While both rheumatoid arthritis (RA) and osteoarthritis (OA) are both types of arthritis that can cause joint pain and stiffness, they also have several distinct differences.

Osteoarthritis (OA) is the most common type of arthritis. It affects approximately 33 million people in the U.S. alone. Around the world, over 520 million people are affected by this condition. OA happens when the protective cartilage that cushions the ends of bones in the joints wears down over time. This breakdown causes the bones to rub against each other, leading to pain, stiffness and swelling. It most commonly affects the hands, knees, hips and spine but can happen in any joint. While it’s more likely to develop after the age of 50, younger people can also get OA, especially if they’ve had an injury or put a lot of stress on their joints.

Rheumatoid arthritis (RA) is an autoimmune disease, which means the body’s immune system mistakenly attacks its own tissue, in this case, the lining of the joints. This attack causes inflammation, leading to pain, swelling and stiffness. RA can affect any joint but often starts in the small joints, like those in the fingers and toes. If left untreated, RA can lead to joint damage. RA isn’t as common as OA, affecting 1.5 million people in the U.S. and 18 million people globally. It can strike at any age but most often starts between ages 30 and 60. 

10 key differences between rheumatoid arthritis and osteoarthritis

RA and OA are both types of arthritis that cause joint pain, but they have some key differences:

• Cause
• Rheumatoid arthritis — As mentioned above, RA is an autoimmune disease, in which the body’s immune system attacks its own tissue. The immune system targets the synovium, the lining of the membranes surrounding the joints. This immune response causes inflammation and thickening of the synovium, which can eventually damage cartilage and bones and result in joint deformity if left untreated.
• Osteoarthritis — OA is a degenerative joint disease caused primarily by wear and tear over time. It happens when the protective cartilage that cushions the ends of bones wears down, usually after years of joint use, repetitive motions or injury. Unlike RA, OA isn’t caused by the immune system and doesn’t trigger widespread inflammation. Instead, it’s the result of mechanical stress on the joints.
• Impact on the body
• RA — Because RA is systemic, it can also cause fatigue and fever and affect internal organs like the lungs, heart and blood vessels. Some people with RA may also experience weight loss or a general feeling of being unwell. Since it impacts the immune system, it can lead to complications beyond the joints.
• OA — OA mainly affects the joints where cartilage is worn down. It’s a localized condition, typically limited to the affected joints rather than affecting the entire body. Over time, the bones may thicken or develop bone spurs, which can contribute to stiffness and limited mobility.
• Affected joints 
• RA — RA commonly starts in smaller joints like the fingers and toes. It also usually affects the same joints on both sides of the body. As it progresses, it can spread to other joints, including the wrists, knees, ankles, and even the jaw and neck.
• OA — OA usually affects weight-bearing joints such as the knees, hips and spine. It can also develop in the fingers and toes. Unlike RA, OA doesn’t necessarily only affect one side.
• Stiffness
• RA — RA causes stiffness in the morning that can last for an hour or more. It’s also associated with prolonged stiffness after periods of inactivity. This stiffness can feel widespread and affect multiple joints.
• OA — The stiffness with OA is typically shorter in duration. Stiffness can improve with movement and activity throughout the day, though it may return after physical activity or in the evening.
• Onset and age of occurrence
• RA — RA can develop at any age but is most common between ages 30 and 60. It can appear suddenly. Joint pain and swelling can develop rapidly over a few days or weeks.
• OA — OA is also known as the wear-and-tear arthritis. It usually develops after the age of 50, but younger people can also experience it due to injuries or repetitive use. OA symptoms typically appear gradually and build up over months or years.
• Frequency of symptoms
• RA — People with RA experience flare-ups, periods when symptoms become worse, followed by times of lower activity. Flare-ups can be triggered by stress, physical overexertion or sometimes with no obvious trigger. Unknown triggers can make RA feel unpredictable.
• OA — OA symptoms tend to be consistent but can get worse over time as the cartilage continues to break down. OA doesn’t involve flare-ups in the same way as RA, but it can feel worse on days with higher activity or joint use.
• Symptoms
• RA — RA symptoms include joint pain, warmth, swelling and tenderness. Systemic symptoms, like fever, fatigue and weight loss, may appear. RA may also cause rheumatoid nodules, which are small lumps under the skin near the affected joints.
• OA — The symptoms of OA are often limited to joint pain, tenderness and stiffness. Swelling can happen in some cases, but not as often or intense as in RA. Joint creaking or cracking sounds and bone spurs may develop as OA progresses.
• Diagnosis
• RA — Diagnosing RA involves a series of tests, including blood tests for inflammation markers and specific antibodies like rheumatoid factor (RF) and anti-CCP. Imaging tests, like X-rays, MRIs or ultrasounds, may show joint damage, like erosions and soft tissue swelling.
• OA — An OA diagnosis is often based on a combination of symptoms, physical exams, and imaging tests like X-rays or MRIs. These images can show joint space narrowing, cartilage loss and bone spurs. Blood tests aren’t usually needed unless they’re being used to rule out other conditions.
• Progression
• RA — RA can progress very quickly, causing joint deformity and permanent damage if left untreated. Because it’s a chronic condition, RA can cause long-term disability and may reduce joint function and flexibility over time.
• OA — OA progresses more slowly, but as the cartilage wears away, the bones may rub against each other, causing pain and limiting mobility. OA doesn’t cause joint deformity; however, it can lead to bone changes and bone spurs and limit movement over time. 
• Treatment
• RA — RA treatment aims to reduce the immune system’s activity to help prevent joint damage and manage inflammation. Common treatments include disease-modifying antirheumatic drugs (DMARDs), biologic drugs and corticosteroids. These medications can help slow or even halt the progression of RA. Physical therapy and lifestyle changes can offer additional support for joint health and function. 
• OA — OA treatment focuses on managing pain and improving joint function. OA treatment options include pain relievers like NSAIDs, physical therapy, and weight management and lifestyle changes to reduce stress on the affected joints. In advanced cases of OA, joint replacement surgery may be needed if the pain becomes severe or movement is significantly limited.

Understanding the differences between rheumatoid arthritis and osteoarthritis can help in selecting the most appropriate treatment option and making lifestyle adjustments to better manage each condition. While both conditions impact the joints, recognizing their unique characteristics allows for a targeted approach that aligns with the specific needs of each individual living with RA or OA.

How physical therapy can help with rheumatoid arthritis and osteoarthritis

Physical therapy can make a big difference for people living with RA or OA. Physical therapy focuses on:

• Reducing pain
• Improving joint movement
• Helping you feel more comfortable

Your physical therapist will use specific techniques designed to help:

• Relieve stiffness
• Reduce inflammation
• Build strength

Techniques your physical therapist may incorporate into your personalized treatment plan include:

• Manual therapy — Physical therapists use their hands to manipulate soft tissue and joints. This can help reduce pain, improve flexibility and restore normal joint function.
• Aquatic therapy — Water-based exercises can reduce stress on joints, improve range of motion and enhance cardiovascular fitness.
• Therapeutic exercises — Tailored exercise programs can strengthen muscles, improve flexibility and boost cardiovascular health. These exercises may include range-of-motion exercises, strengthening exercises, aerobic exercises and balance exercises.

By incorporating techniques such as these and others into a comprehensive treatment plan, physical therapy can help individuals living with RA or OA manage their symptoms, improve their functional abilities and keep an active lifestyle.

Take control of your arthritis for better joint health with the help of Lattimore PT

At Lattimore Physical Therapy, we understand that managing conditions like rheumatoid arthritis and osteoarthritis requires a personalized approach. Our team of skilled physical therapists will work closely with you to create a customized treatment plan that targets your unique needs and goals. Whether it’s reducing pain, improving joint mobility or strengthening muscles, we use a variety of effective techniques, such as manual therapy, therapeutic exercises and more, to help you manage your symptoms and improve your quality of life. With our dedicated support, we aim to empower you to stay active and feel your best, no matter what stage or type of arthritis you’re dealing with. 

Contact our team today for more information or to schedule an initial appointment.