Friday January 20, 2017
Arthritis is often used to mean the pain and stiffness that some people get in their joints as they grow older. However, the term arthritis refers to any condition that causes joint inflammation. There are many types of arthritis, but the two most common forms by far are osteoarthritis and rheumatoid arthritis. While both these conditions share can cause similar symptoms, there are significant differences in their causes and their treatment. Read more, as we at London Doctors Clinic discuss these differences!
What Is Osteoarthritis?
Osteoarthritis (OA) is the most common type of arthritis, affecting one third of over-45 year olds in the UK. It is caused by mechanical damage to the body’s joints – ‘wear and tear’ from constant usage and loading. Over time, the stress that people put their joints through will begin to damage them. This causes the structural changes to the bones of the joints that are present in OA.
Unsurprisingly, OA is therefore associated with both increasing age (more wear and tear over a longer period) and BMI (more force being put through the joints). This condition affects women and men equally.
Symptoms of Osteoarthritis
Someone suffering from OA will typically present with pain and stiffness in the affected joints. These joints may also appear swollen and make clicking or cracking noises as they are moved. The most commonly affected joints are:
- Base of the thumb
- The furthest two knuckles from the wrist
Patients may only have trouble with one joint to begin with, but, over time, more joints can be affected.
As well as aches and pains, osteoarthritic joints will often have a decreased range of movement. When major joints such as the knees are affected, it is easy to imagine how this condition can hamper daily activities! The symptoms tend to worsen after use of the joints, typically improving with rest. As such, sufferers of OA will usually have the worst symptoms towards the end of the day.
Osteoarthritis mainly affects the larger joints, such as the hip and knee
What Is Rheumatoid Arthritis?
Rheumatoid arthritis (RA) is an autoimmune condition. The immune system is the body’s way of protecting itself from infection and disease. However, sometimes the cells of the immune system over-zealously attack parts of the body – in this case, the internal lining of the joints. While OA is strongly associated with age, most people with RA begin to experience symptoms between the ages of 40 and 50. 400,000 people in the UK suffer from RA, with women being 3 times more likely to have it. It is also strongly associated with a family history of RA. Another risk factor is smoking, which also worsens the symptoms of RA.
The symptoms of RA are similar to those of OA – patients will also experience pain and stiffness in the affected joints. However, unlike OA, RA symptoms are usually at their worst early in the day. Rheumatic joints will begin to ‘gel’ with inactivity, getting stiff with disuse. After sleeping throughout the night, people with RA need to take time to loosen up their joints – often with a hot shower and exercises. Another difference to OA is which joints are affected. Symptoms of RA can begin bilaterally (on both sides of the body), with the most commonly affected joints are the closest two knuckles from the wrist. As the condition worsens, increasingly larger joints are affected. RA is associated with more general, systemic features that are not found with OA. These include certain lung and eye conditions, osteoporosis, and an increased risk of heart disease.
The treatments for OA and RA are, once again, similar in some respects but very different in others.
In both conditions, an essential part of treatment is managing pain. Painkillers, such as paracetamol and ibuprofen, are very important to control the aches and joint tenderness associated with arthritis. Ibuprofen and other NSAID drugs can also help to reduce the swelling around the joints.
Patients with RA can also be prescribed DMARDs, or disease modifiying antirheumatic drugs. These are powerful medications which, unlike painkillers, actually slow the progression of the disease while also limiting the symptoms. If treated early and aggressively enough, RA can even be put into remission using these drugs. However, DMARDs are also associated with potentially severe side-effects and will typically be prescribed by specialist doctors.
There are many medications available to help manage arthritis pain
With OA, there is limited medical treatment beyond the use of painkillers – DMARDs have no effect on what is ultimately a mechanical issue. However, with both RA and OA, lifestyle changes can help to reduce the symptoms of arthritis. It is important for those with OA to try to maintain a good level of exercise.
While this can be uncomfortable at first, it is crucial to strengthen the joints and the muscles around them, as well as to help lose weight. Weight-loss is very important in managing OA, as it takes some of the load off the joints.
Patients with RA are advised to stop smoking, as it can exacerbate symptoms. If you need any advice or support in either losing weight or quitting smoking, remember that you can always see your GP.
Swimming is a great exercise for arthritis suffers, as it does not put much pressure on the joints
The most severe cases of arthritis can be treated surgically, with joint replacement. As both surgery and anaesthesia are associated with potentially life-threatening complications, arthroplasty operations are only performed if other medical treatments and therapies have failed. That being said, joint replacement procedures are highly successful operations – particularly in cases of OA. While they can help with RA, the operation does not treat the underlying autoimmune condition.
Hip replacement surgery is a very common treatment for people with severe osteroarthritis in the hips
For more information about RA, OA, and other types of arthritis, why not check the NHS Choices or the Arthritis Research UK websites. The website for Arthritis Care also offers a dedicated helpline to support people living with arthritis.
If you're concerned you may be experiencing the symptoms of arthritis (or if you require any other GP services), why not book an appointment at London Doctors Clinic? Your private GP can provide you with a diagnosis, if appropriate, and help you get the best treatment available. Book now at any of our eight London clinics!
By Ankit Mishra