Rheumatoid arthritis and Osteoarthritis
EDP column by Dr Ketan Dhatariya

“What is the difference between rheumatoid arthritis and osteoarthritis?”

To allow joints to move smoothly the bones are covered in a smooth covering – cartilage. This helps to protect the bones from the wear and tear of everyday use. In osteoarthritis, this smooth layer becomes rougher over time, and so there is an increase in the amount of friction when the bones of the joint move. There is often a redistribution of the pressure within the joint and this leads to the bone remodelling itself. The bone may grow sideways and become more lumpy. These lumps are called ‘osteophytes’. Over time, the cartilage may become so thin that it breaks away and allows the bone to rub together. This can be quite painful and can limit the mobility of the joint. Eventually the joint may become quite deformed and may need replacing. 

Osteoarthritis occurs most often over the age of 40.  Things that cause the joints more pressure making things worse – such as being overweight, previous injury, or overuse of particular joints.

Rheumatoid arthritis is different. In this condition, the membranous material that surrounds the joints and keeps the lubricating fluid in place - the synovial membrane - becomes inflamed. The cause of this is not known, but is thought to be related to the body’s own immune system attacking the membrane. The added inflammation cause more fluid to enter the joint making it stiff and painful.

The condition is common – with up to 1 in a 100 people developing it, and comes on often around the age of 30 to 50 and affects women far more commonly than men.

Your doctor will ask you a few questions including where you get the pain and what time of day it is worst. They will possibly ask for some X-rays and blood tests. Depending on the results, they will advice some treatment. Initially this is pain killers using paracetamol or anti-inflammatory drugs like ibuprofen. If things do not improve then there are other drugs that are available. Occasionally if the joints become deformed, then you may need to see a physiotherapist or occupational therapist to provide you with equipment to minimise the impact of the joint deformity. Eventually, however, it may be necessary to be seen by a rheumatologist or an orthopaedic surgeon to see what else needs to be done. An injection of steroid into the joint may help reduce the swelling and pain, but joint replacement is a well established, successful treatment than greatly helps may people.

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