Arthritis or osteoarthritis? We explain the difference

Both cause joint pain but do not share causes, treatments or prevention possibilities. We tell you all about both diseases so you know how to differentiate them.

Despite all the information we have available at the click of Google, most of us continue to confuse arthritis with osteoarthritis, and vice versa. The fact that both pathologies affect the joints and that both hurt and limit movements increase confusion. But, in reality, we would do well to learn to differentiate them, since both are very common pathologies. According to the Study of Global Impact of Diseases, seven million Spaniards suffer from osteoarthritis and according to the EPISER Study (Study of Prevalence of Diseases in the adult population), one million suffer from arthritis.

The main difference between the two is that each one damages a different tissue of the joint. In osteoarthritis, there is a degenerative process of the cartilage of the bones that, with age, wears away. On the other hand, arthritis is a disease in which the synovial membrane is inflamed (the tissue that covers and protects the joints). The nature of arthritis is very complex because it involves both an inflammatory reaction and the defense system of the organism that attacks, it is not yet known why, that synovial membrane causing inflammation and pain.

While osteoarthritis is usually associated with age (or risky behaviors carried out over years, such as over-exercising without paying attention to warning signs), arthritis can attack at any time, although it mostly affects women between 30 and 50 years. But this is not the only difference between the two. Keep reading and you will learn to distinguish them even more.

  1. And what hurts you?

-Both conditions hurt, but differently. “Osteoarthritis is a mechanical pain, which worsens with activity and improves with rest. The arthritis is inflammatory, worsens at rest and improves by taking a while of activity. The stiffness of arthritis is also greater, ”explains Dr. Elisa Trujillo, assistant rheumatologist of the Rheumatology Service of the University Hospital of the Canary Islands (Tenerife).

-People with osteoarthritis usually wake up with seized joints and that stiffness usually disappears with movement. In contrast, pain, which is located at very specific points, worsens with activity. The most common osteoarthritis is located in the hands, although it can also appear in the knees, feet, hip, and spine.

-In the case of arthritis, pain is a problem, but also it is usually accompanied by others such as symmetrical inflammation of the joints (for example, both hands), tingling and fever.

-As for the risk factors, osteoarthritis is related to the passing of the years and the activity we have carried out. The cause of arthritis is more complex: some risk factors are sex (it is more common in women), being a smoker, obese and having a family history.

  1. How are they diagnosed?

-The first step in making a successful diagnosis is in answering the rheumatologist’s questions. A well-conducted interrogation of the symptoms helps to distinguish between the two diseases. That is why it is important to be clear that the first symptom of osteoarthritis is pain during activity or when moving the affected joint and that of arthritis stiffness and pain when getting up in the morning or after resting and is usually accompanied by a sensation of joint inflammation.

-After answering the doctor’s questions, it is time to explore, which allows us to identify the presence or not of joint inflammation and to see if there are the typical deformities of osteoarthritis or arthritis. “For the diagnosis of arthritis, we will also need an analytical study that includes markers of inflammation and autoimmunity, and a radiological study to observe the presence of changes that are typical of the disease. For the diagnosis of osteoarthritis, an analytical study is not necessary, it is enough to do an x-ray ”, explains Dr. Elisa Trujillo

  1. What problems can they be associated with?

-If you suffer from osteoarthritis and you also have excess weight, you may be in trouble. Obesity worsens the pain of osteoarthritis in the spine, hips, and knees. Unfortunately, it is a fish that bites its tail: having osteoarthritis limits mobility, but exercising is essential not only to control weight but also to avoid metabolic syndrome, diabetes, and hypertension. That is why it is important to seek advice to do the right exercise and prevent the rest of the conditions from getting worse.

-People with arthritis have increased cardiovascular risk, simply because they live in a constant state of inflammation. To make matters worse, arthritis, such as osteoarthritis, can also reduce the physical activity of patients and this (of course) is very necessary to control the rest of the risk factors that can cause cardiovascular problems (both obesity and hypertension like cholesterol).

A tailored diet:

  • The most recommended diet for joints has to be “varied, balanced, with good consumption of foods of plant origin and moderate in those of animal origin. The Mediterranean diet adapts to all these objectives, ”says Dr. Elisa Trujillo
  • “There is a positive association between adherence to the Mediterranean diet and a lower prevalence of osteoarthritis. This diet prevents inflammation and destruction of cartilage. On the other hand, in patients with rheumatoid arthritis this eating pattern also has benefits over inflammation and pain, ”says Dr. Montserrat Romera Baurés, a rheumatologist at the University Hospital of Bellvitge and head of the Communication Commission of the Spanish Rheumatology Society.
  • Olive oil, one of the staple foods of the Mediterranean diet, “has shown that it reduces pain and improves the functionality and quality of life in patients with osteoarthritis and can improve the symptoms of inflammatory diseases such as arthritis,” he concludes.
  1. Can they be prevented?

– We cannot prevent osteoarthritis at all because it is closely related to the passing of the years, but we can slow its progression and delay its appearance if we pamper the joints. We must maintain the correct weight and exercise to have a good muscle tone, of course, avoiding impact or overload sports. The exercise that best suits the joints is aerobic (walking, swimming, cycling …). It is also important not to carry excessive weight, try not to stand for a long time standing or kneeling, avoid walking often on rough terrain and wear cushioned footwear.

– Nor can we prevent arthritis because it is an autoimmune process that is started by factors that are not yet identified. In your case, early diagnosis is especially important: going to the rheumatologist early favors the success of the treatment and improves the quality of life. If you feel pain or stiffness in your joints, do not hesitate, go to the doctor.

  1. How are they treated?

-For arthritis patients, it’s not all bad news. 20 years ago, the first biological drugs against this disease were released, obtained through biotechnology and completely changed their evolution. “In these years, different subcutaneous or intravenous biotechnological drugs have been added that have proven their effectiveness. But the most recent therapeutic novelty, which is a great advance for patients, is the so-called ” small molecules .” These are synthetic molecules that act on the signals that occur within inflammatory cells. Its main advantage over the previous drugs is its oral administration. The effectiveness of these “small molecules” opens a new path in the management of arthritis, “explains Dr. Elisa Trujillo

-The treatment of osteoarthritis is currently based on improving pain and mobility with analgesic-anti-inflammatory drugs (such as paracetamol or NSAIDs), some chondroprotective medications and physical measures “although many are currently being developed that are still pending to be demonstrated its effectiveness and safety, ”says Dr. Trujillo

-The most novel thing in the treatment of osteoarthritis is to employ a family of drugs, sysadmins, as the first choice to treat symptoms in specially chosen cases (because they do not work equally well in all types of osteoarthritis). Both chondroitin sulfate, which is part of this family of drugs, and the combination of this with glucosamine (another sysadoa), have been clinically proven to be able to reduce pain, stiffness and have a good safety profile. Glucosamine is an amino sugar that is produced naturally by the body, as is chondroitin sulfate, which is a structural component of cartilage.

– “If we want the treatment not to fail, what you should never do if you suffer from arthritis is to stop going to the rheumatologist and abandon the treatment without consulting the specialist. And what you never have to do if you suffer from osteoarthritis is to gain weight, make a sedentary life and wear unsuitable shoes, ”summarizes Dr. Elisa Trujillo