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The Differences Between Osteoarthritis & Rheumatoid Arthritis

While there are well over 100 different types of arthritis, osteoarthritis and rheumatoid arthritis are the most common. Osteoarthritis, known as the “wear and tear” disease affects over 32 million U.S. adults. Respectively, rheumatoid arthritis, which is technically an autoimmune disease like lupus or multiple sclerosis, currently affects more than 1.5 million U.S. adults.

Because they’re both forms of arthritis, they share many of the same symptoms, including joint pain, inflammation, and morning stiffness. However, their treatment plans look nothing alike. They’re two very different diseases. Hence, it’s important to learn how to distinguish between the two — even if it’s just understanding the basics — so your doctor can determine the proper treatment.


Osteoarthritis (OA) is the most prevalent type of arthritis, 20 times more common than rheumatoid arthritis. OA occurs when the cartilage between your joints begins to weaken and break down. Given enough time, your cartilage will erode until nothing remains, resulting in bone-to-bone grinding and bony outgrowths called bone spurs.

Osteoarthritis is NOT officially considered an inflammatory type of arthritis, nor is it an autoimmune disease. Simply, OA happens when the normal healthy cartilage of a joint begins to wear down due to age, injury, repetitive use or genetic factors. Even though many OA sufferers experience arthritis on both sides of their body, it is considered an asymmetric disease meaning it does not always occur on both sides of the body simultaneously.

Causes of OA

Several risk factors may contribute to the onset of OA, including:

  • Age (a common cause)
  • Gender (women are more likely to develop OA)
  • Joint injuries
  • Genetic history
  • Obesity
  • Poor posture

Symptoms of OA

How do you know if you could be experiencing osteoarthritis? Symptoms to look out for include:

  • Morning stiffness that usually lasts less than an hour
  • Cracking sounds triggered by joint movement
  • Grinding or grating feeling in the knees
  • Joint pain after exertion

Osteoarthritis manifests in different ways, depending on the joint in question:

  • Fingers: You’ll see redness and swelling around the joints, as well as bone spurs (outward growths) that are tender to the touch.
  • Hips: You may have pain on the inside of the knee, upper thigh, near the groin, or around the buttocks.
  • Knees: Pain/stiffness when getting up from a seated position, especially after sitting for any length of time.
  • Feet: Swelling around the toes and ankles is common, as well as pain in the joint where the big toe meets the foot.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is the second most common type of arthritis, affecting more than 1.5 million Americans. In contrast to OA, rheumatoid arthritis is both a chronic inflammatory condition and an autoimmune disease.

RA occurs when your immune system malfunctions and mistakenly attacks the healthy cells lining your joints. These attacks inflame your joints rather than weakening and grinding down cartilage. As the disease progresses, RA can damage other organs and eventually destroy the joints altogether.

Rheumatoid arthritis is a systemic condition, meaning it affects your entire body, including the skin, lungs, brain, blood vessels, and liver. Unlike OA, RA is symmetrical, meaning that both sides of the body (e.g. your left and right hand) are affected at the same time and at the same rate.

Causes of RA

Unfortunately, the medical community still doesn’t know exactly what triggers RA. However, researchers postulate the onset of RA may depend on a combination of genetic and environmental factors.

  • Family history
  • Gender (women are 3x more likely to develop RA)
  • Positive rheumatoid factor (certain antibodies)
  • Smoking
  • Age (most often occurs to people in their sixties)
  • Weight

Symptoms of RA

RA shares several symptoms with OA, such as painful joints and morning stiffness. However, a few key symptoms differentiate the two:

  • Painful joint swelling
  • Red, tender or warm joints
  • Prolonged morning stiffness (more than an hour)
  • Fatigue
  • Fever

A Side-by-Side Comparison

As you can tell, RA and OA are two fundamentally different diseases. Rheumatoid arthritis occurs when your immune system mistakenly attacks your own body, while osteoarthritis occurs after years of wear-and-tear causes your joint cartilage to break down.

Here’s a helpful graphic that summarizes everything we’ve discussed.

The difference between osteoarthritis and rheumatoid arthritis

How Do RA and OA Treatments Differ?

Unfortunately, both rheumatoid arthritis and osteoarthritis have no cure. Thus, treatment options for both of these diseases involve reducing pain and other symptoms as well as preventing any further joint damage.

With RA, an arthritis doctor might prescribe a disease-modifying antirheumatic drug (also called a DMARD) that suppresses the immune system to get control of the inflammation. If DMARDs don’t work, you may be prescribed a genetically engineered biologic agent. This, along with self-care and therapy, help reduce RA’s symptoms.

An OA treatment looks much different. Because OA isn’t an autoimmune disease, there are no immune system-modifying drugs involved. Instead, doctors may prescribe NSAIDs and other pain relievers, as well as corticosteroid, hyaluronic acid or platelet-rich plasma injections. These shots help reduce joint pain and inflammation as well as improve function.

Below, we’ve gathered even more resources to help you learn about these two conditions. The more you know, the better equipped you’ll be at making arthritis pain a thing of the past.

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Hand swelling caused by rheumatoid arthritisOlder man relaxes in a hammock