Is it Rheumatoid or Osteoarthritis?

Rheumatoid arthritis. General practitioner examining a patient's hand for signs of rheumatoid arthritis.
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Rheumatoid arthritis, one of the most common types of arthritis, is an inflammatory condition that primarily involves the tissue that covers the joints. This disease progresses over time, and eventually other organs are affected as well. Rheumatoid arthritis is three times more common in females versus males and is prevalent in approximately 1% of the U.S. population. It is important to realize that there are different forms of arthritis other than rheumatoid arthritis.

Osteoarthritis is another common form of arthritis experienced by the elderly.

Often people are confused as to what type of arthritis they suffer from, but osteoarthritis, a "wear-and-tear" form of arthritis that occurs with age, should not be confused with rheumatoid arthritis.

Osteoarthritis more often affects the larger weight-bearing joints, such as the hips and knees; whereas rheumatoid arthritis more often affects the smaller joints of the hands, wrists and feet.

Another difference between osteoarthritis and rheumatoid arthritis lies in the duration of joint symptoms. The stiffness in osteoarthritis tends to be brief, lasting just a few minutes. In rheumatoid arthritis, the stiffness is worse after rest, such as the first thing in the morning, and often lasts at least 30 minutes or more. In addition, rheumatoid arthritis has a tendency to affect the knuckles and the wrists—areas that are usually not affected by osteoarthritis.

A few more ways to differentiate rheumatoid arthritis from osteoarthritis includes the following:

  • The joint is swollen or red (suggesting that there is inflammation) in rheumatoid arthritis
  • The joint symptom is associated with systemic features such as fever, general fatigue or body stiffness lasting more than 10 to 15 minutes in rheumatoid arthritis
  • Joints are affected on both sides, rather than one sided in rheumatoid arthritis
  • Special blood tests are positive for auto-antibodies that are often found in rheumatoid arthritis

The presence of any of these findings are more consistent with rheumatoid arthritis, and your doctor should treat your condition accordingly.

A final diagnosis, however, does need to be made by a physician. So, if you are experiencing any of the above symptoms, schedule an appointment with your family physician.

While there is no cure for rheumatoid arthritis, patients can have considerable control over their disease through medications, lifestyle changes, and physical therapy. Your physical therapist can help you devise the right exercise program to help you maintain appropriate joint mobility and range of motion. Strengthening exercises for the hands, arms, hips and knees may be incorporated into your daily routine to maintain maximal function throughout your body.

Joints with osteoarthritis tend to be successfully treated with physical therapy. Your PT can offer treatments to decrease pain and swelling and improve joint mobility and range of motion. Strengthening exercise can help support your joints affected by osteoarthritis.

If you are managing arthritis, either rheumatoid or osteoarthritis, check in with your doctor and consider visiting your physical therapist to learn how to properly manage your condition. 



American Family Physician; Osteoarthritis; Vol. 65/No. 5.

American Family Physician; Diagnosis and Management of Rheumatoid Arthritis; Vol. 72/No. 6.

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