Differences between Osteoarthritis and Rheumatoid Arthritis

Written by Wang Cheng Lin
Orthopedics
Updated on September 12, 2024
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Osteoarthritis is commonly seen in middle-aged and elderly people, primarily due to long-term joint wear, leading to degeneration of the cartilage in the joints, causing symptoms of pain, swelling, and discomfort in movement. In contrast, rheumatoid arthritis often begins in younger individuals and is linked to genetics and viral infections, primarily being an autoimmune disease. It is characterized by positive rheumatoid factor, including elevated erythrocyte sedimentation rate and C-reactive protein. Additionally, the treatment methods for these two diseases are different. Osteoarthritis can mainly be managed with massage therapy, injections of sodium hyaluronate, and oral nonsteroidal anti-inflammatory drugs to alleviate symptoms. Rheumatoid arthritis, on the other hand, might require the use of immunosuppressants, steroids, or nonsteroidal anti-inflammatory drugs to relieve pain. Importantly, rheumatoid arthritis commonly affects the small joints of the fingers, whereas osteoarthritis most frequently affects larger joints, such as the knee, highlighting the fundamental differences between the two conditions. (Note: The answers provided are for reference only. Medications should be taken under the guidance of a professional physician, and self-medication should be avoided.)

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Osteoarthritis complications

In clinical practice, there are many complications associated with osteoarthritis, mainly reflected in the following aspects. First, the presence of osteoarthritis causes the joints to exhibit obvious symptoms of swelling and pain. Often due to the pain and swelling, patients are reluctant to move, and prolonged inactivity can lead to joint stiffness and significant muscle atrophy in the affected areas. Second, osteoarthritis often leads to the extensive detachment of joint cartilage, making it easy for free bodies to form within the joint. Third, the presence of osteoarthritis may lead to the development of bursitis in patients. Fourth, osteoarthritis can also cause damage to the meniscus.

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Difference between Osteoarthritis and Rheumatoid Arthritis

Osteoarthritis and rheumatoid arthritis have clear differences. Osteoarthritis refers to the rupture, loss, and fissuring of joint cartilage caused by degeneration in old age, which can lead to knee pain, and in severe cases, deformity. Rheumatoid arthritis, however, refers to the destruction of joint cartilage caused by rheumatism, which includes the proliferation of synovium, swelling, migratory pain, morning stiffness, among other symptoms. Diagnosis can be confirmed through laboratory tests, such as the rheumatoid factor test, making it quite easy to distinguish between the two.

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Is osteoarthritis serious?

Regarding the severity of osteoarthritis, it is mainly determined by the clinical symptoms of the patient's osteoarthritis. If the osteoarthritis is only manifested by localized pain, and there is no obvious impact on walking, going up stairs, or going downhill, this means that the osteoarthritis is not very severe. However, if the local swelling and pain of the osteoarthritis are very severe, with considerable pain when going up or down stairs, and if there is popping of the joint or symptoms of entrapment, and the joint has already shown obvious deformation affecting the patient's normal functions, then it indicates that the condition is quite severe. In such cases, it is necessary to proactively consider arthroscopic surgery or artificial joint replacement therapy.

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How to reduce swelling in osteoarthritis?

Osteoarthritis often presents with swelling, most commonly seen in knee osteoarthritis. The swelling occurs because of inflammation. For example, if knee arthritis is accompanied by synovitis, it will become swollen and the local temperature will be relatively high. To reduce swelling, the first measure is immobilization, meaning you should avoid bearing weight or moving, and lie in bed without bending the joint, which can help decrease the swelling. Second, you can apply heat, using a hot water bottle or heated salt for heat therapy. Third, if there is fluid accumulation in the joint cavity, draining this fluid can also reduce swelling. Fourth, physical therapy, acupuncture, and massage can all help reduce swelling.

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Is osteoarthritis easy to treat?

Osteoarthritis is a difficult-to-treat disease because currently, there is no complete cure for joint disorders in medicine. Therefore, the treatment principles are early diagnosis, early treatment, and early rehabilitation. Mainly, methods are used to delay the progression of the disease, maximally preserve joint function, and enable patients to live normal lives. The first approach is non-pharmacological treatment, which is the foundation for drug therapy and surgical treatment, primarily involving physical therapy methods such as heat therapy, hydrotherapy, traction, microwave therapy, acupuncture, and massage to alleviate joint pain and swelling during acute flare-ups. The second approach is pharmacological treatment, mainly including non-steroidal anti-inflammatory drugs and traditional Chinese medicine. The third approach involves considering surgical treatment if conservative treatments prove ineffective. Surgical treatments can involve procedures such as joint debridement to remove inflamed, loose cartilage and bone tissues, and smoothing rough joint surfaces. If these methods are still ineffective, the last treatment option may be needed for severe cases, which is artificial joint replacement. Thus, the treatment of osteoarthritis is a stepwise approach. However, regardless of the treatment method used, there is currently no cure, making osteoarthritis a challenging disease to treat.