Differences Between Rheumatoid Arthritis Vs Osteoarthritis

Written by , MSc Shaheen Naser MSc Experience: 3 years

Arthritis is an umbrella term used to define a variety of inflammatory diseases affecting the bones and joints.

You might be quite familiar with two of its types – rheumatoid arthritis (RA) and osteoarthritis (OA). However, many tend to get confused between these two types as their symptoms are quite similar. How do you differentiate between these two? Which of these are you more likely to develop? Keep reading to find out the significant differences between rheumatoid arthritis and osteoarthritis.

What Causes Rheumatoid Arthritis And Osteoarthritis?

Rheumatoid arthritis (RA) and osteoarthritis (OA) are two different types of the same condition – arthritis. While RA is an autoimmune condition, osteoarthritis is a degenerative joint issue.

  • Cause Of RA

Rheumatoid arthritis is a result of your body attacking itself. In individuals with RA, the body misinterprets the soft lining of the joints to be a threat or a foreign particle (like a microbe). This leads to your immune system attacking the lining. Such attacks usually cause fluid to accumulate in your joints and symptoms like pain, swelling, stiffness, and inflammation in the affected joints.

  • Cause Of OA

Osteoarthritis is one of the most common types of arthritis. Since it is a degenerative disorder, people battling OA may have to face the breakdown of cartilage, which acts as a cushion for your bones. When the cartilage wears down, it may result in the bones rubbing against each other. This further leads to exposure of small nerves, which causes pain.

Let’s now take a look at the symptoms.

Symptoms – RA Vs. OA – Similarities And Differences

Both rheumatoid arthritis and osteoarthritis exhibit a few similar symptoms like (1), (2):

  • Stiffness of joints
  • Joint pain
  • Limited motion
  • Tenderness in the affected part
  • Increased severity of the symptoms in the morning

RA and OA also have individual symptoms that are unique to their type.

The main symptoms associated with rheumatoid arthritis are (1):

  • A low-grade fever, which is especially seen in affected children
  • Fatigue
  • Recurring muscle aches

As it is a systemic disease, RA can affect your entire body, including your lungs, eyes, and heart.

Those in advanced stages of the disease may start observing some hard yet tender lumps near the joints. Some lumps are referred to as rheumatoid nodules (1).

Unlike RA, individuals with OA are unlikely to exhibit overall symptoms. The symptoms are often limited to the joints.

One of the unique characteristics of osteoarthritis is the development of small lumps under the skin. These lumps are not similar to rheumatoid nodules. They occur only in people with OA and are referred to as bone spurs or osteophytes (2). These are excess bone growths that occur along the edges of the affected joints. Noisy joints are another common symptom of osteoarthritis.

While both the conditions have some common symptoms, they may occur in different joints. Find out more about the joints affected by each type right below.

Joints Most Often Affected – RA Vs. OA

Rheumatoid arthritis and osteoarthritis can affect different joints.

RA usually begins in the smaller joints. You are quite likely to experience symptoms of pain and stiffness in your finger and feet joints (metacarpophalangeal, proximal interphalangeal, and metatarsophalangeal joints) initially.

As the autoimmune disease progresses, similar symptoms will begin surfacing in your knees, ankles, and shoulders (3). As it is a symmetrical disease, rheumatoid arthritis can cause symptoms to occur on both sides of your body simultaneously.

Compared to RA, OA is less symmetrical, i.e., you may expect symptoms of pain and stiffness on both sides of your body, but the joints on one side experience the worst of it. Like rheumatoid arthritis, osteoarthritis also mostly affects the fingers and hand (2). However, in addition to the knees, OA can affect the hips and spine.

Certain factors can put you at a higher risk of developing both OA and RA. They are discussed below.

Risk Factors

The common risk factors for rheumatoid arthritis and osteoarthritis are:

  • Gender – They are more common in women than in men.
  • Family history – If any of your close family members have had a history of OA or RA, you are at increased risk of developing the disease.
  • Obesity

Certain risk factors are unique to both these conditions.

The risk factors for RA may include (4):

  • Age – Although it can occur at any age, it is more common in the middle-aged.
  • Smoking tobacco
  • Environmental exposure to toxins like silica
  • History of a serious microbial infection
  • Stress

The unique risk factors for osteoarthritis include (5):

  • Age – It is more common in older adults.
  • A history of joint injury
  • An occupation that requires repetitive activities like lifting, walking, climbing stairs, kneeling or squatting for hours
  • Poor posture
  • Congenital bone deformities
  • Medical conditions like gout or diabetes

If you have been exhibiting any of the symptoms associated with RA or OA and also relate to the above risk factors, consult a doctor immediately to rule out the chances of the disease.

How To Test For RA And OA

Rheumatoid arthritis may be quite difficult to diagnose in its early stages as the symptoms associated with it are similar to those of other conditions.

Your doctor may begin by carrying out a physical examination. They may check for signs of swelling, tenderness, or redness. Your reflexes and muscle strength may also be analyzed.

Tests that may be used to diagnose RA are (6):

  • Blood Test – Those affected by rheumatoid arthritis usually have an elevated erythrocyte sedimentation rate (ESR). They may also have an elevated level of C-reactive protein, both of which indicate inflammatory reactions taking place within the body. Some blood tests may also look for anti-cyclic citrullinated peptide (anti-CCP) antibodies or rheumatoid factor.
  • Imaging Tests – X-ray, MRI scan, and ultrasound tests may also be recommended to keep track of the progression of RA

The following tests may be prescribed to diagnose OA in suspected individuals:

  • Physical Examination – As in the case of RA, a physical examination may be carried out to look for tenderness, swelling, and stiffness in the affected joints.
  • Imaging Tests – X-rays may be suggested to reveal cartilage loss. MRI scans may be recommended in complex cases (7).
  • Laboratory Tests – Blood tests are often conducted to rule out other causes, such as RA. Another lab test for OA is joint fluid analysis where the fluid is drawn out from any of the affected joints and tested for symptoms of inflammation (8).

If the tests diagnose you with RA or OA, your doctor may refer you to an orthopedist or rheumatologist. The assigned doctor will prescribe treatment depending on your condition after discussing the possible treatment options with you.

Treatments – RA Vs. OA

Treatment for both rheumatoid arthritis and osteoarthritis is primarily aimed at:

  • Improving the functioning of the affected areas
  • Reducing pain
  • Minimizing further damage to the affected bones

Medications for RA are usually prescribed depending on the severity of the symptoms and how long you have been battling the condition. They may include (9):

  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) Or Steroids: They help reduce pain and inflammation.
  • Disease-modifying Antirheumatic Drugs (DMARDS): They help slow down the progression of the disease and prevent permanent damage to the joints.

Other treatment approaches for rheumatoid arthritis are:

  • Occupational Therapy: It helps make day-to-day tasks easier to do, such that it puts less stress on your joints (10).
  • Use Of Assistive Devices: They help avoid stress on the affected joints.
  • Surgery: It includes synovectomy, which involves removing the inflamed joint lining. Tendon repair, joint fusion, and total joint replacement are the other surgical options for treating rheumatoid arthritis (11).

On the other hand, medications for relieving pain associated with OA are (12):

  • NSAIDs or nonsteroidal anti-inflammatory drugs
  • Steroids
  • Acetaminophen – Do not take more than the prescribed dose as it can cause liver damage.
  • Duloxetine

Other treatment options for osteoarthritis include (13):

  • Physical Therapy: Personalized exercise training to strengthen the joint muscles.
  • Occupational Therapy: It helps you find ways to perform everyday tasks without putting extra pressure on the affected joints.
  • Cortisone And Lubrication Injections: To relieve pain (14).
  • Surgery: It may include realignment of affected bones or joint replacement (15).

Early treatment not only prevents complications but also helps make the remission of the symptoms more likely.

Treating arthritis, be it RA or OA, is aimed at managing the symptoms and preventing the progression of the disease. However, there is no cure for either rheumatoid arthritis or osteoarthritis. By availing treatment, you can improve the quality of your life and protect your joints from further damage.

Hope you found this post helpful. Don’t forget to post your comments and feedback in the comments box below.

Frequently Asked Questions

Can an X-ray show the difference between osteoarthritis and rheumatoid arthritis?

X-rays can help show the joint damage that has occurred as a result of rheumatoid arthritis as well as osteoarthritis. However, you may have to go for a blood test to confirm or rule out rheumatoid arthritis.

What is the most painful type of arthritis?

One of the most painful types of arthritis is gout. It is triggered by the presence of excess uric acid in the blood.

At what age does arthritis usually start?

Arthritis can occur in people of any age. However, depending on its type, it may sometimes be more prominent in the older or middle-aged lot.


  1. Rheumatoid arthritis: Overview” Institute for Quality and Efficiency in Health Care, US National Library Of Medicine.
  2. Osteoarthritis” The BMJ, US National Library Of Medicine.
  3. The clinical features of rheumatoid arthritis.” European Journal of Radiology, US National Library Of Medicine.
  4. Genetic and environmental risk factors for rheumatoid arthritis.” Best Practice & Research: Clinical Rheumatology, US National Library Of Medicine.
  5. Osteoarthritis prevalence and modifiable factors: a population study” BMC Public Health, US National Library Of Medicine.
  6. Rheumatoid Arthritis: Early diagnosis and treatment outcomes” Caspian Journal of Internal Medicine, US National Library Of Medicine.
  7. 5 Diagnosis” National Clinical Guideline Centre, US National Library Of Medicine.
  8. Synovial Fluid White Cell Count in Knee Osteoarthritis: Association with Structural Findings and Treatment Response” Arthritis & Rheumatology, US National Library Of Medicine.
  9. Arthritis, Rheumatoid” StatPearls, US National Library Of Medicine.
  10. Occupational therapy for rheumatoid arthritis.” Cochrane Database of Systematic Reviews, US National Library Of Medicine.
  11. Treatment strategies in surgery for rheumatoid arthritis.” European Journal of Radiology, US National Library Of Medicine.
  12. Use of NSAIDs in treating patients with arthritis” Arthritis Research And Therapy, US National Library Of Medicine.
  13. Rheumatology: 9. Physical and occupational therapy in the management of arthritis” Canadian Medical Association Journal, US National Library Of Medicine.
  14. Intraarticular injections (corticosteroid, hyaluronic acid, platelet rich plasma) for the knee osteoarthritis” World Journal of Orthopedics, US National Library Of Medicine.
  15. Surgical Management of Osteoarthritis” Arthritis Care & Research, US National Library Of Medicine.
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Shaheen Naser

Shaheen NaserHealth & Wellness Writer

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