydroxychloroquine and leflunomide. The first medicine given is usually methotrexate. It can be combined with another DMARD and a short course of corticosteroids (steroids) to relieve the pain.

Other treatments can include joint injections and biological treatments, such as adalimumab and etanercept, an even more advanced form of treatment for rheumatoid arthritis. In addition to the medication to control the progression of rheumatoid arthritis, patients may also be required to take medicine specifically to relieve the pain.

Dr Naveen Bhadauria is a private consultant rheumatologist working at the prestigious location of  25 Harley Street in Central London.  As a leading consultant, he specialises in looking after patients with all aspects of general rheumatology. For further information and appointments, contact 07943 404 279 or 07806 683 980.