Osteoarthritis vs rheumatoid arthritis - what’s the difference and how can seeing a physio help

Osteoarthritis (OA) and rheumatoid arthritis (RA) are two of the most common forms of arthritis, affecting millions of people worldwide. Although they share similar symptoms, they are distinct conditions with different underlying causes and treatment approaches. In this blog post, we will discuss the key differences between OA and RA and explain how a physiotherapist can help manage the symptoms of both conditions.

What is osteoarthritis (OA)?

Osteoarthritis affects the entire joint, particularly the articular cartilage that covers the ends of the bones. The cartilage changes over time due to factors such as genetics, age-related changes, and mechanical stress on the joint. The capacity of the cartilage to tolerate normal loads may change, resulting in joint discomfort and stiffness. This condition typically affects weight-bearing joints like the hips, knees, and spine. Over time, the cartilage providing a smooth surface for the joint to glide on thins and becomes less resilient. Consequently, the joint may not function as smoothly, resulting in discomfort and limited mobility.

What is rheumatoid arthritis (RA)?

Rheumatoid arthritis (RA), on the other hand, is an autoimmune disease that causes chronic inflammation of the joints. The immune system mistakenly attacks the synovium, a thin membrane that lines the joints, causing it to become inflamed and thickened. This can lead to changes to the joint structure and pain. RA can affect any joint in the body, but it typically affects the small joints in the hands and feet. The symptoms of RA may include pain, stiffness, swelling, and loss of function. In some cases, it can also cause systemic symptoms such as fatigue, fever, and weight loss. The exact cause of RA is not yet known, but it is thought to be a combination of genetic and environmental factors. There is currently no cure for RA, but early diagnosis and treatment can help manage the symptoms and slow down the progression of the disease.

How can physiotherapists help?

Physiotherapists can play an important role in managing the symptoms of OA and RA. Your physiotherapist will develop an individualised exercise program with the aim of improving joint mobility, flexibility, and strength and overall health and wellness. 

While some aspects of treatment vary between the different conditions, it is important for both individuals with OA and RA to participate in activities such as swimming, cycling, and walking – these activities can be effective in reducing joint pain and stiffness. Exercises that focus on improving range of motion and strengthening the muscles around the affected joint can be helpful. In addition to exercise, physiotherapists can also provide education on joint protection, pain management techniques, and assistive devices such as braces and splints. Physiotherapy can also help individuals with OA and RA adopt a healthy lifestyle by promoting weight management, stress reduction, and proper nutrition. Physiotherapists will work closely with other healthcare providers to develop a comprehensive treatment plan that addresses the specific needs of each individual.

In addition to physiotherapy, there are other treatments available for both osteoarthritis and rheumatoid arthritis. For osteoarthritis, pain medication and, although not often, joint injections or surgery may be necessary in more severe cases. For rheumatoid arthritis, disease-modifying anti-rheumatic drugs (DMARDs), biologic medications, and other immunosuppressive medications may be necessary.

Want to know more?

Contact your local physiotherapist who can provide advice and liaise with your doctor about the best treatment options for you.

References

Katz, P., Andonian, B. J., & Huffman, K. M. (2020). Benefits and promotion of physical activity in rheumatoid arthritis. Current opinion in rheumatology, 32(3), 307-314.

Scherer, H. U., Häupl, T., & Burmester, G. R. (2020). The etiology of rheumatoid arthritis. Journal of autoimmunity, 110, 102400.

Radu, A. F., & Bungau, S. G. (2021). Management of rheumatoid arthritis: an overview. Cells, 10(11), 2857.

Rodrigues, R., Ferraz, R. B., Kurimori, C. O., Guedes, L. K., Lima, F. R., de Sá‐Pinto, A. L., ... & Roschel, H. (2020). Low‐load resistance training with blood‐flow restriction in relation to muscle function, mass, and functionality in women with rheumatoid arthritis. Arthritis care & research, 72(6), 787-797

Santos, E. J., Duarte, C., Marques, A., Cardoso, D., Apóstolo, J., da Silva, J. A., & Barbieri-Figueiredo, M. (2019). Effectiveness of non-pharmacological and non-surgical interventions for rheumatoid arthritis: an umbrella review. JBI Evidence Synthesis, 17(7), 1494-1531.