It is World Arthritis Day (WAD) on the 12th October 2020. So I have decided to write about the difference between the 2 most commons forms of ‘arthritis’- osteoarthritis (OA) and rheumatoid arthritis (RA). They have both very different processes and causes. Physical treatments and our clinical management are different too.

When we sit down and chat with clients, most would just say “arthritis” to us, which we then have to probe a little more in depth to see if we can work out which one! Most don’t even know there are many different types of ‘arthritis’.

Osteoarthritis:

Is a condition where the smooth cushion between bones (cartilage) breaks down, that causes joints to become painful and stiff. It’s the most common type of arthritis in the UK.

osteo arthritis

Symptoms of osteoarthritis:

The main symptoms of OA are joint pain and stiffness, and problems moving the joint. Some people also have symptoms such as: – swelling – tenderness – grating or crackling sound when moving the affected joints

The severity of symptoms can vary greatly from person to person, and between different affected joints. Not everyone gets OA.

Almost any joint can be affected by osteoarthritis, but the condition most often causes problems in the knees, hips, lower back, neck and small joints of the hands.

Osteoarthritis was long believed to be caused by the wearing down of joints over time. But scientists now see it as a disease of the joint.

Here are some things that may contribute to OA: 

  • Age. The risk of developing OA increases someone gets older because bones, muscles and joints are also ageing.
  • Joint injury. A break or tear, can lead to OA after years.
  • Overuse. Using the same joints over and over in a job or sport can result in OA.
  • Obesity. Extra weight puts more stress on a joint and fats cells promote inflammation.
  • Weak muscles. Joints can get out of the right position when there’s not enough support.
  • Genes. People with family members who have OA are more likely to develop OA.
  • Sex. Women are more likely to develop OA than men.

Other names for OA are ‘wear and tear’, degeneration, or spondylosis. 

Diagnosis: 

We often diagnosis this from taking x-rays, which we have the facility to do so in our Brighton and Hove clinic. You can have OA and be without any pain and discomfort. 

osteo arthritis of the hip

Rheumatoid arthritis:

Is an autoimmune condition, which means it’s caused by the immune system attacking healthy body tissue. However, it’s not yet known what triggers this. The most common joints affected are hands, feet and wrists. Often people have flare ups and can have symptoms to other parts of their body like weight loss and tiredness.

rheumatoid arthritis

If you have rheumatoid arthritis, your immune system mistakenly sends antibodies to the lining of your joints, where they attack the tissue surrounding the joint.

This causes the thin layer of cells (synovium) covering your joints to become sore and inflamed, releasing chemicals that damage nearby:

  • bones
  • cartilage – the stretchy connective tissue between bones
  • tendons – the tissue that connects bone to muscle
  • ligaments – the tissue that connects bone and cartilage

Possible risk factors:

There are several things that may increase your risk of developing rheumatoid arthritis, including:

  • your genes – there’s some evidence that rheumatoid arthritis can run in families, although the risk of inheriting it is thought to be low as genes are only thought to play a small role in the condition
  • hormones – rheumatoid arthritis is more common in women than men, which may be because of the effects of the hormone oestrogen, although this link has not been proven
  • smoking – some evidence suggests that people who smoke have an increased risk of developing rheumatoid arthritis

Treating rheumatoid arthritis:

There’s no cure for rheumatoid arthritis. However, early diagnosis and appropriate treatment enables many people with the condition to have periods of months or even years between flares. 

  • medication
  • physical therapy
  • surgery 

Diagnosis:

  • physical examination
  • blood tests inc CRP, ESR, full blood count.
  • ref to rheumatologist
  • xray/MRI scans
  • some extra tests inc rheumatoid factor and anti-CCP antibodies.
rheumatoid in hands

Copyright: SCIENCE PHOTO LIBRARY

Implications as chiropractor/osteopath:

It is important for us to know which one of these arthritis’ you have. They both can respond favourably to manual therapy. They both need different approaches and both do mean a slower response to care.

We want to get the correct diagnosis, so we may X-ray and we may well request for scan/test results and/or ask for a blood test from your GP.

OA is common in the clients we see in clinic, and we would want to set your expectations to the potential of a slower recovery.

In RA we would taylor techniques to be more suitable for you, and especially if in the flare up stage would include very gentle care. 

Both OA and RA would do well with certain nutritional changes, exercise and posture improvements, focussing on an overall anti inflammatory strategy. We say managing rather than treating/curing. And as always (I know I should’t start a sentence with and!) prevention is always a much better approach when it comes to OA.

There are other types of arthritis as well, just to confuse both us as your physicians and you!

  • polymyalgia rheumatica
  • ankylosing spondylolitis
  • reiter’s
  • psoriatic arthritis

Taking the time to properly listen, assess and diagnose you is important. At Back 2 Balance, this is our approach, rather than trying to get you on the couch as quickly as possible without giving proper due diligence. If you have any questions about osteoarthritis or rheumatoid arthritis, please do not hesitate to email us on info@back2balance.co.uk or call 01273 206868 to ask to speak to a clinical team member.