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What's the Difference Between Osteoarthritis and Rheumatoid Arthritis?

There are many kinds of arthritis, and they’re treated differently. Here’s how to know the difference between the two you hear about most often.

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The term "arthritis" is used a lot, as if it's one condition, but the word can refer to many different types of conditions involving joint pain. One is degenerative — osteoarthritis (OA) — and the other is an autoimmune condition — rheumatoid arthritis (RA).

There are similarities between the two conditions. For instance, they both cause chronic joint pain, and they're both more common in women. But they have different causes, symptoms, treatments, and prognoses. Find out more about how to tell them apart.

The Major Differences: OA is what's known as a degenerative condition, meaning it happens as a result of wear-and-tear of the cartilage between the joints over time. OA tends to affect people more as they age, but can also happen after injury. RA, on the other hand, is an autoimmune disorder, which causes the body to mistakenly attack itself. RA leads to inflammation of the synovial membrane that lubricates and protects joints, and can also affect other tissues. Its symptoms often start between age 40 and 60.

What Causes Each: Certain repetitive motions can lead to OA, so sometimes people who work in specific professions or play particular sports are more at risk. Injuring a joint and being overweight both increase the odds of getting OA. There's also a genetic component.

Scientists aren't sure what causes RA, but they think a combination of genetics and environmental factors are involved.

Who Is Affected: The Rheumatoid Arthritis Support Network estimates that OA affects about 27 million people in the U.S., while RA affects roughly 1.3 to 1.5 million.

Symptoms: The main symptom for both conditions is joint pain or stiffness, especially in the morning, though RA pain tends to last longer than 30 minutes. OA will sometimes appear in only one joint, but RA typically affects more than one joint; the pattern is often symmetrical. RA symptoms can sometimes come on quickly, within a few weeks, whereas OA symptoms tend to develop slowly over years. With RA, you may feel under the weather; fatigue, weight loss, fever, and loss of appetite are common.

Diagnosis: Imaging tests like X-rays and MRIs can show any joint deterioration. RA is more difficult to diagnose, as people experience a range of symptoms, but a number of blood tests can help detect it. A doctor may use these tools, along with a physical evaluation and a look at your personal and family medical history.

Treatment: Your doctor will work with you to determine your best course of treatment, which may involve a combination of therapies to help prevent pain, inflammation, and further joint damage. Non-steroidal anti-inflammatory drugs and physical and occupational therapy are sometimes used to treat both conditions. Analgesics and steroid injections can help those with OA control pain and inflammation, as well as massage therapy, acupuncture, heat, and lifestyle changes (like weight loss). Those with RA may benefit from biologics, disease-modifying anti-rheumatic drugs (DMARDs), corticosteroids, and analgesics. Surgery is generally considered a last-resort option for both conditions.

The Bottom Line

If you’re experiencing joint pain, don’t self-diagnose or simply assume you have arthritis. Make an appointment with your primary care doctor to discuss your symptoms. If necessary, your primary care doctor will refer you to a rheumatologist, a doctor who specializes in musculoskeletal disease and autoimmune conditions.